The symptoms of hepatitis A develop, on average, around 4 weeks after becoming infected. But not everyone with the infection has symptoms.

See your GP if you think you could have been infected with the virus.

A blood test will be needed to rule out more serious conditions that have similar symptoms.

Initial symptoms

The initial symptoms of hepatitis A can include:

• feeling tired and generally unwell
• joint and muscle pain
• a raised temperature
• loss of appetite
• feeling or being sick
• pain in the upper right part of your tummy
• a headache, sore throat and cough
• constipation or diarrhoea
• a raised, itchy rash (hives)

These symptoms usually last from a few days up to a couple of weeks.

Later symptoms

After the initial symptoms, the following symptoms may develop:

• yellowing of the skin and eyes (jaundice)
• dark pee
• pale poo
• itchy skin
• the upper right part of your tummy becoming swollen and tender

Most people make a full recovery within a couple of months, although the symptoms can come and go for up to 6 months.

Signs of a serious problem

Hepatitis A is not usually serious, but in rare cases it can cause the liver to stop working properly (liver failure).

As well as the symptoms mentioned, signs of liver failure can include:

• sudden, severe vomiting
• a tendency to bruise and bleed easily (for example, frequent nosebleeds or bleeding gums)
• irritability
• problems with memory and concentration
• drowsiness and confusion

Get medical advice as soon as possible if you have these symptoms. Liver failure can be life threatening if not treated quickly.

Hepatitis A is caused by the hepatitis A virus, which is spread in the poo of someone with the infection.

Most infections occur in parts of the world where sanitation and food hygiene standards are poor, although there's a small risk of becoming infected in the UK.

How hepatitis A is spread

You can get hepatitis A from:

• eating food prepared by someone with the infection who has not washed their hands properly, or who's washed them in water contaminated with sewage
• drinking contaminated water, including ice cubes
• eating raw or undercooked shellfish from contaminated water
• close contact with someone who has hepatitis A
• having sex with someone who has the infection, particularly if you touch their anus with your fingers, mouth or tongue
• injecting drugs using equipment contaminated with the hepatitis A virus

Someone with hepatitis A is most infectious from around 2 weeks before they start to develop symptoms until about a week afterwards.

At-risk destinations

Hepatitis A is found worldwide, but areas where it's most widespread include:

• sub-Saharan and northern Africa
• the Indian subcontinent (particularly India, Bangladesh, Pakistan and Nepal)
• some parts of the Far East (excluding Japan)
• the Middle East
• South and Central America

To find out about the potential health risks in a specific country, see country information on the Travel Health Pro website.

People at risk of hepatitis A in the UK

Although the chances of getting hepatitis A in the UK are much smaller than in other parts of the world, certain groups have an increased risk.

These include:

• close contacts of someone with hepatitis A
• men who have sex with other men
• people who inject illegal drugs
• people who may be exposed to hepatitis A through their job – this includes sewage workers, people who work for organisations where levels of personal hygiene may be poor, such as a homeless shelter, and people working with monkeys, apes and gorillas (these animals may be infected with hepatitis A)

People in these groups are usually advised to have the hepatitis A vaccine to minimise their risk of infection.

There's currently no cure for hepatitis A, but it normally gets better on its own within a couple of months. You can usually look after yourself at home.

But it's still a good idea to see your GP for a blood test if you think you could have hepatitis A, as more serious conditions can have similar symptoms.

Your GP can also advise you about treatments. They may carry out regular blood tests to check how well your liver is working.

Go back to your GP if your symptoms get worse or have not started to improve within a couple of months.

Relieving your symptoms

The following advice may help:

• get plenty of rest – especially during the initial stages of the infection, as you'll probably feel very tired
• take painkillers, such as paracetamol or ibuprofen, if you have any aches and pains – how much you can take depends on how well your liver is working (ask your GP for advice)
• reduce itching by maintaining a cool, well-ventilated environment, wearing loose clothing and avoiding hot baths or showers – your GP may recommend using an antihistamine in severe cases
• eat small, light meals to help reduce nausea and vomiting – your GP can prescribe a medication called an antiemetic if the problem persists
• avoid alcohol – drinking alcohol can put additional strain on your liver, so avoid it until your GP says it's safe

Preventing the spread of infection

While you're ill, it's also important to try to reduce the risk of spreading the infection to others.

You should:

• stay off work or school until at least a week after your jaundice or other symptoms started
• avoid preparing food for others if possible
• wash your hands with soap and water regularly, particularly after going to the toilet and before preparing food
• avoid sharing towels
• wash soiled laundry separately on a hot cycle
• clean the toilet, flush handles and taps more frequently than usual
• avoid having sex while you're infectious – hepatitis A is most infectious from around 2 weeks before the symptoms start until about a week after they first develop (ask your GP for advice about this)

Any close contacts, such as people who live in the same house as you, may be advised to have the hepatitis A vaccine to reduce their risk of becoming infected.

Vaccination against hepatitis A is not routinely offered in the UK because the risk of infection is low for most people. It's only recommended for people at high risk.

Who should have the hepatitis A vaccine

People usually advised to have the hepatitis A vaccine include:

• close contacts of someone with hepatitis A
• people planning to travel to or live in parts of the world where hepatitis A is widespread, particularly if sanitation and food hygiene are expected to be poor
• people with any type of long-term liver disease
• men who have sex with other men
• people who inject illegal drugs
• people who may be exposed to hepatitis A through their job – this includes sewage workers, people who work for organisations where levels of personal hygiene may be poor, such as a homeless shelter, and people working with monkeys, apes and gorillas

Contact your GP surgery if you think you should have the hepatitis A vaccine or you're not sure whether you need it.

Types of hepatitis A vaccine

There are 3 main types of hepatitis A vaccination:

• a vaccine for hepatitis A only
• a combined vaccine for hepatitis A and hepatitis B
• a combined vaccine for hepatitis A and typhoid fever

Talk to your GP about which vaccine is most suitable for you. All 3 types are usually available for free on the NHS.

Plan your vaccinations in advance if you're travelling abroad. They should ideally be started at least 2 or 3 weeks before you leave, although some can be given up to the day of your departure if necessary.

Extra doses of the vaccine are often recommended after 6 to 12 months if you need long-term protection.

You can find more information about the various hepatitis A vaccines on the NHS Fit for Travel website.

Side effects of the hepatitis A vaccine

Some people have temporary soreness, redness and hardening of the skin at the injection site after having the hepatitis A vaccine.

A small, painless lump may also form, but it usually disappears quickly and is not a cause for concern.

Less common side effects include:

• a slightly raised temperature
• feeling unwell
• tiredness
• a headache
• feeling sick
• loss of appetite