American health officials have issued a Level 1 travel advisory for U.S. citizens traveling to Manitoba, Canada, due to an outbreak of hepatitis A, a contagious liver infection. The Centers for Disease Control and Prevention (CDC) is urging travelers to practice usual precautions.
Since April 2025, Manitoba has reported 658 cases of hepatitis A, resulting in 142 hospitalizations, five intensive care admissions, and four deaths. The provincial capital, Winnipeg, has recorded 143 cases among its nearly 850,000 residents.
Hepatitis A is typically spread through the ingestion of microscopic amounts of fecal matter from an infected individual, often via contaminated food or drinks handled by an infected person who did not wash their hands properly. Close personal contact, such as sharing a household or engaging in sexual activity with an infected person, as well as sharing needles, can also contribute to its spread. The virus does not spread through casual contact like coughing or sneezing.
The disease has an incubation period of approximately 28 days, meaning infected individuals can unknowingly transmit the virus for nearly a month before symptoms manifest. While some cases are asymptomatic, symptoms can include weakness, nausea, vomiting, diarrhea, abdominal pain, dark urine, clay-colored stools, itching, and jaundice, which are indicators of liver damage.
While most individuals recover without specific treatment, severe cases can lead to fulminant hepatitis, a rare but dangerous form of liver failure where the liver cannot filter toxins from the blood, leading to their buildup in vital organs like the brain. Older individuals and those with compromised immune systems are at higher risk for more severe illness.
The CDC recommends that travelers to Manitoba practice diligent handwashing, avoid sharing needles or syringes, and use condoms during sexual activity. Vaccination against hepatitis A is also advised. In the United States, the vaccine is typically administered in two doses to children between 12 and 23 months old. Canadian vaccination schedules differ slightly.
Health authorities advise travelers to seek immediate medical attention if they experience symptoms such as dark or clay-colored stools, diarrhea, fatigue, fever, joint pain, loss of appetite, nausea, abdominal pain, or jaundice during or after their trip to Manitoba.