Hepatitis A and International Travel
Hepatitis A is one of the most common vaccine-preventable infections affecting international travelers. Americans traveling abroad should check their vaccination history and take precautions with food, water and personal hygiene.
What Is Hepatitis A?
Hepatitis A is a contagious viral infection that affects the liver. It usually spreads when a person consumes food or water contaminated with very small amounts of stool from an infected person.
Symptoms may include tiredness, loss of appetite, nausea, stomach discomfort, dark urine, pale-colored stools and yellowing of the skin or eyes. Some infected people, particularly young children, may have few or no noticeable symptoms.
Hepatitis A does not normally cause a chronic infection, but illness can be serious—especially in older adults and people with existing liver disease.
Read the Hepatitis A Disease GuideWhere Are Travelers Most at Risk?
Hepatitis A occurs worldwide, but the risk is generally higher in destinations where access to safe drinking water, sanitation and food hygiene may be inconsistent. Risk can exist in popular resorts, major cities, rural communities and private homes—not only in visibly poor or remote areas.
Mexico, Central America and the Caribbean
Vaccination may be recommended for unvaccinated travelers visiting destinations such as Mexico, Guatemala, Honduras, Nicaragua, the Dominican Republic, Haiti and other parts of the region.
South America
Travelers visiting countries such as Brazil, Colombia, Peru, Bolivia, Ecuador, Venezuela and Guyana should check current hepatitis A vaccination recommendations.
Asia
Hepatitis A vaccination is commonly advised for unvaccinated travelers visiting India, Pakistan, Bangladesh, China, Thailand, Vietnam, Cambodia, Indonesia and the Philippines.
Africa
Risk is present across many parts of North Africa and sub-Saharan Africa, including popular destinations such as Egypt, Morocco, Kenya, Tanzania, Ghana, Nigeria and South Africa.
Middle East
Unvaccinated travelers may be advised to receive hepatitis A vaccination before visiting parts of the Middle East, including Türkiye, Jordan, Lebanon, Iraq and Yemen.
Visiting Friends and Relatives
Travelers staying with friends or relatives may have increased exposure through home-prepared food, longer stays, rural travel and closer contact with local communities.
Hepatitis A Vaccination for U.S. Travelers
Vaccination is the most effective way to prevent hepatitis A. The vaccine is highly effective and is available in the United States as a single-antigen hepatitis A vaccine or as a combined hepatitis A and hepatitis B vaccine.
Routine vaccination in the United States
Hepatitis A vaccine is included in the routine U.S. childhood immunization schedule. Routine vaccination normally begins after a child’s first birthday. Older children and teenagers who were not previously vaccinated should receive catch-up vaccination.
The vaccine is not automatically given to every U.S. adult. However, unvaccinated adults may receive it for protection, and it is particularly recommended for people with certain risk factors—including travel to countries where hepatitis A is common.
When should travelers get vaccinated?
Arrange a travel-health appointment as early as possible, preferably several weeks before departure. Most healthy travelers can obtain meaningful protection after the first dose, but the complete vaccine series is needed for longer-lasting protection.
Do not assume it is too late if your trip is approaching. Last-minute travelers should still speak with a healthcare professional because a first vaccine dose may still provide useful protection.
Infants 6–11 Months
An early travel dose may be recommended for infants traveling to a risk destination. Because this dose is given before the routine vaccination age, it does not replace the regular childhood series.
Travelers Aged 40 or Older
Travelers departing soon should discuss their age, destination and health history with a clinician. In some circumstances, immune globulin may be considered in addition to vaccination.
Higher-Risk Travelers
People with weakened immune systems or chronic liver disease should seek individualized medical advice as soon as international travel is considered.
Learn about available vaccines, dosing schedules, expected protection and possible side effects:
Read the Hepatitis A Vaccine GuideHow to Prevent Hepatitis A While Traveling
Vaccination provides the strongest protection, but careful food, water and hygiene habits further reduce the risk of infection.
Wash Your Hands
Wash your hands thoroughly with soap and safe water after using the bathroom, after changing a diaper and before preparing or eating food.
Choose Safe Water
Where tap water safety is uncertain, use factory-sealed bottled water or appropriately treated water for drinking, making ice, preparing food and brushing your teeth.
Eat Food That Is Fully Cooked
Choose food that is thoroughly cooked and served steaming hot. Be cautious with food that has been sitting uncovered or stored at an unsafe temperature.
Peel Produce Yourself
Select fruit and vegetables that you can wash with safe water and peel yourself. Avoid pre-cut produce when hygiene conditions are uncertain.
Avoid Raw Shellfish
Avoid raw or undercooked oysters, clams and other shellfish, which can become contaminated when harvested from polluted water.
Be Careful with Street Food
Street food is not automatically unsafe, but choose busy vendors who cook food in front of you, serve it piping hot and maintain visibly clean preparation areas.
When to Seek Medical Advice
Contact a healthcare professional if you develop possible hepatitis A symptoms during your trip or after returning to the United States—particularly yellow skin or eyes, dark urine, severe tiredness, nausea or abdominal discomfort.
Tell the clinician where you traveled, when you returned, what you ate and drank, and whether you received hepatitis A vaccination.
Anyone who believes they were recently exposed to hepatitis A should obtain prompt medical advice. Vaccination or immune globulin may help prevent illness when administered soon after exposure.
Pre-Travel Checklist
- Check whether you previously completed the hepatitis A vaccine series.
- Review the latest health recommendations for every country on your itinerary.
- Arrange a medical or travel-health consultation before departure.
- Ask about early vaccination for infants traveling internationally.
- Pack hand sanitizer for situations where soap and water are unavailable.
- Follow safe food and water precautions throughout the trip.
- Seek medical advice promptly after a suspected exposure.