Welcome to The Practical Patient webpage. 

Straight talk about your healthcare.


Hepatitis A Outbreak: What You Need to Know

Hepatitis A Outbreak: What You Need to Know

On August 1, 2019, Florida issued a Public Health Emergency in response to the Hepatitis A outbreak. In 2018 there were 548 cases. So far in 2019 there are 2,123 cases.

Hepatitis A is a highly contagious liver infection caused by the Hepatitis A Virus (HAV). Your liver, located in the right upper abdomen, is the largest organ inside your body. It aids in digesting food, stores energy, and removes harmful substances. Hepatitis, inflammation (swelling) of the liver, occurs when cells are infected with HAV.

Outbreaks (U.S.)

  • 2016: 2,007 cases

  • 2017: 3,365 cases

  • 2018:10,582 cases

CDC: “Since the outbreaks were first identified in 2016, 29 states have publicly reported the following as of August 2, 2019:”

  • Cases: 23,638

  • Hospitalizations: 14,079

  • Deaths: 233


Person-to-person transmission through the fecal-oral route: Ingesting something that has been contaminated with the feces (poop) of an infected person:

  • Can be spread from close personal contact with an infected person, such as through sex or caring for someone who is ill

Exposure to contaminated food or water: Food contamination (including frozen and under-cooked food) can happen at any point: growing, harvesting, processing, handling, and after cooking:

  • Cooking foods to 185º F for one minute kills HAV

  • Freezing doesn’t kill the virus

  • Foods that are contaminated after cooking are associated with infected food handlers

  • Waterborne outbreaks are infrequent. In the U.S., water chlorination kills HAV

  • Can survive outside the body for months

Infected food handlers: Spreading HAV

You can’t get Hepatitis A from

  • being coughed or sneezed on

  • sitting next to an infected person

  • hugging

(Hepatitis B and C viruses are spread through blood and body fluids.)

Those at Increased Risk:

  • Direct contact with someone with Hepatitis A

  • Travelers to countries where Hepatitis A is common

  • Men who have sexual contact with men

  • People who use drugs, both injected and non-injected drugs

  • Persons with clotting factor disorders, such as hemophilia

  • Working with non-human primates

  • Household members or caregivers of a recent adoptee from countries where Hepatitis A is common

Symptoms: Most older children and adults have symptoms, while children under 6 years do not:

  • Fever

  • Fatigue

  • Loss of appetite

  • Nausea/Vomiting

  • Abdominal pain

  • Dark urine

  • Diarrhea

  • Grey-colored or light-colored bowel movements

  • Joint pain

  • Jaundice (skin/eye yellowing)

Symptoms usually appear 4 weeks after exposure and last less than 2 months. Those without symptoms can transmit the virus up to 2 weeks before symptoms appear.

Complications: In rare cases, Hepatitis A can lead to liver failure and death.

Diagnosis is made from a blood test.


  • Unvaccinated people: Hepatitis A vaccine or immune globulin injection to prevent severe illness. (Immune globulin is a substance made from human blood plasma that helps to boost the immune system)

  • Symptom relief: rest, adequate nutrition, and fluids. Some people require hospitalization

  • Talk with your healthcare provider before taking any medication, vitamins, or supplements, as these can damage your liver

  • Don’t drink alcohol until your healthcare provider tells you that you have completely recovered from Hepatitis A

Prevention: Hepatitis A rates in the U.S. have declined by more than 95% since the Hepatitis A vaccine became available in 1995.

Hepatitis A vaccine: 2 shot series

  • Children 12 and 23 months of age

  • People who are at risk

  • People with chronic liver disease

  • Travelers to countries where Hepatitis A is common

Once you recover from Hepatitis A or have completed the vaccine series, you develop antibodies that protect you from the virus for life.

Reducing your risk

Wash your hands thoroughly with soap and warm water for 15 to 30 seconds

  • after using the toilet

  • after changing diapers

  • before and after handling or preparing food

When traveling in a developing country, drink bottled water. Use bottled water to brush your teeth, make ice cubes, and wash fruits and vegetables.

Get Your Flu Shot: 2018-2019 Flu Stats

Get Your Flu Shot: 2018-2019 Flu Stats

RSV: Deadly Respiratory Virus

RSV: Deadly Respiratory Virus