How common is hepatitis A virus (HAV) transmission in hospital settings?

Hospital-acquired HAV infection is rare. In the past, outbreaks were observed in neonatal intensive care units when infants acquired infection from HAV-infected transfused blood and subsequently transmitted HAV to other infants and staff. Outbreaks of hepatitis A caused by transmission from adult patients to healthcare personnel (HCP) are typically associated with fecal incontinence and inadequate hand hygiene, although the majority of hospitalized patients who have hepatitis A are admitted after onset of jaundice, when they are beyond the point of peak infectivity. Transmission in healthcare settings also has resulted from breakdowns in standard infection control practices and transmission from one healthcare provider to another.