Hepatitis A: Signs and Medicines to Avoid

Key takeaways

The virus enters by MOUTH, not by air. According to CDC, usually through person-to-person contact, or through contaminated food and water.
Most people recover. According to NIDDK this is an acute infection; once it clears it leaves NO long-term liver damage and does not lead to cirrhosis. But rarely the illness can be severe enough to cause liver failure — more often in older people and in people who already have another liver disease.
The thing most likely to do harm at home is medicine. According to MedlinePlus, someone with acute hepatitis should avoid alcohol and medicines that are toxic to the liver, INCLUDING acetaminophen — the drug sold here under the name paracetamol.
Which makes “liver tonics” and “liver detox” products the wrong direction entirely: according to MedlinePlus, over-the-counter supplements and herbal products are themselves among the causes of acute hepatitis.
Look at the WHITES OF THE EYES, not only at the skin — according to NHS, yellowing is harder to see on skin with a darker tone.
Young children often have no symptoms and still pass it on — according to CDC, young children are less likely to have symptoms than adults, and someone who is infected can still transmit the virus without having any symptoms at all.

Hepatitis A enters through what you eat and drink, not through the air. Most people recover and it does not become chronic. But the thing most likely to spoil the outcome at home is not the virus — it is what people take for the liver.

Recognising it: where to look, and how

According to CDC, symptoms appear anywhere from a few weeks to nearly two months after infection. Look at the colour in natural light, and look at the whites of the eyes as well: according to NHS, yellowing is harder to see on skin with a darker tone.

Yellow skin or yellow whites of the eyes — according to CDC's clinical information, more than seven in ten older children and adults have this sign; young children usually do not.
DARK URINE and PALE, CLAY-COLOURED STOOLS — according to CDC, both belong among the signs of the illness. Worth noting because hardly anyone looks closely at either.
According to CDC: marked tiredness, loss of appetite, nausea, vomiting, fever, joint pain, diarrhoea. According to MedlinePlus it often comes with pain in the upper right side of the abdomen; according to NHS the skin may itch.

What it gets confused with

JAUNDICE IN A NEWBORN is a different matter altogether: according to NHS, jaundice in newborn babies is common and mostly harmless. Do not apply this article to a newborn.
Gallstones and a blocked bile duct also cause yellow skin, dark urine and pale stools, but usually with severe pain under the right ribs.
The first few days are easily put down to a cold: according to NHS this stage feels like flu — headache, aching all over, fever. The yellowing arrives later.
Food poisoning causes vomiting and diarrhoea within hours to a few days of the meal — with hepatitis A the meal was weeks earlier.

What to do

Rest and drink enough — according to CDC, managing symptoms means rest, a balanced diet and enough fluids.
Eat what you can manage, but according to MedlinePlus avoid fatty food at this stage because it brings on vomiting more easily.
Ease the itch without medicine: according to NHS, keep the room airy, wear loose clothing, avoid hot baths.
Keep a daily note: how far the yellowing goes, the colour of urine and stool, how eating and drinking are going.
Gather up EVERYTHING you are taking — prescriptions, over-the-counter medicines, vitamins, supplements, traditional remedies — and bring the boxes themselves to the appointment.

Stopping it spreading at home, and preventing it later

Wash hands with soap and water. According to CDC: after using the toilet, after caring for someone who is ill, after changing a nappy, and before preparing or eating food.
According to NHS, the person who is ill should NOT prepare food or drink for anyone else, and should limit contact during the first week from when symptoms began or from when the yellowing started.
Everyone living in the household needs to be assessed by a medical facility, the sooner the better — according to NIDDK, if you think you have been exposed to the virus, see a doctor right away.
According to CDC, the best protection for the future is vaccination; whether you need it is for a doctor to decide.
Travelling where the illness is common, according to NHS: drink bottled water, avoid raw seafood and uncooked fruit and vegetables.

What NOT to do

Do NOT drink alcohol. According to NIDDK, avoid alcohol until your doctor tells you that you have fully recovered, because alcohol causes further damage to the liver.
Do NOT take any medicine on your own, INCLUDING anything for fever or pain. According to MedlinePlus, someone with acute hepatitis should avoid medicines that are toxic to the liver, acetaminophen — paracetamol — among them; ask a pharmacist or a doctor first.
Do NOT buy “liver tonics”, traditional remedies or herbal “liver detox” products. According to NIDDK, ask your doctor before taking vitamins, supplements or traditional and alternative medicines, because some of them can damage the liver.
Do NOT give yourself an intravenous drip “to cool the liver”, and do not use leftover antibiotics in the house: this illness is caused by a virus.
Do NOT treat the yellowing going away as the end of it — according to NIDDK, if you still have symptoms after six months, go back and be seen again.

