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Hepatitis B

DEFINITION:

A viral infection infecting the liver.

SYMPTOMS:

Symptoms may be absent at first, but will eventually appear. When present, symptoms include nausea, vomiting, abdominal pain, joint pain, yellow eyes and skin (jaundice), decreased appetite and lethargy.

CAUSES:

A virus.

CONTAGION:

This virus is contagious. A newborn infant can catch it during birth from an infected mother. It is also acquired by exposure to infected people through sexual contact, exposure to blood or body fluids, or sharing of needles in people who use intravenous drugs. The incubation period for this virus is two to five months.

DIAGNOSIS:

Jaundice is usually the first sign of a hepatitis infection. Sometimes a rash or joint pain may accompany this. A blood test can confirm the diagnosis.

TREATMENT:

This is a virus and therefore there is not a cure. Once this illness is diagnosed, the therapy is supportive. Fluids for dehydration, medicines to keep removing toxic substances that the liver cannot manage anymore, blood transfusions for blood loss, and pain medications are the only ways to help alleviate the symptoms.

OUTCOME:

Poor outcome. Over decades it can lead to cirrhosis of the liver, cancer of the liver, liver failure and eventually death.

DISCUSSION:

Hepatitis B is a devastating illness. There is no cure and therapy is minimal. The illness can go on for years before any symptoms develop which can allow the virus to be transmitted even more. Every year, 10,000 people are hospitalized in the United States with Hepatitis B and 400 people a year die from it. Hepatitis B is the second-most common cause of cancer after cigarette smoking. Once exposed, the incubation period is two to five months. Symptoms will develop at some point after that, but it can be decades. The only way to combat this illness is through prevention. Prevention is through vaccination. The Hepatitis B vaccine has been given over twenty-five million times since 1990. Side effects are extremely rare and usually mild. Prior to 1990 the vaccine was produced from using blood products of infected individuals and purifying the product so that only the immunity to Hepatitis B would be transmitted. However, due to fear of using blood products, a completely new and totally safe vaccine was made by genetic engineering using no blood products at all. At this time the recommendations for Hepatitis B vaccine expanded. Prior to 1990 the vaccine was recommended only for high-risk individuals including intravenous drug users, sexually promiscuous people, healthcare workers and people exposed to known carriers. This recommendation failed and many new cases of Hepatitis B developed. Once the new vaccine was developed, the recommendation changed to include all newborns and adolescents. Now the incidence of Hepatitis B is finally decreasing. Unfortunately about 20,000 women a year in the United States are infected with Hepatitis B when they are giving birth. If untreated, 90% of these infants will contract the illness. By using the vaccine, the transmission to the infant can be stopped. Also, about 40-50% of people who contract Hepatitis B have no idea where they got it. So universal vaccination is the only way to put the stop to this illness. The vaccine can be given according to a wide range of acceptable schedules. The first vaccine can be given from birth to two months of age, the second from one-month to six-months of age and the third, from six-months to eighteen-months of age. There must be at least one month between the first and second injection, two months between the second and third injection and four months between the first and third injection. For infants born to a Hepatitis B positive mother or for people exposed to a carrier, Hepatitis B immunoglobulin can give temporary immunity. The vaccine can then be given to afford permanent immunity. The schedule for exposed people is zero, one and six months for the three doses of vaccine.

ONE DOCTOR'S OPINION:

Vaccination is so important to combat this illness. People may ask why we vaccinate babies if the mother is negative. The answer is three-fold. First, blood tests are not 100% accurate so why take the chance. Second, many babies get the illness from an unknown carrier, since not everyone with the illness has symptoms. Third, the vaccine has been proven in all well-controlled studies to be safe and effective. If anyone doubts the importance of this vaccine, find a child with this illness and your mind will be changed forever. Most of the other vaccines are to prevent acute short-term illnesses that if you survive the acute illness, you'll do well. Only the Hepatitis B and Polio vaccines prevent chronic illnesses that can go on for years and make your life miserable. There is no good reason to withhold this important vaccination. Vaccinate for Hepatitis B immediately.