What you need to know about Hepatitis A and B before you travel?
Hepatitis A and B are two serious liver diseases caused by the hepatitis A and B viruses. These viruses are endemic (constantly present) in much of the developing world. Many popular holiday destinations such as (Africa, Asia, Latin America and Middle East) are considered risk areas for unprotected travellers.
Video 1

Hepatitis A and B

Video 2

Hepatitis A

Video 3

Hepatitis B

What is Hepatitis A?
Hepatitis A is a viral infection of the liver that can cause mild to severe illness.1 The hepatitis A virus is the most common hepatitis virus (it is responsible for over 75% of all cases of viral hepatitis).2
Who can get Hepatitis A whilst travelling?
Anyone who has not been vaccinated or previously infected is at risk, particularly travellers to countries where the disease is prevalent, such as:1

High risk areas:3 Africa (Sub-Saharan); Asia (South)
Intermediate risk areas:3 Africa (North); Asia (Central); Latin America (Andean, Central, Southern, Tropical Regions); Middle East; Oceania
The hepatitis A virus is transmitted primarily through contaminated food and water4 such as:

Drinking water from an infected source5
Ice cubes in a drink5
Shellfish, such as mussels or clams6
Drinks or food prepared or touched by an infected person with unwashed hands5
Contaminated mussels / clams
Contaminated Ice cubes in drinks
Food handler infected with hepatitis A
Many travellers are not always protecting their health before travelling to endemic areas.7
What are the symptoms of Hepatitis A?
Once infected, the disease usually takes 2-4 weeks to appear.4

In general:8
70% children < 6 years have no symptoms
More than 70% of older children and adults can get jaundice (yellowing of the skin and eyes)
Other symptoms may include weight loss, dark urine or pale stools, extreme fatigue, nausea, vomiting, abdominal pain.4

There is no specific treatment for a hepatitis A infection. Recovery from symptoms following infection may be slow and may take several weeks or months.1
What is the impact of Hepatitis A?
Even if not serious, Hepatitis A can lead to:8
Relapsing signs and symptoms for up to 6 months
More than 3 weeks of missed work
Medical costs
How can you protect yourself and your family against Hepatitis A?
The most effective way to tackle the disease is through vaccination, especially for travellers to high-risk areas. Improved sanitation (safe water and sewage disposal) and hand washing may also help protect from hepatitis A.1
Improved sanitation – safe water and sewage disposal
Hand washing
Vaccination – especially for travellers to high-risk areas
What’s next?
Before your next trip, talk to your healthcare provider to help protect yourself,and your loved ones, from Hepatitis A
COME BACK FROM YOUR HOLIDAYS WITH ONLY HAPPY MEMORIES
What is Hepatitis B?
Hepatitis B is a viral infection of the liver that can cause both short (acute) and life-long (chronic) disease. Though people with chronic hepatitis B infection might not feel sick, they carry the virus in their blood and can pass it to others.9

Hepatitis B infection can cause lifelong liver damage and even death.9

Hepatitis B infection can lead to cirrhosis, liver failure, and liver cancer.9
Who can get Hepatitis B?
The hepatitis B virus can be transmitted via blood and the exchange of body fluids.10

It is even possible to get infected as a result of:
Sexual intercourse with an infected person10
Coming in contact with the blood or open sores of an infected person10
Using unsterilized needles in ear or body piercing, tattooing, or acupuncture10,11
Sharing personal care items such as toothbrushes, razors, or nail clippers10,11,12

THE VIRUS IS 50-100 TIMES MORE INFECTIOUS THAN HIV. It can survive outside the body for > 7 days.9

