15 Jun 2017

Changes to the Country Information pages: Hepatitis A vaccine recommendations

NaTHNaC has reviewed and updated the hepatitis A country specific information and vaccine recommendations Changes to the Country Information pages: Hepatitis A vaccine recommendations

NaTHNaC with Public Health England (PHE) has recently reviewed the country specific guidance for countries with a known or a possible risk of hepatitis A virus (HAV). Detailed information on our review.

Based on this review:

Country specific vaccine recommendations have been updated for the following countries: Albania, Algeria, Argentina, Azerbaijan, Belarus, Belize, Bosnia and Herzegovina, Bulgaria, Chile, Cuba, Fiji, Guyana, Iran, Iraq, Jordan, Kazakhstan, Kyrgyzstan, Latvia, Libya, Lithuania, Malaysia, Maldives, Mauritius, Montenegro, Palau, Poland, Réunion (France), Samoa, Serbia, Sri Lanka, Tajikistan, Thailand, Tonga, Turkey, Ukraine, and Uzbekistan.

Advice for travellers

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.

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

More information about HAV is available in our hepatitis A Diseases in Brief section.

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. However, the disease becomes more serious with advancing age, with an approximate mortality (death) rate of two percent in those over 50 years of age.
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 going to areas of hepatitis A outbreaks who have limited access to safe water and medical care
When undertaking travel risk assessment, health professionals should refer to our individual Country Information pages, where there are details relating to HAV risk in a country and the necessary preventive measures, including whether vaccination is recommended.


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