When you must go to hospital

GO NOW — according to MedlinePlus, someone with hepatitis needs to be seen immediately if there is: confusion or rambling speech; VOMITING BLOOD; black tarry stools or blood in the stool; or any sign of having taken too much of a fever or pain medicine, or of any other medicine. Go now as well if vomiting is constant and no fluid stays down, or if the yellowing deepens while the person grows more and more sluggish. — BE SEEN THE SAME DAY, do not wait until tomorrow, if yellow skin or yellow whites of the eyes have newly appeared in an adult: according to NHS, jaundice can be a sign of something serious such as liver disease and needs to be seen urgently. Be seen the same day too if you think you have hepatitis A AND are pregnant, over 60, or already have liver disease — the group NHS places in the urgent category, and according to NIDDK the group more likely to go into liver failure. — BE SEEN WITHIN THE NEXT ONE TO THREE DAYS if you think you have been in contact with someone who is ill but have none of the signs above.

Hepatitis A is diagnosed by a blood test, not by eye: at home there is no way to establish which kind of hepatitis you have. Y Te Xanh (GreenCare) does something different — a remote consultation so you can decide between being seen now and booking later; a doctor coming to the house to take your history, examine you and say clearly which cases must go into hospital; and tests at home if more information is needed.

But not every test belongs at home: anything that has to be run immediately, or needs specialised equipment, gives a more reliable result when the sample is taken at a medical facility. The fourth thing, and the one that fits this illness best, is a medication review: going back through your prescription and your supplements and flagging what is questionable so you can raise it with the doctor who prescribed it — we do not change prescriptions ourselves. With a sign in the box above, go in first and call afterwards.

Each part above follows the source named with it: the public materials of the US CDC, NHS, NIDDK and MedlinePlus. Citing CDC here does not imply that CDC endorses Y Te Xanh or our services.

Need personalised advice for your loved one? Call our hotline 094 368 81 15 (24/7) — calling to ask a question or to book costs nothing. GreenCare has doctors who come to examine, nurses who carry out doctor's orders (injections, infusions, dressing changes), remote consultation by video call, and a review of the medicines you are taking; an in-depth remote consultation, or any one after the first, is a paid service. For children we take examination and acute care only — not long-term care at home, and not newborns or expectant mothers. We confirm we have staff in your area and provide transparent pricing before we begin.

Sources

CDC — Hepatitis A Basics
NHS — Hepatitis A

Frequently asked questions

How does hepatitis A spread? Can I catch it by sitting next to someone or talking to them?

Not through the air. According to NIDDK, you do not get hepatitis A from someone coughing or sneezing on you, from sitting next to them or from hugging them; a breastfed baby does not get it through breast milk either. The route is by mouth: according to CDC, the virus gets in when it is eaten or drunk, even in a very small amount. According to NIDDK, that happens when you eat food prepared by someone infected who did not wash their hands after using the toilet, when you drink untreated water, or when you care for someone who is ill. So the most useful things to do in a household are very simple: wash hands, and keep the person who is ill out of the kitchen.

Can I take paracetamol for fever or headache while I have hepatitis A?

Do not take it on your own — ask first. This is exactly where hepatitis A differs from ordinary feverish illnesses, in which paracetamol is the familiar choice. According to MedlinePlus, someone with acute hepatitis should avoid alcohol and medicines that are toxic to the liver, acetaminophen — paracetamol — among them, throughout the acute illness and for several months after recovery. According to NHS, ask a pharmacist or a doctor about painkillers, including how much you may take; NHS also says a doctor can prescribe something to ease symptoms. So medicine is not banned outright, but the person who decides has to be a doctor or a pharmacist who knows your liver is inflamed, not the medicine box in your cupboard.

Do liver tonics or herbal liver-detox remedies help the liver recover faster?

None of the sources above recommends them, and one recommends the opposite. According to NIDDK, if you are diagnosed with hepatitis A you should talk with your doctor before taking any vitamins, supplements, or traditional and alternative medicines, because some of them can damage the liver. According to MedlinePlus, over-the-counter supplements and herbal products are themselves among the causes of acute hepatitis. What the sources actually recommend is far simpler: rest, enough fluids, a balanced diet, and no alcohol.

Does hepatitis A turn into chronic hepatitis or cirrhosis? How long until it clears?

It does not. According to NIDDK this is an acute infection that does not lead to long-term liver damage or to problems such as cirrhosis; according to MedlinePlus, once it has cleared there is no remaining damage and you do not get this illness again. On timing: according to CDC symptoms usually last less than two months, though some people feel tired for as long as six months; according to NHS the illness usually clears by itself in about three to six months. Note that this immunity is to hepatitis A only: it does not protect you from hepatitis B or C, which spread differently and are the kinds that become long-term liver disease.

Someone in our household has hepatitis A — what should the rest of us do?

Two things, and the second needs doing early. The first is stopping it spreading: wash hands at each of the points CDC names above, keep the person who is ill out of food preparation, and limit contact during the first week as NHS advises. The second is getting everyone living in the household assessed by a medical facility as soon as possible: according to CDC, if you have been exposed to the virus within the past two weeks, tell your doctor; according to NIDDK, vaccine or immune globulin given soon after exposure may keep you from becoming infected, and doctors often raise this with people living in the same household. Do not decide for yourselves what to take.