The hepatitis A virus is found predominantly in the stools (feces) of people with hepatitis A. HAV is transmitted when a person puts something in his or her mouth that has been contaminated with the feces of an affected person. This is referred to as fecal-oral transmission. However, variations of this primary way in which a contagious person transmits the disease are as follows:
- Food or drinking water contaminated with stool from an infected person (usually because of inadequate hand washing or poor sanitary conditions), the virus can quickly spread to anyone who drinks or swallows the contaminated food or water.
- Eating raw or undercooked shellfish collected from water that has been contaminated by sewage
- Blood transfusions, although this is extremely rare
- Sexual contact, especially oral/anal
People who are infected can start spreading the infection (shedding virus) about 1 week after their own exposure. People who do not have symptoms can still spread the virus. Infection with HAV is known to occur throughout theworld.
- The risk of infection is greatest in developing countries with poor sanitation or poor personal hygiene standards.
- Infection rates are also higher in areas where direct fecal-oral transmission is likely to occur, such as daycare centers, prisons, and mental institutions.
People at increased risk for hepatitis A infection include:
- Household contacts of people infected with HAV
- Sexual partners of people infected with HAV
- International travelers, especially to developing countries
- Military personnel stationed abroad, especially in developing countries
- Men who have sex with other men
- People who use illegal drugs (injected or non-injected)
- People who may come into close contact with HAV infected people at work
Individuals who work in professions such as health care, food preparation, and sewage and waste water management are not at greater risk of infection than the general public.
People who live or work in close quarters, such as dormitories, prisons, andresidential facilities; or work in or attend daycare facilities are at increased risk only if strict personal hygiene measures are not observed.
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