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Protect yourself from hepatitis A when traveling

Immunization against the hepatitis A virus (HAV) is recommended for anyone traveling to any country or areaexcept: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 wherehepatitis Ais a known problem, see your doctor about receiving the hepatitis A vaccine,immune globulin(IG), or the combination hepatitis A and B vaccine. (Risk ofhepatitis Bincreases if you go to a high-risk country frequently or stay for a long time.)

If you complete the hepatitis A vaccination series, it is believed that you will be protected against hepatitis A virus (HAV) for at least 20 years.²In 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.³A 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. Two separate doses are given at least 6 months apart. The second shot should be given 6 to 18 months after the first shot.)⁴
If you receive IG 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.
Immune globulin (IG) is made from components of human blood. There is no risk of getting a bloodborne disease from IG made in 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 at a lower cost by choosing the IG injection. But if you plan to travel abroad on a regular basis, getting the vaccine will save you money in the long run.
People who are allergic to the components of the hepatitis A vaccine and children younger than 1 year of age should receive IG.

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

Boil water before drinking it. Bring the water to a rolling boil for 1 minute. If you are at an elevation of6562ftor 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.

Citations

Centers for Disease Control and Prevention (2008). Prevention of specific infectious diseases: Hepatitis, viral, type A.Yellow Book: Health Information for International Travel 2008.Available online: wwwn.cdc.gov/travel/yellowbook/ch4/hep-a.aspx.

Craig AS, Schaffner W (2004). Prevention of hepatitis A with the hepatitis A vaccine.New England Journal of Medicine, 350(5): 476-481.

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.

Centers for Disease Control and Prevention (2008). Recommended immunization schedules for persons aged 0-18 years-United States, 2008.MMWR, 57(01): Q1-Q4. Also available online: http://www.cdc.gov/mmwr/pdf/wk/mm5701-immunization.pdf. [Erratum inMMWR, 57(12): 319. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5712a6.htm.]

Author	Maria G. Essig, MS, ELS
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	W. Thomas London, MD - Hepatology
Last Updated	September 9, 2008

WebMD Medical Reference from Healthwise

Last Updated: September 09, 2008

This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.