This form of hepatitis is caused by an RNA virus that is transmitted person-to-person via the fecal-oral route. This may occur through water, food or close personal/sexual contact. Most children and about 50% of adults have few, if any, symptoms. Symptoms, when present, are initially flu-like, with malaise, fatigue, muscle pain and chest pain on the right side lasting 3 to 10 days. This is followed (for 1 to 3 weeks but possibly much longer) by jaundice (slight skin yellowing), anorexia, nausea, fatigue, pale stools, dark urine and liver enlargement, but usually no fever.