The Centers for Disease Control and Prevention has issued a level 1 travel notice for Costa Rica following an outbreak of hepatitis A. The federal public health agency warned that while the advisory applies across the Central American nation, the majority of reported cases are concentrated in San Jose province.
The Level 1 alert is the lowest of four risk classifications maintained by the US health agency, advising travelers to practice usual precautions while visiting the country. The warning comes as Costa Rica remains a primary destination for American tourists, with figures from the Costa Rican Tourism Institute showing that approximately 1.5 million US travelers visited in 2024, representing about 60 percent of all international arrivals.
The Atlanta-based public health institute uses its travel advisory system to inform international travelers about infectious disease outbreaks and environmental health hazards worldwide. A Level 1 notice does not advise against travel, but urges visitors to remain vigilant regarding personal hygiene, water quality, and food safety.
Outbreak details and transmission risks
According to health officials, the current outbreak is centered primarily in San Jose province, home to the national capital and the country's main economic hub. Although most cases are localized in San Jose, the CDC extended the advisory nationwide due to the movement of travelers and domestic food distribution networks.
Hepatitis A is a highly infectious liver disease transmitted through the fecal-oral route, close person-to-person contact, or the consumption of contaminated food and beverages. Health authorities warned that symptoms typically appear two to seven weeks after exposure, creating a window during which an infected individual can transmit the virus before realizing they are sick.
Understanding symptoms and health risks
Symptoms of hepatitis A infection include fatigue, fever, loss of appetite, nausea, vomiting, abdominal pain, diarrhea, joint pain, dark urine, pale or clay-colored stools, and jaundice, which causes yellowing of the skin and the whites of the eyes. The CDC noted that symptom severity varies significantly by age. Roughly 70 percent of infections in children younger than six cause no symptoms at all, whereas older children and adults typically develop symptomatic illness, most commonly jaundice.
Unlike hepatitis B and hepatitis C, which frequently develop into chronic conditions that damage liver tissue over decades, hepatitis A causes an acute infection and does not become chronic. For most healthy individuals, the body's immune system clears the virus on its own, and symptoms generally resolve in less than two months. However, in 10 to 15 percent of symptomatic patients, symptoms can be prolonged or relapse for up to six months. In rare severe cases, particularly among older adults or individuals with underlying liver disease, the infection can trigger fulminant hepatitis, a rapid loss of liver function known as acute liver failure that can be fatal.
The global impact of the virus remains significant. Figures from the World Health Organization estimate that 35,570 people died from hepatitis A globally in 2023, the latest data available. In the United States, the CDC reported 1,648 hepatitis A cases in 2023, though the agency estimates there may have been up to 3,300 total infections after accounting for underdiagnosis and underreporting. Health records show 85 hepatitis A-related deaths were reported in the US that year.
Prevention, vaccination, and treatment options
Medical providers emphasize that there is no specific cure or antiviral medication available to treat a hepatitis A infection once contracted. Clinical management relies on supportive care, including adequate rest, hydration, and proper nutrition while the immune system clears the infection.
To prevent transmission of hepatitis A, the CDC recommends vaccination against the virus, practicing good hygiene, avoiding sharing needles or syringes, and practicing safe sex. Public health experts stress that vaccination offers the most effective protection. The vaccine can be administered starting at age one as part of routine childhood immunization, consisting of two doses given between 12 and 23 months of age and separated by at least six months.
Adults who never received the vaccine in childhood can get it at any age. The CDC specifically recommends vaccination for individuals at increased risk, including people traveling to a country where the virus is more common, men who have sex with men, people who use drugs, unhoused individuals, and people with chronic liver disease or HIV. For an unvaccinated person who has been exposed to the virus, the vaccine can also be administered as post-exposure prophylaxis if given as soon as possible after exposure and within two weeks.
