--- title: Symptoms of Hepatitis A Infection date: 2021-01-06T18:14:00-08:00 author: admin canonical_url: "https://marlerclark.com/foodborne-illnesses/hepatitis-a/hepatitis-symptoms-risks" section: Resource Library --- [Foodborne Illnesses](/foodborne-illnesses) / [Hepatitis A](https://marlerclark.com/foodborne-illnesses/hepatitis-a) / # Symptoms of Hepatitis A Infection ### What are the symptoms of Hepatitis A infection? ![](https://holistic-kudu.transforms.svdcdn.com/production/about_hepatitis/image10.png?w=1193&h=314&auto=compress%2Cformat&fit=crop&dm=1686508891&s=be4ab4c2ac39c897c2e1dc6179711294)Hepatitis A may cause no symptoms at all when it is contracted, especially in children. Asymptomatic individuals may only know they were infected (and have become immune, as infection gives lifelong immunity) by getting a blood test later in life. Approximately 10 to 12 days after exposure, HAV is present in blood and is excreted via the biliary system into the feces. Although the virus is present in the blood, its concentration is much higher in feces. HAV excretion begins to decline at the onset of clinical illness and decreases significantly by 7 to 10 days after onset of symptoms. Most infected persons no longer excrete virus in their feces by the third week of illness, although children may excrete HAV longer than adults. **Figure 3.** Timeline for hepatitis A manifestations. ![](https://s3.us-west-2.amazonaws.com/abouthepatitiscom-images/outbreaks/image3.jpeg)The average incubation period for HAV is between 2 and 4 weeks (but can be up to 8 weeks). Signs and symptoms, as described above, typically begin about 28 days after contracting the virus, but can begin as early as 15 days or as late as 50 days after exposure. Jaundice (i.e., icterus) is a clinical sign that appears relatively later on in an HAV infection—after a few days to a week of typical symptoms. A sign of “cholestasis,” jaundice, manifests as yellowing of the skin, eyes (“scleral icterus”), and mucous membranes. It is caused by bile flowing poorly through the liver, backing up into the blood, and resulting in the characteristic yellowish tint to the tissues. The same mechanism causes the urine to turn dark tea- or cola-colored because of the presence of bile, and the stool may turn white or clay-colored from the absence of bile. ![](https://s3.us-west-2.amazonaws.com/abouthepatitiscom-images/outbreaks/image4.jpeg) ![](https://s3.us-west-2.amazonaws.com/abouthepatitiscom-images/outbreaks/image5.jpeg)*Scleral icterus* In general, symptoms usually last less than two months, although 10 to 15 percent of symptomatic persons have prolonged or relapsing disease for up to six months. It is not unusual for blood tests to remain abnormal for six months or more (see ALT, IgM, IgG in Figure 3 above). The jaundice so commonly associated with hepatitis A can also linger for a prolonged period in some infected persons—sometimes as long as eight months or more. Bilirubin rises soon after the onset of bilirubinuria (bilirubin in the urine) and follows rises in ALT and AST levels. Serum bilirubin levels may be impressively high and can remain elevated for several months; persistence beyond three months indicates cholestatic HAV infection. Additionally, pruritus, or severe itchiness of the skin, can persist for several months after the onset of symptoms. These conditions are frequently accompanied by diarrhea, loss of appetite, and extreme fatigue. [ Next: Complications of Hepatitis A Infection › ](https://marlerclark.com/foodborne-illnesses/hepatitis-a/hepatitis-complications) ### More information about Hepatitis A [May 20, 2023 ###### A quick look at the 2018 Hepatitis A outbreak Litigation proceeded in a Virginia state court against Tropical Smoothie and the strawberry supply chain. 