Hepatitis A and Drinking Water from Private Wells

What is hepatitis A?

Hepatitis A is a contagious liver disease that results from infection with the hepatitis A virus. It can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months. Hepatitis A is usually spread when a person ingests fecal matter – even in microscopic amounts – from contact with objects, food, or drinks contaminated by the feces, or stool, of an infected person.

How is hepatitis A spread?

Hepatitis A is usually spread when the hepatitis A virus is taken in by mouth from contact with objects, food, or drinks contaminated by the feces (or stool) of an infected person. A person can get hepatitis A through:

• Person-to-person contact
  • When an infected person does not wash his or her hands properly after going to the bathroom and touches other objects or food
  • When a parent or caregiver does not properly wash his or her hands after changing diapers or cleaning up the stool of an infected person
  • When someone engages in certain sexual activities, such as oral-anal contact with an infected person
• Contaminated food or water
  • Hepatitis A can be spread by eating or drinking food or water contaminated with the virus. This is more likely to occur in countries where hepatitis A is common and in areas where there are poor sanitary conditions or poor personal hygiene. In the United States, chlorination of public water systems kills hepatitis A virus.

Where and how does hepatitis A virus get into drinking water?

Hepatitis A can be found in every part of the United States and throughout the world. Wells, if properly installed and maintained, provide a safe source of water in the U.S. When any water source, including private wells, is contaminated with feces from infected humans, the water can potentially spread the hepatitis A virus. The virus can enter the water through various ways, including sewage overflows or broken sewage systems.

What are the symptoms of hepatitis A?

The most common symptoms of hepatitis A include:

• Fever
• Fatigue
• Loss of appetite
• Nausea
• Vomiting
• Abdominal pain
• Dark urine
• Clay-colored bowel movements
• Joint pain
• Jaundice (a yellowing of the skin or eyes)

Three out of four adults who are infected with HAV will develop symptoms, usually over a period of several days. The symptoms generally appear 2 to 6 weeks after infection with the virus. Children who are infected often have no symptoms.

What should I do if I think I have hepatitis A?

See your health care provider to discuss your concerns.

I think I have been exposed to hepatitis A. What should I do?

If you have any questions about potential exposure to hepatitis A, call your health professional or your local or state health department.

If you were recently exposed to hepatitis A virus and have not been vaccinated against hepatitis A, you might benefit from an injection of either immune globulin or hepatitis A vaccine. However, to be effective, the vaccine or immune globulin must be given within the first 2 weeks after exposure. A health professional can decide the best option, on the basis of your age and overall health.

How is hepatitis A diagnosed?

A doctor can determine if you have hepatitis A by discussing your symptoms and taking a blood sample.

How is hepatitis A treated?

There are no special treatments for hepatitis A. Most people with hepatitis A will feel sick for a few months before they begin to feel better. A few people will need to be hospitalized. During this time, doctors usually recommend rest, adequate nutrition, and fluids. People with hepatitis A should check with a health professional before taking any prescription pills, supplements, or over-the-counter medications, which can potentially damage the liver. Alcohol should be avoided.

Can hepatitis A be prevented?

Yes. The best way to prevent hepatitis A is through vaccination with the hepatitis A vaccine. Vaccination is recommended for all children, for travelers to certain countries, and for people at high risk for infection with the virus. Frequent handwashing with soap and warm water after using the bathroom, changing a diaper, or before preparing food can help prevent the spread of hepatitis A.

How do I remove hepatitis A from my drinking water?

Heating water at a full boil for 1 minute (3 minutes if you live in a high altitude) will kill or inactivate the hepatitis A virus. Water should then be stored in a clean container with a lid and refrigerated. Because of the small size of the virus, using a point-of-use filter will not remove it from water. You may also disinfect your well; adequate chlorination kills the hepatitis A virus. Contact your local health department for recommended procedures. Have your well water tested regularly, at least once a year, after disinfection to make sure that the problem does not recur.

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