What Should You Know About Hepatitis B Before You Travel
Hepatitis B is quite common in China and other Asian countries, where as many as 1 in 12 people have the virus, though many dont know it. Before traveling to those places, you should make sure youve been vaccinated against the virus.
In addition to getting the vaccine, you can take these additional precautions to reduce your risk of contracting the virus:
- Refrain from taking illegal drugs.
- Always use latex or polyurethane condoms during sex.
- Make sure new, sterile needles are used during all piercings, tattoos and acupuncture sessions.
- Avoid direct contact with blood and bodily fluids.
- Know the HBV status of all your sexual partners.
- Ask your doctor about possible vaccination before you travel to a place where hepatitis B is common.
A note from Cleveland Clinic
Hepatitis B is a liver disease that can cause serious damage to your health. One reason that is dangerous is that it can easily go undetected for years while damaging your liver. Talk with your healthcare provider about being tested for hepatitis B if you have any reason to believe that you were not vaccinated or if you have engaged in risky behavior. If you do test positive, follow the directions from your healthcare provider so that you can live a longer, healthier and happier life.
Last reviewed by a Cleveland Clinic medical professional on 07/09/2020.
References
How Is Hepatitis B Diagnosed
There are three main ways to diagnose HBV infection. They include:
- Blood tests: Tests of the blood serum shows how your bodys immune system is responding to the virus. A blood test can also tell you if you are immune to HBV.
- Abdominal ultrasound: An ultrasound uses sound waves to show the size and shape of your liver and how well the blood flows through it.
- Liver biopsy: A small sample of your liver tissue is removed though a tiny incision and sent to a lab for analysis.
The blood test that is used to diagnose hepatitis B is not a test that you get routinely during a medical visit. Often, people whove become infected first learn they have hepatitis B when they go to donate blood. Blood donations are routinely scanned for the infection.
The virus can be detected within 30 to 60 days of infection. About 70% of adults with hepatitis B develop symptoms, which tend to appear an average of 90 days after initial exposure to the virus.
Is There A Cure For Chronic Hepatitis B
Currently, there is no complete cure for hepatitis B. But when managed properly, those living with the virus can expect to live a normal life. Maintaining a healthy diet and avoiding alcoholic beverages and tobacco products are crucial components in managing the disease.
You should also visit a doctor familiar with hepatitis B at least annuallythough twice a year might be best to monitor your liver through blood tests and medical imaging. As with most diseases, detecting it early leads to a better outcome. If youre exposed to the virus, you should get an antibody injection within 12 hours of exposure.
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What Should You Know About Pregnancy And Hepatitis B
A pregnant woman who has hepatitis B can pass the infection to her baby at delivery. This is true for both vaginal and cesarean deliveries.
You should ask your healthcare provider to test you for hepatitis B when you find out you are pregnant. However, while it is important for you and your healthcare provider to know if you do have hepatitis B, the condition should not affect the way that your pregnancy progresses.
If you do test positive, your provider may suggest that you contact another healthcare provider, a liver doctor, who is skilled in managing people with hepatitis B infections. You may have a high viral load and may need treatment during the last 3 months of your pregnancy. A viral load is the term for how much of the infection you have inside of you.
You can prevent your infant from getting hepatitis B infection by making sure that your baby gets the hepatitis B vaccine in the hours after they are born along with the hepatitis B immunoglobulin. These two shots are given in two different locations on the baby. They are the first shots needed.
Depending on the type of vaccine used, two or three more doses must be given, usually when the baby is 1 month old and then 6 months old, with the last by the time the baby is 1 year old. It is critical that all newborns get the hepatitis B vaccination, but even more important if you have hepatitis B yourself.
What Are The Symptoms Of Hepatitis B And C
In most patients, hepatitis B develops slowly over the course of several decades, and thus most patients have no symptoms. People who have advanced liver disease such as cirrhosis of the liver may experience complications and symptoms that reflect liver failure. Other symptoms include:
- A buildup of fluid within the abdominal cavity
- Confusion and tremors , which are complications due to the inability of the liver to filter out toxins that are normally cleaned out by a healthy liver
- Vomiting of blood, or blood within the stool . This is a complication in which enlarged veins within the esophagus or stomach bleed as a consequence of increased pressure around the diseased liver.
Most patients with chronic hepatitis C infection report no symptoms. But some patients may have very nonspecific symptoms related to fatigue and discomfort on the right side of the abdomen. Often, symptoms that lead to a diagnosis of hepatitis C are noticeable only at the end stage of liver disease, when the patient has developed liver cirrhosis and liver failure.
Because hepatitis B and C typically have no specific symptoms, many people who have the viruses dont even know it.
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How Do You Get Hepatitis A
The main way you get hepatitis A is when you eat or drink something that has the hep A virus in it. A lot of times this happens in a restaurant. If an infected worker there doesn’t wash their hands well after using the bathroom, and then touches food, they could pass the disease to you.
