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Can hepatitis A virus (HAV) be spread through drinking water?

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In short, yes. Hepatitis A virus is found throughout the world and across the United States. When water sources, including private wells, are contaminated with feces from infected humans, the water will spread the hepatitis A virus to others who drink this water. The virus can enter water supplies through sewage overflows or from broken sewage systems.

The virus also may be spread by eating uncooked food (such as raw shellfish) and unpeeled fruits and vegetables washed in contaminated water. Hepatitis A outbreaks caused by contaminated drinking water are rare in the United States because water supplies are treated to destroy the virus and other harmful organisms.

In the United States, HAV is spread mainly among people who have close contact with someone who has the virus. You can become infected with HAV if you:

  • Eat food prepared by someone who does not wash his or her hands well after using the bathroom or changing a diaper.
  • Don't wash your hands after changing a diaper.
  • Eat raw or undercooked shellfish that was harvested from waters contaminated with raw sewage.
  • sexual contact with someone that carries tha HAV virus.

Outbreaks of hepatitis A among children in day care facilities occur because children, especially those who wear diapers, may get stool on their hands and then touch objects that other children put into their mouths. Caregivers in day care centers can spread the virus if they do not wash their hands thoroughly after changing a child's diaper. It is very rare for hepatitis A virus to be spread by infected blood or blood products. It is not known to be spread through saliva or urine.

What are the symptoms of hepatitis A? The most common symptoms of hepatitis A include:

  • Jaundice or yellowing of the skin and eyes
  • Dark urine
  • Fatigue
  • Loss of appetite
  • Nausea
  • Vomiting
  • Fever
  • Stomach pain

Three out of four adults who are infected by 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 been exposed to hepatitis A?
Contact your doctor or your local health department if you think that you have been exposed to hepatitis A or any type of viral hepatitis. Immune globulins, a preparation of antibodies, can prevent the disease if you receive it within 2 weeks of exposure. Vaccines for hepatitis A are available to provide long-term protection.

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 periodically after disinfection to make sure that the problem does not recur.