Hepatitis is an inflammation of the liver, most commonly caused by a viral infection. There are five main hepatitis viruses, referred to as types A, B, C, D and E.

Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids (e.g. from blood transfusions or invasive medical procedures using contaminated equipment). Hepatitis B is also transmitted by sexual contact.

The symptoms of hepatitis include jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.
World Health Organisation

Hepatitis A

Hepatitis A is spread via infected food and drink, person to person contact and by the faecal-oral route. Hepatitis A is connected with poor sanitary conditions and low hygiene standards.

In countries where there is poor sanitation and sewage disposal, there can be major outbreaks of hepatitis A due to the water supply becoming contaminated.

If food such as salads and fresh fruit have been washed with contaminated water then there will be a risk of hepatitis A. Ice cream and ice cubes are also considered to be of high risk. Seafood such as shellfish that come from dirty seawater can also transmit hepatitis A.

The vaccine for hepatitis A is an inactivated vaccine prepared from the hepatitis A virus and containing virus antigens. The vaccine is given in a single injection and protects against hepatitis A for roughly one year. Ideally you should have the vaccination four to six weeks before you intend to travel. However, if you are travelling at short notice to an area where hepatitis A is a high risk, then it well worth having your vaccination.

You can have a combined vaccination to protected you from hepatitis A and typhoid which is convenient if you are travelling to an area where both diseases are prevalent. It is also possible to have a combined vaccination against hepatitis A and B as well as typhoid. However, the combined vaccination needs three doses and the second is given one month after the first and the third is given six months after the second. A rapid schedule course may also be an option.

Even though you may have had your hepatitis A vaccination you should still take particular care when travelling in high risk hepatitis A areas. Drink bottled or sterilised water and make sure that cold food, fruit and vegetable are cleaned properly. Always wash your hands thoroughly after using the toilet.

Your Abermed Travel Health Nurse can advise you which countries are high risk for hepatitis A. The Travel Nurse will also give you any information you regard regarding any possible side-effects from the vaccine and will know the categories of people who should not have the hepatitis A vaccination.

Hepatitis B

Hepatitis B is a blood borne infection that is passed on through infected blood. Hepatitis B causes liver inflammation (hepatitis), jaundice and leads to long term liver damage and sometimes liver cancer.

Hepatitis B is often associated with drug taking as it can be passed on through sharing contaminated needles. If you are considering tattooing or any procedure such as acupuncture that involves piercing the body, then ensure that all needles used are sterile.

Hepatitis B is considered to be a sexually transmitted disease and can be passed on in the same ways as HIV. However, hepatitis B is spread more easily than HIV due to its concentration in an infected person’s blood and it can also exist on outer surfaces of the body. If you take precautions against the risk of catching hepatitis B, you will also help protect yourself from HIV and hepatitis C. It is therefore extremely important that sexual intercourse is never unprotected.

If you are travelling to an area where there is a high risk of hepatitis B or your work puts you at higher risk (healthcare or prison work for example) you should arrange hepatitis B vaccination. The hepatitis B vaccination is administered in three intra-muscular injections. After the initial injection a second is given one month later and the third injection takes place 6 months after the second. A rapid schedule course may also be an option.

A course of three vaccinations provides protection against hepatitis B and should offer immunity for at least ten years. Occasionally full immunity is not achieved and a booster may be given. After the course of vaccinations is completed you can have a blood test to measure antibodies to confirm that you have immunity to hepatitis B. If at a later date you are travelling to a very high risk area or your work places you in high risk situations, you can have a blood test to check that you have continuing immunity.

You can choose to have a combined vaccine which protects against hepatitis A as well as hepatitis B. Your Travel Health Nurse can give you more information about this combined vaccination.

Your Abermed Travel Health Nurse can advise you which countries are at particular risk for hepatitis B. There are very few side-effects from hepatitis B vaccination and it is considered to be a very safe method of protection but feel free to ask your Travel Nurse about any issues that may concern you. If you are travelling at short notice and do not have immunity to hepatitis B, the Travel Health Nurse can advise you on ways to avoid becoming infected with hepatitis B.

Hepatitis C

Hepatitis C is a blood-borne infection which like hepatitis B can be passed on through sharing contaminated needles. If you are considering tattooing or any procedure such as acupuncture that involves piercing the body, then ensure that all needles used are sterile.

Hepatitis C is not passed on by everyday human contact but can be sexually transmitted so sexual intercourse should not be unprotected.

Since 1991 all blood used for blood transfusions in the UK has been screened for hepatitis C. If you should need a blood transfusion or invasive medical treatment in a country where blood screening for the virus is not carried out and medical equipment is not thoroughly sterilised, there is a risk of infection.

There is no vaccination for hepatitis C but treatment is available. If you consider that you may have been at risk of becoming infected or have other concerns regarding hepatitis C, you should speak to your GP.

Remember avoidance is always the best policy.