Brazil: Large increase in hepatitis A cases in São Paulo in 2017 /update 1

Event

A large increase in hepatitis A cases has been reported in São Paulo in 2017 compared to 2016. Through November 2017, 656 hepatitis A cases were reported, including two associated deaths; comparatively, 60 cases were reported over the same period in 2016 - representing a 1000 percent increase from 2016 to 2017. The majority of those infected in 2017 through November (45 percent) were infected through unprotected sexual contact; 11 percent were infected through contaminated food, and the transmission vector was unknown in 44 percent of reported cases. Additional cases of hepatitis A are likely to be reported in São Paulo in the coming weeks.

Context

Hepatitis A is transmitted via food and water that has been contaminated by human fecal material containing the virus. The incubation period is between 15 and 50 days. In approximately 90 percent of cases the infected person presents no symptoms. In cases where symptoms are present the patient may display flu-like symptoms, long-term fatigue (lasting weeks or months), headaches, nausea, vomiting, loss of appetite, hives, and muscle and joint pain. In some cases the individual may complain of discomfort in the upper right portion of the abdomen (liver). A gradual yellowing of the skin may also be observed, which can last up to a month. Given that symptoms of Hepatitis A are rare and easily confused with other illnesses, a doctor should be consulted in order to obtain an accurate diagnosis.

Advice

Individuals in or considering travel to São Paulo are advised to contact their medical provider regarding vaccination. To reduce exposure to the virus, practice safe sex and exercise proper personal hygiene and food sanitation measures: wash hands regularly, do not drink tap water, and eat only thoroughly cooked foods.​