Public Health Action In Response To A Case
HBV infection is a notifiable disease in the UK . Following notification, public health action aims to reduce the risk of onward transmission by providing prevention advice to the case and by identifying close contacts of the case who should be offered HBV testing and PEP as appropriate . Similar recommendations for the identification and management of contacts have been made in the USA .
Preventing Hepatitis A B & C
The three most common types of hepatitis, a disease characterized by inflammation of the liver, are those caused by the hepatitis A, B, and C viruses. All viral types are contagiousthat is, they can be spread from one person to anotheralthough the methods of transmission vary.
NYU Langone doctors recommend specific preventive steps for each type to limit your risk of acquiring or spreading infection.
Do I Need The Hepatitis B Vaccine
The hepatitis B vaccine is recommended for:
- All babies at birth
- Anyone under age 19 who didnt get the vaccine as a baby
- Adults who are at risk for hepatitis B
- Anyone who wants to protect themselves from hepatitis B
If you think you might be at risk for hepatitis B, talk with your doctor or nurse about getting the vaccine. Find out more about who needs to get the hepatitis B vaccine.
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Prevention Of Hbv Infection Hepatitis B And Nephropathy
After universal HBV immunization, the incidence of acute hepatitis B declined . Owing to breakthrough HBV infection from mother-to-infant transmission, vaccinated infants had higher rates of infection than those aged 114 yr , who had the lowest rates. After 25 years of universal HBV immunization in Taiwan, acute hepatitis B among adolescents and young adults 25 yr old was markedly reduced, rendering the previously unvaccinated 25- to 39-yr-old cohort additional targets for the prevention of acute hepatitis B .
The mortality associated with fulminant hepatitis in infants has also declined significantly . In addition, HBVMN in the vaccinated children also decreased drastically, very likely because of the reduction in horizontal transmission of HBV infection after universal HBV vaccination .
An 90% reduction of chronic HBV infection rate has been achieved after the HBV immunization program. We conducted serial seroepidemiologic surveys of HBV markers before and 5, 10, 15, and 20 years after the implementation of the vaccination program in Taipei, Taiwan . The HBsAg carrier rate decreased steadily from 10% before the vaccination program to 0.6%0.7% afterward in vaccinated children younger than 20 yr of age. The infection rate declined from 38% to 16% and further to 4.6% in children 1520 years after the program .
Can You Prevent Hepatitis
There are many ways to prevent hepatitis, from getting a vaccine to washing your hands well. But it all depends on what type you have. Here are some tips for preventing the three major kinds of this liver disease — hepatitis A, B, and C — and explanations of how one spreads in a different way.
How to prevent hepatitis A: You can get hepatitis A if you eat food or drink water that has the hepatitis A virus in it. You could also get infected if you’re in close physical contact with someone who has the disease or have sex with someone who has it.
The best way to prevent hepatitis A is to get a vaccine. Kids should get a shot around their first birthday.
As an adult, you should get the shot if you:
- Travel to Africa, Asia , the Mediterranean, Eastern Europe, the Middle East, Central and South America, Mexico, and parts of the Caribbean
- Use recreational drugs
- Work in a day-care center, nursing home, or you’re a health care professional
- Are a man who has sex with men
- Have long-term liver disease
- Take blood products to treat hemophilia or other conditions
If you’re planning a trip to a place where there are outbreaks of hepatitis A, keep in mind that the vaccine only starts to work 2 to 4 weeks after you get it. And if you want long-term protection, you’ll need a follow-up shot 6 to 12 months later.
If you haven’t had a hepatitis B shot as an adult, it’s important to get it if you:
- Live with someone who has hepatitis B
- Travel to a country with outbreaks of hepatitis B
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Juvenile Health Education And Release Planning
— counseled, along with their parent or guardian, regarding preventing transmission to household, sexual, and drug-use contacts — provided referral for hepatitis B vaccination of contacts — counseled regarding ways to reduce further liver damage, including limiting alcohol and drug use, and afforded substance-abuse treatment when appropriate and — provided aftercare that includes medical follow-up .
Antiviral Medication For Hepatitis B
Doctors may recommend antiviral medication for people with chronic hepatitis B, which occurs when the virus stays in your body for more than six months.
Antiviral medication prevents the virus from replicating, or creating copies of itself, and may prevent progressive liver damage. Currently available medications can treat hepatitis B with a low risk of serious side effects.
NYU Langone hepatologists and infectious disease specialists prescribe medication when they have determined that without treatment, the hepatitis B virus is very likely to damage the liver over time. People with chronic hepatitis B may need to take antiviral medication for the rest of their lives to prevent liver damage.