Food or drinks you buy at the supermarket can sometimes cause the disease, too. The ones most likely to get contaminated are:
- Shellfish
- Ice and water
You could catch or spread it if you’re taking care of a baby and you don’t wash your hands after changing their diaper. This can happen, for example, at a day care center.
Another way you can get hep A is when you have sex with someone who has it.
Is Hepatitis Testing Recommended For People With Hiv
Yes. Everyone living with HIV should be tested for HBV and HCV when they are first diagnosed with HIV and begin treatment. People living with HIV who have ongoing risk factors for getting hepatitis B or hepatitis C should be tested annually.
In addition, new HCV screening recommendations from the Centers for Disease Control and Prevention call for:
- One-time screening for all adults 18 years and older
- Screening of all pregnant women during every pregnancy
- Testing for all persons with risk factors, with testing continued periodic testing those with ongoing risk.
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What Are The Risk Factors For Getting Hepatitis B
Due to the way that hepatitis B spreads, people most at risk for getting infected include:
- Children whose mothers have been infected with hepatitis B.
- Children who have been adopted from countries with high rates of hepatitis B infection.
- People who have unprotected sex and/or have been diagnosed with a sexually transmitted infection.
- People who live with or work in an institutional setting, such as prisons or group homes.
- Healthcare providers and first responders.
- People who share needles or syringes.
- People who live in close quarters with a person with chronic hepatitis B infection.
- People who are on dialysis.
Where Is The Hepatitis B Virus Found And How Is It Transmitted
Blood is the major source of the hepatitis B virus in the workplace. It can also be found in other tissues and body fluids, but in much lower concentrations. The risk of transmission varies according to the specific source. The virus can survive outside the body for at least 7 days and still be able to cause infection.
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How Does It Affect The Body
The incubation period for hepatitis B can range from . However, not everyone who has acute hepatitis B will experience symptoms.
About 95 percent of adults completely recover from hepatitis B. However, hepatitis B can also become chronic.
The risk of chronic hepatitis B is greatest in those who were exposed to HBV as young children. Many people with chronic hepatitis B dont have symptoms until significant liver damage has occurred.
In some people whove had hepatitis B, the virus can reactivate later on. When this happens, symptoms and liver damage may occur. People with a weakened immune system and those being treated for hepatitis C are at a higher risk for HBV reactivation.
Can Hepatitis B And C Be Prevented
Today, all babies get vaccinated against the hepatitis B virus in a series of three shots over a 6-month period. Doctors also recommend “catch-up” vaccination for all kids and teens younger than 19 years old who didn’t get the vaccine as babies or didn’t get all three doses.
Unfortunately, there’s no vaccine for hep C yet.
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Poor Infection Control For Tattooing And Piercing
The notes that HCV may be transmitted by receiving tattoos or piercings from unregulated settings with poor infection control standards.
Commercially licensed tattooing and piercing businesses are generally thought to be safe.
More informal settings may not have adequate safeguards to help avoid the spread of infections. Receiving a tattoo or piercing in settings such as in a prison or in a home with friends carries a of HCV transmission
How Is Hepatitis B Prevented
Testing & Vaccination
- The hepatitis B vaccine offers excellent protection against HBV. The vaccine is safe and highly effective. Vaccination consists of 3 doses of vaccine over the course of 6 months. Protection lasts for 20 years to life.
- The American Academy of Pediatrics recommends that all children should receive hepatitis B vaccine starting at birth. .
- The CDC recommends hepatitis B vaccine for persons traveling to countries where HBV is common .
- If you have one or more risk factors for hepatitis B infection, you should get a simple HBV blood test. The blood test will determine whether you are:
- immune to hepatitis B or
- susceptible to hepatitis B and need vaccination or
- infected with hepatitis B and need further evaluation by a physician
Perinatal Hepatitis
- California law requires testing of all pregnant women for hepatitis B infection
- If the mother is HBV-infected, she will pass the infection to the baby during the birth process, unless the baby gets immunized within hours of birth
- Giving the infant HBIG and HBV vaccine right away will reliably prevent infection of the infant
- Other family members should best tested for hepatitis B too, and given vaccine if they are not already infected or immune
Healthy Habits
After Exposure to Hepatitis B
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How Serious Is It
- People can be sick for a few weeks to a few months
- Most recover with no lasting liver damage
- Although very rare, death can occur
- 15%25% of chronically infected people develop chronic liver disease, including cirrhosis, liver failure, or liver cancer
- More than 50% of people who get infected with the hepatitis C virus develop a chronic infection
- 5%-25% of people with chronic hepatitis C develop cirrhosis over 1020 years
Whos At Risk For Hepatitis C
You might be more likely to get it if you:
- Inject or have injected street drugs
- Were born between 1945 and 1965
- Got clotting factor concentrates made before 1987
- Received a blood transfusion or solid organ transplants before July 1992
- Got blood or organs from a donor who tested positive for hepatitis C
- Are on dialysis
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What Is Hepatitis B
Hepatitis B is caused by a virus that infects the liver. It is one of the most common vaccine-preventable diseases affecting travellers and can cause either acute or chronic infection.
