Viral hepatitis is a disease caused by a virus that infects the liver. There are many types of viral hepatitis, the most common being hepatitis A, B and C. Currently a vaccine is only available against Hepatitis A, B but there is no vaccine to protect against Hepatitis C disease. It is important to understand the mode of transmission and how best to avoid acquiring these viruses.
The Hepatitis A and B vaccine are so important that all children in the US are now given these two vaccines as part of their childhood vaccination. However, most adults who did not receive them in childhood may consider receiving them, especially if they are traveling international to developing countries or, often, as part of the requirements of entering the health and medical field.
Vaccination is the Best way to prevent getting Hepatitis A and B.
Hepatitis A Virus (HAV) is spread through contaminated food and water. It is rarely fatal but can cause severe disease and loss of work lasting anywhere from a few days to over a month.
HAV is spread through the “fecal-oral” route. Typically someone who is infected with HAV does not wash their hands after using the toilet and then prepares uncooked food or an unchlorinated community water source. The virus can live outside the body for several days waiting to be eaten by another person. It then invades the intestinal lining and settles in the liver where it reproduces.
After 3-6 weeks HAV has reproduced in the liver causing inflammation and dysfunction. The infected person becomes yellow (jaundiced), nauseous and generally low on energy and feels sick. The liver can be enlarged and easily bruised or traumatized. Even before symptoms occur a person can transmit the virus; transmission can continue during the symptomatic period. Once the disease is resolved a person is generally immune for life.
The best way to prevent Hepatitis A is to get vaccinated. The vaccine is given on day 0 and again 6 months later. If not vaccinated, risk can be reduced by drinking only boiled water and eating food that is well cooked while traveling. Hepatitis A can also be transmitted by sexual intercourse involving the anus and mouth. This should be avoided if one is not immunized.
Download pdf for hepatitis A HERE
Hepatitis B Virus (HBV) is a disease spread through human blood and body fluids.
It is thought that that virtually any body fluid from an infected person can contain (shed) HBV such as: perspiration, urine, semen, mucous, blood and more. In order to become infected the virus must come in contact with a mucous membrane, usually one that is inflamed or otherwise compromised, or broken skin, or somehow be injected into the blood stream commonly via a needle ( Tattoo, IV Drug use, unclean hospital practice, etc). The virus finds it’s way to the liver where it is able to infect liver cells and multiply. Approximately 5% of people infected with HBV are never able to clear the infection from their body and become Chronic Carriers of the disease and often die within a few years from liver disease depending upon treatment and response.
Once a person becomes infected they usually do not fall ill or show signs of disease anywhere between 6 weeks to 6 months. During this incubation time the infected person is capable of shedding the virus even though they do not feel ill. At one point the viral load in the liver becomes extensive and the liver becomes inflamed and painful. The person becomes jaundiced (turns yellow) and can have multiple organ dysfunctions. At this point the person can die from acute liver failure. Generally, most people survive the disease and become immune to further infection. However, about 5% never get rid of the virus which continues to live and destroy liver cells. These people are termed Chronic Active carriers of HBV and require medical treatment to contain the virus. In some cases the virus cannot be contained and the person may suffer early death from chronic liver failure (cirrhosis) or liver cancer.
HBV can be prevented by protecting oneself from contact with the virus. Measures of protection include:
Despite all best efforts, exposure to blood and body fluids still occurs. That is why optimum protection is to become vaccinated against HBV. The vaccine is administered in 3 doses starting on day 0 then 1 month and 4-6 months later. For most people this 3 dose regimen is enough. Some occupations require proof of immunity after vaccination.
A blood test for the antibody to the surface antigen of HBV (anti-HBs) can be done by virtually any laboratory for a reasonable price. If the anti-HBs antibody is negative after the first 3 doses, the entire 3 dose series should be repeated. If it is still negative a final single dose of the vaccine is given and no further attempts at proving immunity are currently recommended. This does not necessarily mean the person is NOT immune to HBV; but rather, a precise determination cannot be made by current lab methods.
People with the following conditions should either postpone or not get the HBV vaccine:
Download pdf for hepatitis B HERE
(no vaccine available)
Infection with Hepatitis C Virus (HCV) can be similar to that of Hepatitis B above with the following exceptions:
At this point in time HCV is far less as widespread as HBV. However the frequency with which HCV becomes a chronic active case (>60%) is much higher than HBV and carriers of HCV are much more likely to be unaware that they have a disease! Currently, there is no vaccine against Hepatitis C, and treatments to control the disease are extremely limited and expensive.
Persons with acute HCV infection typically are either asymptomatic or have a mild clinical illness; 60%-70% have no discernible symptoms; 20%-30% might have jaundice; and 10%-20% might have nonspecific symptoms (e.g., anorexia, malaise, or abdominal pain). The average time period from exposure to symptom onset is 6-7 weeks, whereas the average time period from exposure to detection in the blood is typically 8-9 weeks. Rarely, seroconversion might be delayed until 9 months after exposure.
The only tests currently approved by the U.S. Food and Drug Administration (FDA) for diagnosis of HCV infection are those that measure antibody (anti-HCV) that your body has made against the virus. These tests detect anti-HCV in greater than or equal to 97% of infected patients, but do not distinguish between acute, chronic, or resolved infection.
CDC is recommending that everyone born during 1945 through 1965, also known as baby boomers, get a blood test for Hepatitis C. This recommendation calls for one-time testing of baby boomers.
Download pdf for hepatitis C HERE
Currently we can check your blood titers for Hepatitis A and B
Titers are blood tests that check your immune status to vaccinations you may have received in the past. If your titers results are positive, it means that you have received the vaccine in the past and have adequate immunity to a particular infectious disease. Therefore, you do not need to get that particular vaccine.
For more info on blood titers please go to Bloodtiter.com
The Vaccine Center and Travel Medicine Clinic has ALL the recommended and/or required vaccines needed for your travel:
|Hepatitis B||TD/Tdap (Tetanus)|
|Hepatitis A/B||Typhoid IM|