NSW Health is urging men who have sex with men to watch for hepatitis A symptoms and get vaccinated, with further Sydney outbreak cases now confirmed.

Hepatitis A is caused by a virus that spreads through sexual contact, contaminated food or poor hygiene. Symptoms may include nausea, vomiting, fever and yellowing of the skin, dark urine and pale stools.

Dr Vicky Sheppeard, Director Communicable Diseases NSW Health, said there are now 18 cases linked to the hepatitis A outbreak, including eight who are men who have sex with men, with at least four having visited public sex venues in Sydney while infectious.

“Anyone who has visited public sex venues between 29 July and 12 September this year should watch for symptoms and visit their GP or local sexual health clinic if concerned,” Dr Sheppeard said.

“Men who have sex with men are a high risk group for hepatitis A infection, and vaccination is the best protection against the disease.

“The vaccine is available at GPs or sexual health clinics. One dose of vaccine within two weeks of exposure is highly effective at preventing infection, and two doses (at least six months apart) provide lifelong protection.”

Men with symptoms should take care to not spread the infection to others by avoiding any sexual activity for two weeks after the onset of illness. They should also not prepare food or drink or share utensils, provide personal care for others, share linen or towels, or donate blood until infection is excluded, or if infection is confirmed, for two weeks after symptom onset.

Dr Sheppeard said the risk of infection can also be reduced by: washing hands after sex and handling condoms, sex toys/ equipment and going to the toilet; and before eating or preparing food or drink.

ACON’s Acting Director of HIV and Sexual Health, James Gray, said: “Given the high rates of immunisation among gay men, these types of outbreaks are now quite rare in Australia.

“We are encouraging all sexually active gay men to check their vaccination status and to get vaccinated if they are not immune. If you have symptoms, get them checked out by a medical professional so that we can stop onwards transmission.

“We will also be working in partnership with sex on premises venues to ensure that their customers are aware of the outbreak and the steps they can take to look after their health.”

NSW Health is continuing to work with the NSW Food Authority to determine whether a food source is the cause of the outbreak.

Of the 18 cases linked to this outbreak 16 have not travelled outside of Australia – which is far higher than the average two cases of locally acquired hepatitis A in NSW each year.

Several hepatitis A outbreaks have been reported internationally in the past six months, including over 1600 cases in men who have sex with men in Europe.

For further information see Hepatitis A.