Hepatitis A: What It Is, How to Prevent It, and How Long Recovery Takes

Most people think of hepatitis as something that sticks around forever-like hepatitis B or C. But hepatitis A is different. It doesn’t hang around in your liver. It doesn’t turn chronic. It hits hard, makes you feel awful for weeks, and then, for most people, it just… goes away. No lifelong medication. No liver damage. Just a rough few months and a full recovery. But that doesn’t mean you can ignore it.

How Hepatitis A Spreads-It’s Not What You Think

You don’t need to have sex or share needles to catch hepatitis A. The virus spreads through something far more common: poop. Not in a scary, dramatic way, but in the quiet, everyday moments. Someone doesn’t wash their hands after using the bathroom. They touch a doorknob, a counter, or food. You touch it next. You eat. You get infected.

The hepatitis A virus (HAV) is tough. It can live on surfaces for up to 30 days. It survives in water, on raw produce, and even in shellfish harvested from contaminated waters. Outbreaks in the U.S. have often been tied to food workers who didn’t wash their hands after using the restroom. The FDA tracked 17 foodborne outbreaks in 2022, affecting over 600 people-mostly from contaminated lettuce, berries, or scallions.

It’s also spread through close personal contact. Think: living with someone who’s infected, caring for a sick child, or having sex with someone who has hepatitis A. It’s not airborne. You can’t catch it from coughing or sneezing. But you can catch it from a handshake, a shared towel, or a contaminated kitchen sponge.

What Happens When You Get Infected

After you swallow the virus, it takes time to show up. The average incubation period is 28 days, but it can range from 15 to 50 days. During that time, you feel fine. But you’re already contagious.

The virus travels from your gut to your liver. That’s where the trouble starts. Your liver cells get inflamed. Your body fights back. And then, symptoms hit-often all at once.

The most common signs:

• Dark urine (68-94% of cases)
• Yellow skin or eyes (jaundice, 40-80%)
• Extreme fatigue (52-91%)
• Loss of appetite (42-90%)
• Nausea and vomiting (30-90%)
• Fever (30-60%)
• Abdominal pain, especially on the right side
• Clay-colored stools
• Joint pain

Here’s the twist: kids under 6 often have no symptoms at all. They don’t turn yellow. They don’t feel sick. But they’re still spreading the virus. That’s why outbreaks in daycare centers are so common.

Adults? They usually feel it. Badly. Fatigue hits like a freight train. People describe it as being drained of every ounce of energy-even after sleeping 12 hours. One Reddit user wrote: “I couldn’t walk from the couch to the kitchen without needing to sit down for 10 minutes.”

How Long Does Hepatitis A Last?

Most people recover fully. But “recover” doesn’t mean “feel normal in a week.”

Symptoms typically last about 8 weeks on average. About 85-90% of adults are back to normal within 2 months. But 10-15% of cases drag on. Symptoms come and go for up to 6 months. Relapses are real. You might feel better for a week, then crash again. That’s not a new infection-it’s your body still cleaning up.

Liver enzymes (ALT, AST) usually return to normal within 12 weeks for 80% of people. For 95%, it’s done by 6 months. That’s when your liver is truly healed.

The worst-case scenario? Acute liver failure. It’s rare-less than 1% of cases-but more likely if you’re over 50 or already have liver disease like cirrhosis or hepatitis B. The fatality rate jumps from 0.1% in kids to 2.6% in adults over 50.

When Are You No Longer Contagious?

You’re most infectious two weeks before you even feel sick. That’s why it spreads so easily. By the time you’re in bed with jaundice, you’ve already exposed people.

The good news? Once jaundice appears, your contagiousness drops sharply. Most people stop shedding the virus in stool within a week of jaundice starting. Public health guidelines say you can return to work or school after one week of jaundice-or when symptoms are gone and a doctor confirms you’re no longer infectious.

But here’s what most people don’t realize: you can still pass it on if you don’t wash your hands. Even after you feel better. So if you’re a food handler, a nurse, or a parent of a toddler, keep washing. Don’t assume you’re clean just because the yellow’s gone.