There are many different types of antiviral medications available, and your doctor recommends the right type for you based on your symptoms, your overall health, and the results of diagnostic tests. A doctor may take a wait-and-see approach with a person who has a healthy liver and whose blood tests indicate a low viral load, the number of copies of the hepatitis B virus in your bloodstream.
Someone with HIV infection or AIDS may have a weakened immune system and is therefore more likely to develop liver damage. The U.S. Centers for Disease Control and Prevention strongly recommends that people with HIV infection who are diagnosed with hepatitis B immediately begin treatment with antiviral medication.
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Is Hepatitis B Contagious
Hepatitis B is highly contagious. It spreads through contact with infected blood and certain other bodily fluids. Although the virus can be found in saliva, its not spread through sharing utensils or kissing. It also doesnt spread through sneezing, coughing, or breastfeeding. Symptoms of hepatitis B may not appear for 3 months after exposure and can last for 212 weeks. However, you are still contagious, even
To screen for hepatitis B, your doctor will perform a series of blood tests.
Hepatitis B Vaccine Development
In 1965, Baruch S. Blumberg reported a new antigen, the Australia antigen, in sera of patients with leukemia. He later discovered that the antigen is closely associated with a causal agent of viral hepatitis . Australia antigen was later found to be the hepatitis B surface antigen . Antibody to HBsAg was later shown to be a neutralizing antibody against HBV infection.
Currently, there are two kinds of HBV vaccines, a plasma-derived vaccine, the first-generation vaccine, and the recombinant vaccine, the second-generation vaccine. The recombinant vaccine was produced by expressing the HBsAg gene in the yeast Saccharomyces cerevisiae . Both are safe and effective.
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The Earliest Universal Hbv Mass Immunization Program
The first universal hepatitis B mass vaccination program in the world was launched in Taiwan in July 1984. Pregnant women were screened for HBsAg and then HBeAg. Infants of mothers negative for HBeAg or HBsAg received the plasma-derived hepatitis B vaccine only at 0, 1, 2, and 12 mo. The vaccine was shifted to a recombinant hepatitis B vaccine at 0, 1, and 6 mo after October 1992. The immunization program in the initial 2 years covered only infants of HBsAg carrier mothers. From the third year on, all of the infants were covered. Infants of highly infectious mothers with positive HBeAg received HBIG within 24 h after birth in addition to the hepatitis B vaccine. The coverage rate of hepatitis B vaccine for neonates was 94% in initial years, and was 99% recently. Catch-up vaccination was also given to preschool and then school children .
Duration Of Protection After Hbv Immunization In Infancy
Anti-HBs titers gradually decline with age in children immunized in infancy with hepatitis B vaccine, which is also seen in those who received a booster dose during childhood . In a prospective long-term follow-up study of 1200 HBV vaccinees in the general population , the annual new anti-HBc seropositive rate was low , and no new chronic HBV infection was detected. The decay rate of anti-HBs titer during age 716 yr was 20% of the titer of the previous year. Among the uninfected children who had anti-HBs < 10 mIU/mL, the boosted and nonboosted children developed new anti-HBc positivity at a similar rate, indicating that a vaccine booster at this age is not necessary .
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If I Have No Symptoms How Would I Know If I Have Hepatitis B
To confirm whether or not you have hepatitis B, you will need blood tests.
If you have at least one risk factor , you should ask your health care provider to be tested for hepatitis B. Also, you should be tested for hepatitis B if:
- you were born in a region where hepatitis B is more common, including Asia, Africa, southern and eastern Europe, the Pacific Islands, the Middle East, and the Arctic
- one or both of your parents immigrated from a region where hepatitis B is more common
- you live or travel to regions where hepatitis B is more common
- you have a family history of liver disease or liver cancer
- you have been in prison
- you are pregnant
- you have ever used injection drugs, even just once
- you have unexplained abnormal liver enzymes or if
- you receive medicines that suppress the immune system.
Prevention Of Mother To Child Transmission
PEP, initiated at birth, is recommended for all infants of HBV infected mothers . PEP using a combination of HBIG and an accelerated course of HBV vaccine has been shown to be effective in preventing perinatal HBV transmission in 90% of cases . Many countries, including the USA and the UK, have introduced routine antenatal screening of all pregnant women to identify HBsAg-positive mothers and maximize opportunities to prevent mother to child transmission of HBV infection .
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Transmission Route Of Hbv And Outcomes Of Hbv Infection At Different Ages
To prevent HBV infection effectively, it is crucial to understand its route of transmission. HBV infection is transmitted through either a horizontal route or through a mother-to-infant route. Mother-to-infant transmission was called vertical transmission in the past, but this term is less frequently used now because it caused confusion with genetic transmission, which does not occur with HBV. In endemic areas, perinatal mother-to-infant transmission is the most important route of transmission HBV infection is encountered mainly during infancy and early childhood.
