It is possible to become infected with the hepatitis A virus without ever leaving Canada. Cases of hepatitis A have occurred in private households, daycare centers, neonatal intensive care units and chronic care hospitals. Outbreaks of hepatitis A have occurred as a result of contaminated food and water supplies. Infection can also occur by consuming certain foods, such as raw shellfish, foods washed in contaminated water or uncooked foods prepared by an infected food handler. It is also possible to be infected with hepatitis A via blood transfusions and from needles shared with an infected person. Cases of sexually transmitted hepatitis A have also been reported.