Changes to the Country Information pages: Hepatitis A vaccine recommendations

NaTHNaC has reviewed and updated the hepatitis A country-specific information and vaccine recommendations

NaTHNaC with UK Health Security Agency has recently reviewed the country-specific guidance for countries with a known or a possible risk of hepatitis A virus (HAV). Further information is available about this review.

Based on this review country-specific vaccine recommendations have been updated for the following countries:

Albania, Algeria, Argentina, Ascension Island, Azerbaijan, Belarus, Belize, Bulgaria, Cuba, Czech Republic, Estonia, Guyana, Hong Kong, Hungary, Iran, Israel, Jamaica, Jordan, Kyrgyzstan, Libya, Macau, Macedonia, Malaysia, Panama, Pitcairn Islands, South Korea, St Helena, Taiwan, Tajikistan, Thailand, Tristan de Cunha and Uzbekistan.

Country-specific information can be found on our Country Information pages and Outbreak Surveillance section.

Advice for travellers

Before you travel

HAV is a highly infectious virus that can cause liver problems. The virus is usually spread by food or water contaminated by human faeces, or by direct contact with an infectious person, including sexual contact. HAV is rare in the UK, with most cases occurring in travellers who have recently visited countries where the disease is common.

HAV is a vaccine preventable disease. Check our Country Information pages to see if vaccine is recommended for your destination.

While you are away

You can reduce your risk of HAV by following advice on food and water hygiene and by ensuring good personal hygiene. Wash your hands after visiting the toilet, changing nappies and before preparing or eating food.

More information about HAV is available in our Topics in Brief section.

When you return

If you have returned from areas where HAV is common and develop unexplained stomach or digestive symptoms, tiredness, jaundice (yellowing of the skin and whites of the eyes) and/or pale stools, you should seek medical advice from your GP or NHS 111. Remember to mention your travel history, so that appropriate measures and testing can be undertaken.

Advice for health professionals

HAV is usually a sub-clinical infection (without symptoms) in young children. Jaundice may occur in 70 to 80% of those infected as adults with the disease with an overall low case-fatality ratio but is greater in older people and those with pre-existing liver disease.

Vaccination is recommended for most travellers to countries with a high burden of HAV.

In countries where there is a lower risk of HAV factors such as access to improved sanitation, travel plans, activities, and medical conditions should be considered in the risk assessment.

Travellers who may be at increased risk of hepatitis A infection include:

• Those staying with or visiting the local population.
• Frequent/long-stay travellers to areas where sanitation and food hygiene are likely to be poor.
• Adventure travellers visiting rural areas and staying in basic accommodation.
• Those with existing medical conditions such as liver disease or haemophilia
• Men who have sex with men.
• People who inject drugs.
• Those who may be exposed to the virus through their work.
• Those going to areas of hepatitis A outbreaks who have limited access to safe water and medical care.