ABSTRACT
In the United States, the most common source of infection is contact with an hepatitis A virus (HAV)-infected person. Hepatitis A virus is primarily hepatotropic, although limited data suggest that the virus may replicate in cells other than hepatocytes. Cyclical epidemics of hepatitis A have been shown to occur in populations where HAV infection is considered highly endemic. Hepatitis A virus is transmitted by the ingestion of feces on contaminated objects, as fomites, or in food or water. Hepatitis A virus has been shown to be transmitted by water, and fecally polluted water used in food processing can be a source of contamination. Hepatitis A virus has a single-stranded RNA genome of positive polarity that is approximately 7500 nucleotides long. Hepatitis A virus stability in the environment facilitates transmission from contaminated foodstuffs. In the United States, one patient with no history of travel to endemic areas has been shown to have hepatitis E infection.