134 people with Hepatitis A were reported from nine states, including: Arkansas (1), California (1) ... ](https://marlerclark.com/news_events/a-quick-look-at-the-2018-hepatitis-a-outbreak) [March 26, 2023 ###### Hepatitis A outbreak linked to strawberries The CDC, state public health and regulatory officials, and the U.S. Food and Drug Administration are investigating an outbreak of Hepatitis A linked to frozen organic strawberries imported from certain ... ](https://marlerclark.com/news_events/hepatitis-a-outbreak-linked-to-strawberries) [December 11, 2022 ###### Since 2016, the US has seen 44,760 Hepatitis A cases with 27,327 hospitalizations and 426 deaths According to the CDC, when hearing about hepatitis A, many people think about contaminated food and water. However, in the United States, hepatitis A is more commonly spread from person ... ](https://marlerclark.com/news_events/since-2016-the-us-has-seen-44760-hepatitis-a-cases-with-27327-hospitalizations-and-426-deaths) [December 11, 2022 ###### Famous Anthony’s Hepatitis A case moves towards justice The Roanoke Times reports: The victims of a hepatitis A outbreak at a Roanoke restaurant — which killed four people and sickened more than 40 — were allowed Thursday to ... ](https://marlerclark.com/news_events/famous-anthonys-hepatitis-a-case-moves-towards-justice) [1. View all ](/news_events/outbreaks?illness=hepatitis-a&year=all) ## All Hepatitis A Resources [###### Hepatitis A Food Poisoning ](https://marlerclark.com/foodborne-illnesses/hepatitis-a/about-hepatitis) [###### The Incidence of Hepatitis A Infection ](https://marlerclark.com/foodborne-illnesses/hepatitis-a/how-common-is-hepatitis-a-infection) [###### Transmission of Hepatitis A ](https://marlerclark.com/foodborne-illnesses/hepatitis-a/how-does-hepatitis-a-spread) [###### Symptoms of Hepatitis A Infection ](https://marlerclark.com/foodborne-illnesses/hepatitis-a/hepatitis-symptoms-risks) [###### Complications of Hepatitis A Infection ](https://marlerclark.com/foodborne-illnesses/hepatitis-a/hepatitis-complications) [###### Diagnosis of Hepatitis A Infection ](https://marlerclark.com/foodborne-illnesses/hepatitis-a/hepatitis-diagnosis) [###### Treatment for Hepatitis A Infection ](https://marlerclark.com/foodborne-illnesses/hepatitis-a/hepatitis-treatment) [###### Real Life Impacts of Hepatitis A Infection ](https://marlerclark.com/foodborne-illnesses/hepatitis-a/real-life-impacts) [###### Real Life Impacts: The Story of Michael ](https://marlerclark.com/foodborne-illnesses/hepatitis-a/real-life-impacts-the-story-of-michael) [###### Real Life Impacts: The Story of Ben and Lynn ](https://marlerclark.com/foodborne-illnesses/hepatitis-a/real-life-impacts-the-story-of-ben-and-lynn) [###### Real Life Impacts: The Story of Richard Miller ](https://marlerclark.com/foodborne-illnesses/hepatitis-a/real-life-impacts-the-story-of-richard-miller) [###### How to Prevent Hepatitis A Infection ](https://marlerclark.com/foodborne-illnesses/hepatitis-a/hepatitis-prevention) [###### Outbreaks of Hepatitis A ](https://marlerclark.com/foodborne-illnesses/hepatitis-a/hepatitis-outbreaks) [###### Hepatitis A References ](https://marlerclark.com/foodborne-illnesses/hepatitis-a/hepatitis-a-references) ### Other foodborne illnesses [E. coli](https://marlerclark.com/foodborne-illnesses/e-coli) [Salmonella](https://marlerclark.com/foodborne-illnesses/salmonella) [Listeria](https://marlerclark.com/foodborne-illnesses/listeria) [Reactive Arthritis](https://marlerclark.com/foodborne-illnesses/reactive-arthritis) [Guillain-Barre Syndrome](https://marlerclark.com/foodborne-illnesses/guillain-barre-syndrome) [Irritable Bowel Syndrome](https://marlerclark.com/foodborne-illnesses/irritable-bowel-syndrome) [Norovirus](https://marlerclark.com/foodborne-illnesses/norovirus) [Botulism](https://marlerclark.com/foodborne-illnesses/botulism) [Campylobacter](https://marlerclark.com/foodborne-illnesses/campylobacter) [Shigella](https://marlerclark.com/foodborne-illnesses/shigella) [Cyclospora](https://marlerclark.com/foodborne-illnesses/cyclospora) [Hemolytic Uremic Syndrome](https://marlerclark.com/foodborne-illnesses/hemolytic-uremic-syndrome)