ONLY THOSE WHO ARE IMMUNE (VIA PREVIOUS INFECTION OR SUCCESSFUL VACCINATION) ARE PROTECTED FROM HEPATITIS B.9

Contact with blood / open sores
During intimacy through body fluids
Use of unsterile needles
What are the symptoms Hepatitis B?
Most people do not experience any symptoms during the acute infection, however short-term symptoms can last several weeks, and can include:9
Yellowing of the skin and eyes (jaundice)
Dark urine
Extreme fatigue
Nausea
Vomiting
Abdominal pain
What is the impact of Hepatitis B?
Hepatitis B may lead to serious illness and death, mainly from liver damage and liver cancer.12,13
Hepatitis B is one of the three most common vaccine-preventable diseases for which travellers are at risk.14
of travellers to high endemicity regions expose themselves to the potential risk of hepatitis b infections.15
How can you protect yourself & your family against Hepatitis B before travelling?
Vaccination is an effective way of preventing hepatitis B infection, and the severe consequences associated with it.9

The WHO (World Health Organization) recommends vaccination against hepatitis B for people travelling to moderate or high-risk hepatitis B areas.13
What’s next?
Before your next trip, talk to your healthcare provider to help protect yourself, and your loved ones, from Hepatitis B
COME BACK FROM YOUR HOLIDAYS WITH ONLY HAPPY MEMORIES
References:
Hepatitis A
  1. World Health Organization (WHO). Factsheet 328 – Hepatitis A. Available at http://www.who.int/mediacentre/factsheets/fs328/en/ (Last accessed October 2017).
  2. Markus JR et al. Seroprevalence of hepatitis A in children and adolescents, Jornal de Pediatria - Vol. 87, No. 5, 2011
  3. Jacobsen KH, Wiersma ST. Hepatitis A virus seroprevalence by age and world region, 1990 and 2005. Vaccine, 2010;28:6653-7.
  4. World Health Organization (WHO). Weekly Epidemiological Record No. 28-29, 2012. Available at: http://www.who.int/wer/2012/wer8728_29/en/ (Last accessed October 2017).
  5. Immunization Action Coalition, St. Paul, MN 55104, (651) 647-9009 available at http://www.vaccineinformation.org/hepatitis-a/ (Last accessed October 2017)
  6. Anthony E. Fiore, Hepatitis A Transmitted by Food. CID 2004:38 (1 March) FOOD SAFETY
  7. GlaxoSmithKline Biologicals. Data on. le, 2015, DNG number: 2016N288159_00
  8. Centers for Disease Control and Prevention (CDC). Epidemiology and Prevention of Vaccine-Preventable Diseases - The Pink Book: Course Textbook - 2015. Available at https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/hepa.pdf (Last accessed October 2017).
Hepatitis B
  1. World Health Organization (WHO). Hepatitis B Factsheet N204. Available at: http://www.who.int/mediacentre/factsheets/fs204/en/ (Last accessed: October 2017).
  2. US Centers for Disease Control and Prevention (CDC). Hepatitis B FAQs for the Public. Available at: http://www.cdc.gov/hepatitis/hbv/bfaq.htm#bFAQ10 (Last accessed: October 2017).
  3. Hepatitis B Healthy Facts. Minnesota Department of Health, 2005. Available at http://www.health.state.mn.us/divs/idepc/diseases/hepb/hepbfacts.pdf (Last accessed October 2017)
  4. Immunization Action Coalition. Every week hundreds of people get hepatitis B. Brochure for adults [#P4112], 2014. Available at http://www.immunize.org/handouts/hepatitis-b-vaccines.asp (Last accessed October 2017)
  5. World Health Organization (WHO). Weekly Epidemiological Record no. 40, 2009, 84(40), 405–420. Available at: http://www.who.int/wer/2009/wer8440/en/ (Last accessed: October 2017).
  6. Zuckerman JN, Van Damme P, Van Herck K, et al. Vaccination options for last-minute travellers in need of travel-related prophylaxis against hepatitis A and B and typhoid fever: a practical guide. Travel Med Infect Dis. 2003; 1:219-226.
  7. Van Damme P, Chlibek R, Keeffe EB. Hepatitis A and B Vaccination in Elderly Travellers. European Gastroenterology & Hepatology Review. 2011; 7:2-10.
Job no. MLT_GIB/VAC/0004/17a Date of preparation Feb 2018