About 90 to 95 percent of adults with acute hepatitis B infection will clear the virus on their own within six months, and develop lifelong protection against it.
Some people are unable to clear the virus, and develop chronic hepatitis B. Untreated chronic hepatitis B can later develop into serious health problems. Children under four years old are at particular risk of chronic hepatitis B, because only up to 10% will clear the virus.
How Common Is Hepatitis B
Hepatitis B is fairly common in Africa and the western Pacific region. Throughout the world, there are about 292 million people who are infected with chronic hepatitis B. In the U.S., the figure exceeds 2 million people.
The number of infections had been falling in the U.S., but fewer vaccinations among adults combined with the onset of the opioid crisis and injected drug usage has resulted in the numbers rising again. Infected women can pass the infection on to their babies. Children who are infected before age 5 are more likely to have chronic infection than those infected later in life.
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Hepatitis B: How Does It Spread
You can get it through contact with the blood or body fluids of an infected person. In the U.S., it’s most often spread through unprotected sex. It’s also possible to get hepatitis B by sharing an infected person’s needles, razors, or toothbrush. And an infected mother can pass the virus to their baby during childbirth. Hepatitis B is not spread by hugging, sharing food, or coughing.
Keep Personal Items Personal
Any tools or implements that may have a bit of blood on them from infected people are potential sources of hepatitis B or C transmission. Toothbrushes, nail clippers, razors, needles, and washcloths may all contain trace amounts of blood that can transmit infection. Keep personal items such as these to yourself and never use personal items that belong to others.
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What Occupations Have Increased Risk Of Hepatitis B
In general, occupational groups with increased risk include:
- Health-care workers repeatedly exposed to blood or blood products or those who are at risk of needlestick injury.
- Pathologists, laboratory personnel, or embalmers.
- Dentists, dental assistants, and dental hygienists.
- Certain staff members of institutions for the developmentally handicapped.
- Staff of institutions where workers may be exposed to aggressive, biting residents.
Travellers to regions with intermediate or high rates of endemic HBV infection may also consider being vaccinated.
What Treatments Are Available For Chronic Hepatitis B If Medications Dont Work
If you have advanced hepatitis B, you might also become a candidate for a liver transplant. This path does not always result in a cure because the virus continues in your bloodstream after a transplant. To prevent being infected again after your transplant, you may be prescribed hepatitis B immunoglobulin with an antiviral agent.
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Acute Vs Chronic Infection
Doctors distinguish between chronic and acute infection with hepatitis viruses. Acute infection is a short-term condition, lasting under six months. Chronic infection is a long-term condition, lasting more than six months.
Hepatitis B infection can be either acute or chronic. Most people who get acute hepatitis B dont end up progressing to chronic hepatitis B. By contrast, acute hepatitis C tends to develop into chronic hepatitis C. Approximately 7585 percent of adults newly infected with hepatitis C develop a chronic infection, according to the CDC . Others clear the infection.
When you get acute hepatitis C you may or may not have symptoms. Most cases of acute hepatitis C are asymptomatic, meaning people dont notice the symptoms. Symptoms are only noticeable in 15 percent of cases of acute hepatitis C.
Complications Of Hepatitis B
A small proportion of people who become infected with the hepatitis B virus develop a long-term hepatitis B infection. They may have the virus in their bloodstream for most of their life without realising they are infected.
People with chronic hepatitis B infection may not notice any health problems until they develop liver problems such as liver disease or liver cancer later in life. Treatment for hepatitis B is essential because it is not possible to be a healthy carrier of the hepatitis B virus. Chronic hepatitis B infection occurs more commonly in some communities, including:
- Aboriginal and Torres Strait Islander communities.
- In people from parts of the world where hepatitis B is more common, such as:
- North-East Asia
- Sub-Saharan Africa.
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Can You Be A Blood Or Organ Donor
People with hepatitis C cant currently donate blood. The American Red Cross eligibility guidelines prohibit people who have ever tested positive for hepatitis C from donating blood, even if the infection never caused symptoms.
According to the Department of Health and Human Services , information on organ donation, those with underlying medical conditions shouldnt rule themselves out as organ donors. This reflects new guidelines for organ donation announced by the HHS.
People with HCV are now able to be organ donors. This is because advances in testing and medical technology can help the transplant team determine which organs or tissues can be safely used for transplantation.