How to Prevent Hepatitis A

There’s one simple, powerful tool: the hepatitis A vaccine.

It’s two shots, given 6 to 18 months apart. After the first dose, you’re 95% protected within 4 weeks. After the second, it’s nearly 100%. The vaccine has cut U.S. cases by 95% since it became routine in 1995.

The CDC recommends:

• All children get the first dose at age 1 (12-23 months)
• Unvaccinated adults at risk: travelers to developing countries, men who have sex with men, people who use drugs, those with chronic liver disease
• Anyone who wants protection-especially if you work in food service, healthcare, or childcare

If you’ve been exposed and haven’t been vaccinated, you still have a window. Get the vaccine or immune globulin (a shot of antibodies) within two weeks of exposure. It’s 85-90% effective at stopping infection.

Handwashing works. Really. Soap and water for 20 seconds-especially after using the bathroom, changing diapers, or before cooking-cuts transmission by 30-50%. Alcohol-based hand sanitizer? Useless against HAV. You need soap and running water.

If someone in your home has hepatitis A, clean surfaces with bleach. Mix 5-10 tablespoons of household bleach per gallon of water. Let it sit for 2 minutes. That kills the virus.

Recovery: What to Do (and Not Do)

There’s no cure for hepatitis A. Your body fights it off. Your job? Support it.

• Rest. Don’t push through fatigue. Your liver is healing. Pushing too hard delays recovery.
• Hydrate. Vomiting and poor appetite lead to dehydration. Sip water, broth, or electrolyte drinks.
• Eat small, low-fat meals. Your liver struggles to process fat. Stick to 1,800-2,200 calories a day. Avoid greasy, fried, or heavy foods.
• Avoid alcohol completely. Even a single drink can stress your liver during recovery. Wait until your liver enzymes are normal.
• Don’t take acetaminophen (Tylenol) over 2,000 mg daily. It’s safe in low doses, but your liver is already under stress. Talk to your doctor before taking any painkillers or supplements.
• Move gently. Once fatigue eases, aim for 30-45 minutes of light activity daily-walking, stretching. Increase slowly. Studies show this helps recovery without overtaxing your liver.

Most people-75%-don’t need hospitalization. But if you can’t keep fluids down, have confusion, or your skin turns very yellow, go to the ER. Those are signs of serious liver trouble.

Why This Matters More Than You Think

Hepatitis A isn’t just about you. It’s about your community.

One infected person can trigger an outbreak. A food worker. A parent. A traveler. In 2019, the U.S. had over 31,000 cases-mostly linked to homelessness and drug use. But outbreaks spread to restaurants, schools, and nursing homes.

The economic cost? About $300 million a year in lost workdays and medical care. Each adult case averages 15 missed workdays.

And here’s the kicker: hepatitis A is 100% preventable. We have the tools. We know how it spreads. We have a safe, effective vaccine.

So why do people still get it? Because they think it’s “just a stomach bug.” Because they don’t wash their hands. Because they don’t get vaccinated.

It’s not a disease of the past. It’s a disease of choices. And those choices affect everyone around you.

What’s Next?

If you’ve never been vaccinated, get the first shot. It’s covered by most insurance. If you’re over 50, have liver disease, or travel internationally, it’s a no-brainer. Even if you think you’re low-risk, ask your doctor. Protection takes 4 weeks to kick in-don’t wait until you’re packing for a trip.

If you’ve had hepatitis A, you’re immune for life. No need for a vaccine. But make sure your close contacts are protected.

And if you’ve ever been misdiagnosed with “gastro” or “food poisoning” and then got jaundice? You’re not alone. Nearly half of hepatitis A cases are initially mistaken for something else. That delay costs time-and sometimes, health.

Hepatitis A doesn’t have to be a life-altering event. With the right knowledge, it’s just a bump in the road. A few months of rest. A few weeks of caution. And then, back to normal.

But only if you take it seriously.