Age at infection and source of infection affect the outcome of HBV infection . Without immunoprophylaxis, perinatal transmission from highly infectious hepatitis B carrier mothers results in chronic infection in 90% of their infants . In contrast, only 5% of infants of HBeAg-negative HBsAg carrier mothers become chronic carriers and a small fraction may develop acute or fulminant hepatitis B . Among 2- to 4-yr-old toddlers, 25% will become chronic carriers . In contrast, only 2.7% of the newly HBV-infected 18- to 19-yr-old university students became chronic carriers . Thus, the younger the age at infection, the higher the HBV carriage rate .
What Are Clinical Trials For Hepatitis B
Clinical trialsand other types of clinical studiesare part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future.
Researchers are studying many aspects of hepatitis B, such as
- progression of hepatitis B and long-term outcomes
- new treatments for hepatitis B
- prevention of reactivated or worsening hepatitis B in people receiving cancer treatment
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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.
How To Prevent Hepatitis B
This article was co-authored by Raj Vuppalanchi, MD. Dr. Raj Vuppalanchi is an Academic Hepatologist, a Professor of Medicine at Indiana University School of Medicine, and the Director of Clinical Hepatology at IU Health. With over ten years of experience, Dr. Vuppalanchi runs a clinical practice and provides care to patients with various liver disorders at the University Hospital in Indianapolis. He completed dual fellowships in Clinical Pharmacology and Gastroenterology-Hepatology at Indiana University School of Medicine. Dr. Raj Vuppalanchi is board certified in Internal Medicine and Gastroenterology by the American Board of Internal Medicine and is a member of the American Association for Study of Liver Diseases and the American College of Gastroenterology. His patient-oriented research is dedicated to finding new treatments for various liver disorders as well as the use of diagnostic tests for non-invasive estimation of liver fibrosis and portal hypertension .There are 11 references cited in this article, which can be found at the bottom of the page. This article has been viewed 25,560 times.
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How To Help Stop The Spread Of Hepatitis B
There are several things you can do to help stop the spread of this disease. Please follow these instructions until your doctor tells you the child with hepatitis is completely well:
- Good hand washing by all family members must be done. Hands should be washed using soap and warm water before meals, after using the bathroom and before preparing or serving food.
- Wash your hands after caring for your child. You may have come in contact with the hepatitis B virus from such things as changing diapers, cleaning up vomit, or exposure to blood.
- Wear disposable gloves when handling blood . Wash your hands after removing the gloves.
- Hepatitis B can be spread by sexual activity. Not having sex is the best way to keep Hepatitis B from being spread sexually. If an infected person has sex, a condom should be used every time. Condoms should be used until the doctor says there is no longer any risk of spreading the disease.
- All family members who are not infected should get Hepatitis B vaccines .
How Can You Avoid Hepatitis B
Getting the vaccine for hepatitis B is the best way to prevent hepatitis B. The hepatitis B vaccine is safe and effective. It is usually given as 3-4 shots over a 6-month period. You will not get hepatitis B from the vaccine. Ask your health care provider if you should get this vaccine. It is recommended for:
- All infants, starting with the first dose of hepatitis B vaccine at birth
- Everyone under the age of 19 who has not been vaccinated
- People whose sex partners have hepatitis B
- Sexually active people who are not in a long-term, faithful relationship
- People with a sexually transmitted disease
- People who share needles, syringes, or other drug-injection equipment
- People who have close household contact with someone infected with the hepatitis B virus
- Health care and public safety workers at risk for exposure to blood or body fluids on the job
- People with kidney disease. This includes all those on dialysis and those being considered for dialysis.
- Adults with diabetes
- Before anal sex
- Before oral sex
- Have sex with only one partner who does not have sex with others and does not have hepatitis B.
- Sterile tools
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Other Body Fluids And Tissues
Hepatitis B is found in semen and vaginal secretions. The virus can be transmitted during unprotected sexual intercourse, and from mother to infant during birth.
Synovial fluid , amniotic fluid, cerebrospinal fluid, and peritoneal fluid can contain the hepatitis B virus, but the risk of transmission to workers is not known.
Feces, nasal secretions, sputum, sweat, tears, urine, and vomit have not been implicated in the spread of hepatitis B. Unless they are visibly contaminated with blood, the risk of contracting hepatitis B from these fluids in the workplace is very low.
Hepatitis B is not transmitted by casual contact. For example, hospital employees who have no contact with blood, blood products, or blood-contaminated fluids are at no greater risk than the general public. However, the virus can spread through intimate contact with carriers in a household setting, possibly because of frequent physical contact with small cuts or skin rashes. The virus can also spread through biting and possibly by the sharing of toothbrushes or razors. It is not spread through sneezing, coughing, hand holding, hugging, kissing, breastfeeding, sharing eating utensils, water or food.