What Is Hepatitis?

The liver is one of our most important organs. It removes toxins from the body, aids digestion, and performs numerous metabolic functions. Hepatitis is an inflammation of the liver and can significantly impair the organ’s ability to function. Globally, hepatitis is most commonly caused by viruses, and each type has its own characteristics.

Some infections are mild and resolve on their own. In rare cases, however, they can cause severe illness with acute liver failure. Other infections may become chronic and cause serious long-term liver damage.

The good news is that effective vaccines are available against hepatitis A and B. Medications are also available for hepatitis B and C and can effectively combat the virus in the vast majority of cases. A vaccine against hepatitis E is not currently available in Switzerland, and treatment is generally limited to managing symptoms during the acute illness.

Hepatitis A: An Unwanted Travel Souvenir

Hepatitis A is transmitted by the fecal–oral route—that is, through contaminated drinking water, ice cubes, inadequately cooked food, seafood, or unpeeled fruit. The virus is found primarily in regions with limited sanitation, including large parts of Asia, Africa, Central and South America, and Eastern Europe. It is therefore considered a classic travel-related infection.

Hepatitis A is often mild in children. In adults, however, it may cause loss of appetite, nausea, fever, jaundice, and severe fatigue that can persist for weeks or months. There is no specific treatment; only the symptoms can be relieved. After recovering from hepatitis A, a person has lifelong immunity.

A well-tolerated vaccine provides protection against hepatitis A. Even the first dose offers good protection for travel. A second dose administered six to twelve months later provides long-lasting—and likely lifelong—protection. Vaccinated travelers should still follow the precautions recommended for preventing travelers’ diarrhea: “Cook it, boil it, peel it, or leave it.” In other words, eat only thoroughly cooked food, peel fruit yourself, and make sure your drinking water is safe.

Hepatitis B can be acute, meaning that it appears suddenly and resolves on its own, but it can also become chronic. Chronic infections are particularly concerning because they may lead to cirrhosis² or liver cancer over the course of many years—often without the affected person initially noticing anything. Antiviral medications usually do not cure the infection, but they significantly reduce the amount of virus in the body and help prevent the liver disease from progressing.

Here, too, vaccination is the most effective form of protection. In Switzerland, hepatitis B vaccination is now one of the recommended routine vaccinations and is given to infants as part of a combination vaccine. Many younger adults are therefore already protected against the disease. Anyone who has not been vaccinated or has received only some of the required doses can complete the vaccination series. Adults generally need three doses administered over several months. Travelers can also receive a convenient combination vaccine that protects against both hepatitis A and hepatitis B.

² progressive scarring of the liver in which healthy liver tissue is replaced by scar tissue, increasingly preventing the liver from functioning properly

Hepatitis C: No Vaccine, but Treatable

Hepatitis E: Why Good Hygiene Is the Best Protection

Hepatitis E is primarily contracted through contaminated water and food and is one of the most common causes of acute viral hepatitis worldwide. How the virus is transmitted depends on its genotype. In regions with limited access to clean water, infection generally occurs through the fecal–oral route via contaminated drinking water. In areas with better sanitation, however, hepatitis E is usually a zoonotic disease³ and is most often transmitted through raw or inadequately cooked pork or game meat. For travelers, therefore, it is important to consider not only where they are traveling but also what ends up on their plate.

³ Infectious diseases that can be transmitted between animals and humans.

Many infections are mild or go unnoticed and resolve on their own in healthy adults. However, hepatitis E can be dangerous for certain groups. In pregnant women, the infection may be severe and, depending on the genotype, is associated with a mortality rate of up to 25%. In people with weakened immune systems, the infection may become chronic. In people with existing liver disease, it may cause an acute deterioration in liver function.

A hepatitis E vaccine has so far been approved only in China and Pakistan and is not available in Switzerland. As with hepatitis A, protection while traveling therefore depends primarily on careful food and drinking-water hygiene: Follow the rule “Cook it, boil it, peel it, or leave it,” avoid ice cubes and tap water, and eat meat only if it has been thoroughly cooked. There is no specific treatment; care is generally supportive.