Infants and preschool children may experience only mild, nonspecific symptoms without jaundice. In contrast to most other infectious diseases common in childcare settings, the first indication of the disease may come when an adult exhibits symptoms. The hepatitis A virus is spread from person to person through fecal matter. This means something contaminated with the virus reaches the mouth of another person. For this reason, hepatitis A virus easily can be spread in settings where sanitary conditions are poor or where good personal hygiene is not practiced.
Food is often the source of outbreaks.
Hepatitis A is a reportable disease. This means that the medical provider who diagnoses the disease is required by law to report it to local health officials. The local health department should then work with the medical provider and others to try to manage the disease to limit its spread and treat those who are exposed to it. Children or adults who have had hepatitis should provide written medical clearance before returning to the childcare setting. Additionally, the local health department should make the decision as to how to treat individuals who may be exposed.