Hepatitis A in the Republic of Ireland
There has been an increase in the number of hepatitis A cases in the Republic of Ireland. Around 17 cases have been recorded which is more than twice the normal annual number. Most of the cases are suspected to have been caused by the consumption of frozen berries, however two cases are thought to be caused by infection from another individual.
Visitors to the Republic of Ireland should be made aware of the outbreak and be advised to follow local advice and maintain a good standard of personal hygiene. The Food Safety Authority of Ireland has not confirmed the source of the outbreak and is advising that all imported frozen berries are boiled before consumption.
Hepatitis A is found worldwide but is more common where sanitary conditions are poor. Most cases in UK are imported from the Indian subcontinent (India, Pakistan, Bangladesh and Nepal) where the density of population and poor sanitation combine to make this disease common. Risk areas also extend to the Far East and Eastern Europe.
Many people living in areas with a high incidence of Hepatitis A will develop natural immunity in childhood. (HAV infection induces lifelong protection against re-infection). Travellers from countries with good hygiene are at risk because few are immune from previous infection.
Hepatitis A is an infection of the liver caused by hepatitis A virus (HAV) and is spread by faecal-oral route through contaminated water and food, especially shell fish and can also be spread via person to person contact when personal hygiene is poor. The incubation period - 3-5 weeks (average 28 days) but during this time the virus is shed in stools and convalescence - may be prolonged but most patients make an uneventful recovery and case fatality is normally low. Case fatality is higher in those with chronic liver disease and > 60 age group.
Children are often asymptomatic but symptoms are common in adults and severity tends to increase with age.
- Onset of illness is usually abrupt with:
- diarrhoea and abdominal pain
- jaundice may follow often associated with uncomfortable itching
- duration of jaundice is usually 7-14 days
As with all other illnesses spread by the faecal oral route, precautionary measures should be taken to avoid consumption of potentially contaminated drinks and drinking water and to ensure food is uncontaminated or cooked thoroughly. Personal hygiene when eating and drinking is also important including hand washing prior to eating and using clean plates, cups and utensils.
Vaccination should be considered under the following circumstances and is dependent on the individual risk assessment.
- Non immune travellers to developing countries are at most risk of infection.
- Occasionally cases have occurred in travellers staying in good quality hotel accommodation but the risk is increased for:
- those travelling to areas where they will be exposed to unsafe drinking water
- where sanitation conditions are poor
- travellers visiting friends and family
- long stay travellers
For more information and advice contact The Travel Clinic on 08455 480543 or email at firstname.lastname@example.org for a personalised assessment of your needs.
Consultations available in Ipswich and Cambridge.