Protect Yourself From Hepatitis A When Travelling

Topic Overview

Immunization against the hepatitis A virus (HAV) is recommended for anyone Travelling to any country or area except: 1

  • Australia.
  • Canada.
  • Japan.
  • New Zealand.
  • The United States.
  • Western Europe and the Scandinavian countries (Norway, Sweden, and Finland).

Talk to your doctor before visiting any other areas.

If you plan to travel to a part of the world where sanitation is poor or where hepatitis A is a known problem, see your doctor about receiving the hepatitis A vaccine, immunoglobulin (IG), or the combination hepatitis A and B vaccine. (Risk of hepatitis B increases if you go to a high-risk country frequently or stay for a long time.)

  • Completing the entire hepatitis A vaccination series protects against HAV for at least 25 years in adults and 14 years in children. 2 In adults (people older than 18 years of age), it is best if the first shot is given at least 4 weeks before a person may be exposed to the hepatitis A virus. But the vaccine does provide some protection shortly after the first shot. 3 A second shot should be given 6 to 18 months later to prolong protection. (Immunization with hepatitis A vaccine is recommended for all children beginning at 1 year of age or as recommended by your provincial health unit. Two separate doses are given at least 6 months apart. The second shot should be given 6 to 18 months after the first shot.)
  • If you receive IG instead of the hepatitis A vaccine and are planning an extended stay in an area where hepatitis A is a problem, you should get a higher dose of IG. You will need to get additional injections of the same high dose of IG every 3 to 5 months.
  • Immunoglobulin is made from components of human blood. There is no risk of getting a blood-borne disease from IG made in Canada or the United States. The safety of IG manufactured in other countries cannot be guaranteed.
  • If you will be visiting countries where hepatitis A is a problem and you will be staying for less than 3 months, you will receive enough protection by choosing the IG injection. But if you plan to travel abroad on a regular basis, getting the vaccine will save you needing a shot every time you travel.
  • People who are allergic to the components of the hepatitis A vaccine and children younger than 1 year of age should receive IG. Depending on the recommendation of the province, children 6 months of age or younger may get IG.

When Travelling in an area where hepatitis A is a known problem or where water quality is questionable:

  • Boil water before you drink it. Bring the water to a rolling boil for 1 minute. If you are at an elevation of 2000 m (6562 ft) or higher, boil the water for 3 minutes. Do not drink tap water or well water or beverages containing ice cubes.
  • Do not brush your teeth with tap water or well water.
  • Make sure all foods are cooked well, especially shellfish.
  • Eat only raw fruits and vegetables that you have washed in uncontaminated water and peeled yourself.
  • Don't swim in water that has not been treated with chlorine.
  • Don't drink bath or shower water.

Related Information

References

Citations

  1. Sharapov UM (2012). Infectious diseases related to travel: Hepatitis A. The Yellow Book: CDC Health Information for International Travel 2012. New York: Oxford University Press. Also available online: http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/hepatitis-a.htm.
  2. Centers for Disease Control and Prevention (2008). Hepatitis A FAQs for health professionals. Available online: http://www.cdc.gov/hepatitis/HAV/HAVfaq.
  3. Centers for Disease Control and Prevention (2007). Update: Prevention of hepatitis A after exposure to hepatitis A virus and in international travelers. Updated recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR, 56(RR-41): 1080–1084. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5641a3.htm.

Credits

ByHealthwise Staff

Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine

Brian D. O'Brien, MD - Internal Medicine

Specialist Medical Reviewer W. Thomas London, MD - Hepatology

Current as ofNovember 14, 2014