How to prevent Hepatitis A in endemic destinations: vaccination, hygiene and medical consultations

How to prevent Hepatitis A in endemic destinations: vaccination, hygiene and medical consultations

Introduction

It is essential that travelers are adequately informed and prepared to protect their health while exploring new regions of the world. The Hepatitis A infection is caused by the hepatitis A virus (HAV). Humans are the only known reservoir. HAV infection is typically a self-limiting illness that does not become chronic. It is primarily spread through the ingestion of food or water contaminated with feces from infected individuals. HAV can remain infectious on hands for several hours, on food for several days, and on frozen foods, surfaces, and in feces for several months. 

The infection occurs worldwide and is particularly prevalent in regions with poor sanitation conditions, posing a significant concern for travelers visiting these areas. Globally, an estimated 159 million new HAV infections leading to 39,000 fatalities occur each year. Global assessment of HAV endemicity is challenging due to limited data on variations in HAV antibody seroprevalence among different subpopulations within regions.

Manifestations vary from mild to intense and can encompass elevated body temperature, general feeling of illness, decreased desire to eat, digestive issues such as diarrhea and nausea, discomfort in the abdomen, darkening of urine color, and yellowing of the skin and eyes known as jaundice. It should be noted that not all individuals infected will experience all of these symptoms.

 

What to do before the trip

Before traveling, it is highly advisable to consult a healthcare professional specializing in travel medicine. They can provide updated information on the hepatitis A situation at the destination and offer personalized advice on other preventive measures, including vaccination and potential prophylactic treatments.

Vaccination is the most effective preventive measure against hepatitis A. It is recommended that all travelers, regardless of the duration of their stay in endemic areas, receive the vaccine. Two hepatitis A vaccines, Havrix (GlaxoSmithKline) and Vaqta (Merck), are approved for individuals aged ≥12 months in a 2-dose series. While the first dose provides significant protection within a few weeks, the second dose is crucial for ensuring long-term immunity. A combination vaccine for hepatitis A and hepatitis B (Twinrix, GlaxoSmithKline) is approved for those aged ≥18 years. If vaccination is not possible due to age or allergies, immune globulin can help reduce the risk of infection for up to 2 months.

Measures to take during the journey

Food hygiene is essential to prevent hepatitis A. Travelers should avoid consuming raw or undercooked foods, especially seafood and fresh products that cannot be properly peeled or washed. It is advisable to eat at establishments that appear to follow good hygiene practices and to avoid street vendors. Some key guidelines include:

  • Drink only bottled or treated water: Avoid drinking tap water and use bottled water to brush your teeth as well.
  • Consume well-cooked foods: Especially seafood and meats.
  • Avoid ice in beverages: Unless it is made with safe water.

On the other hand, maintaining good personal hygiene is a crucial strategy. Washing hands frequently with water and soap, especially before eating or handling food, and after using the restroom, can significantly reduce the risk of infection. In the absence of water and soap, using alcohol-based hand sanitizers (with at least 60% alcohol) is an effective alternative.

In addition to vaccination and hygiene measures, travelers should be alert to other potential sources of contamination. It is advisable to avoid swimming in recreational waters that may be contaminated with sewage and to be cautious with dairy products that may be unpasteurized.

In conclusion, it is vital that in case of any symptom that attracts attention, do not self-medicate, stay properly hydrated and consult the nearest medical center.

Bibliography:

https://www.who.int/es/news-room/fact-sheets/detail/hepatitis-a

https://wwwnc.cdc.gov/travel/yellowbook/2024/infections-diseases/hepatitis-a

About the authors

Medical Team at MCI
Our medical team  is composed of highly qualified and dedicated professionals who strive to provide the best possible care to our clients. With extensive experience in various areas of medicine, our team collaborates closely to implement innovative practices and continuously improve patient outcomes.

Among our team are professionals with diverse backgrounds in emergency medicine, primary care, telemedicine, and intensive care. They have contributed to significant clinical research and managed patients with complex medical needs. Additionally, they are actively engaged in continuous learning and professional development, ensuring they stay at the forefront of medical advancements.

We are proud to have a team that participates actively in the medical community, sharing their knowledge and learning from other experts in the field. Their commitment to excellence and patient care is the cornerstone of our services.