HEPATITIS B

KEY POINTS

1. Hepatitis B is NOT easily acquired. It is a body fluid/bloodborne virus, and so vaccination is only considered in special travel circumstances,

a. When unsafe sex is practiced.

b. Where exposure to re-used, blood contaminated medical equipment and blood products for transfusion is possible through local medical care.

c. Where work assignment might expose one to wounds and body fluids of co-workers.

2. Blood tests can be done prior to vaccination to see if Hepatitis B vaccine is needed, or if the individual is already immune.

Disease: Inflammation of the liver by hepatitis B virus. Like hepatitis A, adults often (50%) are quite ill, but not children. Unlike hepatitis A, a substantial percentage of hepatitis B virus infections cause chronic disease and/or a lifelong virus carrier state, able to transmit the virus to others.

  1. Acute (short-term) Illness:

a. Fever

b. Poor Appetite

c. Muscle/Joint Aches

d. Abdominal Pain

e. Nausea

f. Diarrhea

g. Jaundice (yellow skin, eyes, urine)

h. Fatigue

i. Average incubation is 90 days (range 60-150 days).

j. Chronic Illness: Cirrhosis (liver damage)

k. Liver cancer

l. Death

m. Chronic Hepatitis B virus carrier (infectious to others)

Prevalence:

  1. Worldwide, but more so in developing countries

Transmission (Sources):

  1. Body Fluids (blood, sexual)

  2. Hepatitis B virus can live on a contaminated object up to 7 days (razor blades, toothbrushes, needles, etc).

  3. Blood transfusion products

Special Risk Groups

  1. Prolonged stay or frequent travelers

  2. New sexual contact(s) during trip

  3. High potential for medical or dental care in local facilities

  4. Travelers with underlying medical illness/conditions (especially liver disease)

  5. Traveling to obtain medical/dental services

  6. Adventure travelers

  7. Travelers using local public transportation extensively

  8. Travelers receiving tattoos, acupuncture, or body-piercing

  9. Healthcare workers

Treatment:

  1. Antiviral drugs for Hepatitis B virus

 Prevention:

1. Avoid casual (unprotected) sexual contact.

2. Use latex condoms and vaginal spermicidal jelly for intercourse.

3. Never share needles, razors, toothbrushes, or medical equipment, like diabetic blood lancets.

4. Avoid tattoos, body-piercing, acupuncture.

5. Avoid medical/dental care abroad, especially involving needles, IV lines, surgery, blood product transfusions.

6. Hepatitis B Virus Vaccine,

a. The Vaccine

i. 3 doses: day 1, day 30, then 6-12 months after 1st dose (there is an accelerated schedule, also).

ii. Optimally complete first 2 doses a month before travel.

iii. If suffering from a moderately severe illness, delay vaccination until recovered.

iv. Some hepatitis B virus vaccine products can cause reactions in those allergic to neomycin, yeast, aluminum, 2-phenoxyethanol, or formalin.

v. Possible side-effects (all uncommon and brief): Injection site soreness, fever, headache, nausea

vi. Targeted groups,

1. Solid organ transplant candidates

2. HIV positive

3. Mentally retarded who are institutionalized

4. Sexually polygamous

5. Healthcare workers or other jobs with body fluid exposure (first-responders)

6.Diabetics

Access the VIS Sheet here

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