The CDC has issued a Level 1 travel notice for hepatitis A in Costa Rica, advising travelers to "Practice Usual Precautions." An outbreak of hepatitis A virus (HAV) has been reported, with most cases identified in San José province. HAV is contagious and spreads through close person-to-person contact and ingestion of contaminated food or drink.
Primary preventive actions recommended include ensuring hepatitis A vaccination, practicing thorough hand hygiene, avoiding sharing needles or drug equipment, and practicing safer sex. Travelers who develop symptoms during or after travel should seek medical care promptly. If someone believes they were exposed to HAV and are not previously vaccinated, clinicians can consider post-exposure prophylaxis (PEP); PEP is most effective when given as soon as possible and within 2 weeks of exposure.
Hepatitis A is a vaccine-preventable liver infection caused by the hepatitis A virus (HAV). Transmission occurs when a person ingests the virus, even in small amounts. Common transmission routes include close personal contact with an infected person—such as certain sexual contact, caring for someone who is infected, or using shared drug equipment—and consumption of contaminated food or water.
Symptoms may include dark urine, clay-colored stools, diarrhea, fatigue, fever, joint pain, loss of appetite, nausea, abdominal pain, and jaundice (yellowing of the skin or the whites of the eyes). Some individuals, especially young children, may not develop noticeable symptoms.
Symptoms generally begin 2–4 weeks after exposure (range 15–50 days) and typically resolve within about 2 months, though some people can feel ill for as long as 6 months. People with weakened immune systems, chronic liver disease, and those older than 60 years are at greater risk for severe disease. There is no specific antiviral treatment for HAV; most people recover fully with supportive care such as rest and fluids.
To reduce the risk of HAV infection, the CDC recommends ensuring travelers are up to date with hepatitis A vaccination. If a traveler cannot receive vaccination, a clinician may recommend immune globulin as an alternative protective measure; immune globulin can provide protection for up to 2 months.
Additional preventive measures include:
Seek medical attention if you develop any of the following during or after travel: dark urine, clay-colored stools, diarrhea, fatigue, fever, joint pain, loss of appetite, nausea, abdominal pain, or jaundice (yellow skin or eyes). Inform clinicians about recent travel to areas with reported HAV activity, such as Costa Rica, to support appropriate evaluation and management.
If you think you have been exposed to HAV and have not previously received hepatitis A vaccine, talk with your health care provider about post-exposure prophylaxis. PEP should be administered as soon as possible and is recommended within 2 weeks of exposure. Specific PEP recommendations (vaccine versus immune globulin) depend on the individual’s age, health status, and vaccination history; those details and personalized recommendations were not reported in this notice and should be obtained from clinical guidance or a treating clinician.
The CDC provides destination-specific guidance and additional resources for travelers to Costa Rica, including a general health information page for travelers to Costa Rica, the CDC Hepatitis A website, and an overview of hepatitis A outbreak basics. Travelers can consult these resources for further details on vaccination, preventive behaviors, and country-specific health considerations.
Clinicians are directed to CDC resources for clinical management and guidance on hepatitis A, including a clinical overview for health care professionals and detailed entries in the CDC Yellow Book (Health Information for International Travel). These resources cover diagnosis, prevention strategies including vaccination and immune globulin, and considerations for special populations.
This travel notice content is sourced from the National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) and the Division of Global Migration Health (DGMH). The page was last reviewed on September 18, 2026. For the most current clinical guidance and detailed PEP recommendations, clinicians and travelers should consult the CDC Hepatitis A pages and the CDC Yellow Book.