Hepatitis A : FAQ, Part 4

by CDC

(Page 4 of 4)

Sewerage workers

In the United States, no work-related outbreaks of hepatitis A have been reported among workers exposed to sewage.

Health-care workers

Health-care workers are not at increased risk for hepatitis A. If a patient with hepatitis A is admitted to the hospital, routine infection control precautions will prevent transmission to hospital staff.

Children under 12 months of age

Because of the limited experience with hepatitis A vaccination among children under 12 months of age, the vaccine is not currently licensed for children below this age group.

Day-care attendees

The frequency of outbreaks of hepatitis A is not high enough in this setting to warrant routine hepatitis A vaccination. In some communities, however, day-care centers play a role in sustaining community-wide outbreaks. In this situation, consideration should be given to adding hepatitis A vaccine to the prevention plan for children and staff in the involved center(s).

Residents of institutions for developmentally disabled persons

Historically, hepatitis A virus infections were common among persons with developmental disabilities living in institutions. Currently, the occurrence of hepatitis A virus infections have diminished.

International Travel

Who should receive protection against hepatitis A before travel?

All susceptible persons traveling to or working in countries that have high or intermediate rates of hepatitis A should be vaccinated or receive immune globulin before traveling. Persons from developed countries who travel to developing countries are at high risk for hepatitis A. Such persons include tourists, military personnel, missionaries, and others who work or study abroad in countries that have high or intermediate levels of hepatitis A. The risk for hepatitis A exists even for travelers to urban areas, those who stay in luxury hotels, and those who report that they have good hygiene and that they are careful about what they drink and eat.

How soon before travel should the first dose of hepatitis A vaccine be given?

For optimal protection, at least 4 weeks prior to travel. Check with your doctor about when the next dose is due.

What should be done if a person cannot receive hepatitis A vaccine?

Travelers who are allergic to a vaccine component or who elect not to receive vaccine should receive a single dose of immune globulin (0.02 mL/kg), which provides effective protection against hepatitis A virus infection for up to 3 months. Travelers whose travel period exceeds 2 months should be administered immune globulin at 0.06 mL/kg; administration must be repeated if the travel period exceeds 5 months.

If travel starts sooner than 4 weeks prior to the first vaccine dose, what should be done?

Because protection might not be optimal until 4 weeks after vaccination, persons traveling to a high-risk area less than 4 weeks after the initial dose of hepatitis A vaccine should also be given immune globulin (0.02 mL/kg), but at a different injection site. Therefore, the first dose of hepatitis A vaccine should be administered as soon as travel to a high-risk area is planned.

What should be done for travelers who are less than 12 months of age to protect them from hepatitis A virus infection?

Immune globulin is recommended for travelers less than 12 months of age because the vaccine is currently not licensed for use in this age group.

About the Author

www.cdc.gov
The Centers for Disease Control and Prevention (CDC) is one of the 13 major operating components of the Department of Health and Human Services (HHS), which is the principal agency in the United States government for protecting the health and safety of all Americans and for providing essential human services, especially for those people who are least able to help themselves.