What is the incubation period of hepatitis A (infectious hepatitis)?

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Hepatitis A Incubation Period

The incubation period for hepatitis A is 15 to 50 days, with an average of 28 days. 1

Key Clinical Timeline

The incubation period represents the time from viral exposure to symptom onset, and understanding this timeline is critical for:

  • Contact tracing and prophylaxis decisions: The 15-50 day range (average 28 days) means exposed individuals remain at risk for up to 7 weeks after contact. 2

  • Peak infectivity timing: Patients are most contagious during the 2-week period before jaundice or liver enzyme elevation occurs, which falls within the late incubation period. 2 This means infected individuals are spreading virus before they know they're sick—a critical public health consideration.

Age-Dependent Clinical Presentation

The incubation period remains consistent across age groups, but symptom manifestation differs dramatically:

  • Children under 6 years: Over 90% remain asymptomatic throughout infection, making them silent spreaders. 2

  • Older children and adults: More than 70% develop jaundice and symptomatic disease. 2

  • Initial prodrome: After the incubation period, a 1-7 day prodromal illness with anorexia, malaise, fever, and nausea typically precedes jaundice. 2

Practical Implications for Prophylaxis

The 28-day average incubation period directly informs post-exposure prophylaxis guidelines:

  • Immune globulin (IG) must be administered within 2 weeks of exposure to be effective, as this targets the early-to-mid incubation period before viral replication becomes overwhelming. 3

  • Hepatitis A vaccine provides protection within 4 weeks of the first dose, which aligns with the average incubation period, making it suitable for pre-exposure prophylaxis in travelers. 3

Viral Shedding Duration

While the incubation period ends when symptoms begin, viral shedding patterns extend beyond:

  • Children shed virus for up to 10 weeks after clinical illness onset. 2

  • Neonates may shed for up to 6 months, creating prolonged transmission risk. 2

  • Peak fecal shedding occurs during the 2 weeks before jaundice, overlapping with the late incubation period. 2

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Hepatitis A Clinical Presentation and Management

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Hepatitis A Prevention and Treatment

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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