Hepatitis B is a disease caused by the Hepatitis B Virus (HBV) and affects the liver. Hepatitis B is preventable. The virus is transmitted from human to human through several means including unprotected sex, shared needles, tattoos/body piercings, blood transfusions and medical/dental procedures to name a few. Infected women giving birth naturally can pass the infection onto their infants during delivery. If left untreated, (chronic) Hepatitis B can cause cirrhosis, liver cancer and liver failure. HBV is most prevalent in Southeast Asia, China, parts of the Middle East, Southern and Western Pacific and the Amazon River Basin in South America. Unprotected sexual encounters, the sharing of drug paraphenalia (needles/syringes), tattooing/piercings and medical procedures account for the greatest number of HBV infections among travelers.
*This precautionary statement is made only for the purpose of preventing HBV transmission and is not one condoning the use of recreational drugs.
The Hepatitis B vaccine provides greater than 90% immunity to the disease and is given as a series of three injections on days 0, 30 (1 month) and 180 (6 months). The immunizations have been shown to be effective up to 15 years duration. The vaccine becomes fully effective over a four week period. People planning to travel before fully immunized should consider receiving an immune globulin injection before embarking on their travels. Immune globulin boosts the immune system and lowers the infection rate if exposed. Those traveling to endemic areas regularly or are at greater risk should receive a booster at 1-2 years following the initial injections.
Currently, a combination vaccine (Twinrex®) can be given to persons 18 years of age and over. Twinex® has been shown to provide protection against both Hepatitis A & B, and is considered as effective as both vaccines when each is administered separately.
Hepatitis B has a long incubation period and ranges from 1-6 months. During this time, the virus can be spread to others. Approximately 30% of all patients infected with HBV will not develop symptoms of the disease. Infants and children are less likely to display symptoms, than are adults, and are at a much higher risk of developing chronic (long-term) Hepatitis B infection.
Symptoms of HBV can be mild to severe and include weakness/fatigue, loss of appetite, nausea, vomiting, abdominal pain (with possible localization around the liver), "orange/brown" urine, jaundice and joint pain. Not all patients will display all symptoms.
Persons who have traveled to areas where Hepatitis B is endemic or think they have been in contact with an infected individual(s) should request testing for HBV. Diagnosis of Hepatitis B in the asymptomatic patient can only be achieved through laboratory blood work.
Persons who know they have been exposed to HBV within the last 24 hours should seek immediate medical attention and received Hepatitis B immune globulin and the first of the three vaccine injections. Such action may prohibit the development of the disease.
Patients with acute symptoms of the disease will be treated symptomatically. At this time, there is no treatment for acute Hepatitis B infections.
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