One of the most important illnesses to which the Irish traveller will be exposed fits between these two extremes. Hepatitis A certainly can kill but generally patients survive after experiencing a miserable couple of months.
In the developing parts of our world, where faecal contamination of food and water supplies are a common occurrence, many of the population will be exposed to the disease while they are children. In these regions the disease remains endemic and tourists will be at significant risk.
The disease is mainly transmitted through the oro-faecal route (contaminated fingers, food and water consumption) but sexual transmission is also well reported. The virus is only present in the blood for a very brief time so transmission through blood transfusion or needle stick exposure is very rare. By far the most common means of transmission is through the drinking of contaminated water or the consumption of contaminated foods.
Following an incubation period, which is usually between 25 to 30 days, the individual presents with diffuse flu like symptoms. At that stage the diagnosis may be fairly straightforward and blood can be drawn for confirmation. Abdominal tenderness in right upper quadrant of the abdomen and perhaps a history dark looking urine. Other typical signs and symptoms include anorexia, fatigue, vomiting, abdominal discomfort, fever, muscle aches and, occasionally, arthritis has been reported. In children, especially under 5 years of age, the disease may present with an non-jaundiced pattern.
In the majority of cases Hepatitis A is a non-life threatening condition with a 2% mortality. The majority of adults remain lethargic and off work for one to two months and feel under par for up to six months.
Care with food and water hygiene are paramount in protecting the individual traveller.
Hepatitis A Vaccine:
One single vaccine provides protection within 2 to 4 weeks which last for approximately 6 months to 1 year. A single booster dose at that time maintains the protection for at least a further 10 years.