Source: https://medasend.com/hepatitis-b-workplace-vaccination/
In high endemic areas like Malaysia and the rest of East Asian countries – the main mode of transmission is spread from mother to child at birth or from person to person in early childhood. Besides through sex and sharing infected needles, you can also get Hep B through blood transfusions, sharing personal items like a shaver or a toothbrush or direct contact with an open wound.
That means – it can infect anyone!
The hepatitis B virus can survive outside the body through contact with infected human body fluids for at least seven days. During this time, the virus can still cause infection if it enters the body of a person who is not protected by the vaccine. The hepatitis B virus by itself is not spread by contaminated food or water and cannot be spread casually in the workplace or daycare center.
2. I feel healthy so I could not possibly have Hep B
Most people do not experience any symptoms during the acute infection phase. However, some people have acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.
In some people, the hepatitis B virus can also cause a chronic liver infection that can later develop into cirrhosis of the liver or liver cancer.
More than 90% of healthy adults who are infected with the hepatitis B virus will recover and be completely rid of the virus within six months.
3. Since most people recover – I do not have to worry as it is harmless. Most people who gets is do not get sick anyway.
But if you are the unlucky few who develops chronic disease – it can cause liver cancer and liver cirrhosis which can be deadly.
Do you know that 15–25% of adults who become chronically infected with Hepatitis B during childhood die from hepatitis B-related liver cancer or cirrhosis.
4. I don’t need to get screening if I don’t do drugs or out of wedlock sex.
See no. 1 – anyone can get infected. But if you are pregnant with Hepatitis B – it is very important for you to get screened so we can give you medicine before you deliver your child to reduce the risk of you infecting your child. Even if the mother does not have Hepatitis B, the baby should be offered with Hepatitis B vaccination as they can still get infected by people close to her like a caretaker or other family members.
Why is this important? Majority of children who become infected with the hepatitis B virus at birth or during early childhood (less than 6 years) are the ones most likely to develop chronic infections and develop liver failure or cancer.
Source: http://www.webmd.com/hepatitis/ss/slideshow-hepatitis-overview
Do you know that in Taiwan, after they started their infant Hepatitis B vaccination program – the incidence of childhood liver cancer dropped dramatically. That means insted of causing cancer – they actually reduce incidence of cancer.
Read more here
Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. Taiwan Childhood Hepatoma Study Group.
http://www.ncbi.nlm.nih.gov/pubmed/9197213
6. I was vaccinated at birth – I am forever immune to Hepatitis B
Once vaccinated – more than 95% of infants, children and young adults develops immunity towards Hepatitis B. Protection lasts at least 20 years and is possibly lifelong.
Unfortunately for a small percentage of people, they do not develop enough immunity with usual dose of the vaccination. They are called poor responders. If you are someone who have high risk of contracting Hepatitis B (health care worker, patients on dialysis, hemophiliacs etc) – you can check your Hepatitis antibody level to see if you are immune or not. If it is low, you can opt for revaccination or a booster dose of Hepatitis B vaccination.
7. I am a medical student. If I get needle prick injury – I worry about getting HIV more than Hepatitis B.
You have higher chance of getting Hepatitis B rather than HIV during a needle prick injury. The risk of transmission after exposure to HIV-infected blood is about 0.3%, whereas it is estimated to be up to 100 times greater for hepatitis B virus (30%) and could be as high as 10% for hepatitis C virus.
8. My friend has chronic Hepatitis B. I should not be close to him anymore.
It is important to understand that hepatitis B is not spread through sharing food or water, sharing eating utensils or drinking glasses, casual contact, coughing or sneezing, hugging or kissing and breastfeeding. There is no reason to distance oneself from an individual infected with the hepatitis B virus. Individuals living with chronic hepatitis B should not be excluded from work, school, or other daily activities.
Source: http://agreport365.com/causes-prevention-hepatitis-b/
If your hepatitis B result had been positive for longer than six months, this suggests that you have a chronic (long-lasting) hepatitis B infection. Most people with chronic hepatitis B can live a normal life. However, it is important to know what to do to avoid infecting others – you should inform your close ones (family members and sex partners) so that they can get vaccinated to protect themselves.
There is treatment for Hepatitis B but not all infected people needs to be treated. In chronic Hepatitis B patients – some virus lies dormant and do not attack the liver. Some people however has very active virus which replicates inside their body in high numbers while attacking your liver. People who have high level of Hepatitis B virus and/or have damaged liver because of Hepatitis B should be seen by a liver specialist and get antiviral treatment.
The treatment does not cure you of Hepatitis B. They actually suppress the virus activity in your body, stop them from replicating and slow down the virus damage to the liver. Also, the doctor will monitor your liver function and screen you for complications such as liver cancer.
Other things you can do after getting Hepatitis B
– Avoid alcohol consumption or other medications that can damage liver.
– Adopt a low fat healthy diet. Exercise and aim to keep a healthy weight range.
– Stop smoking.
– Have protected sex (use a condom!)
-Take great care of cuts and wounds (make sure you clean after any blood spillages)
– tell your family to get vaccinated!
10. I have Hepatitis B and to avoid infecting the baby, I should not be breastfeeding my child.
Despite there is presence of Hepatitis B virus in the breast milk, a Hepatitis B infected mother can breastfeed their child provided that the baby get a shot called H-BIG and a shot of hepatitis B vaccine within 12 hours after birth. Hepatitis B is not transmitted through breast milk! But the mother need to take good care of their nipple areas to prevent sores,cracking and bleeding.
All women with hepatitis B are encouraged to breastfeed their babies since the benefits of breastfeeding outweigh the potential risk of transmitting the virus through breast milk
However if you are currently taking antiviral medication for hepatitis B like entecavir/lamivudine etc, it is generally recommended NOT to breastfeed while on the medication. This is because the medication is secreted in breast milk and overall safety in newborns are not well established
*This article is dedicated in memory of Hepatitis B patients who died from complications of liver cirrhosis and liver cancer – in hopes that with more education – there will be less Hepatits B associated deaths in the future
[This article belongs to The Malaysian Medical Gazette. Any republication without written permission from The Malaysian Medical Gazette is prohibited.]
Hi doctor, as a carrier of hep B, what is the chances for them to develop hep B/liver cancer?
Salam Zakirah,
Your individual risk depend on what type of carrier you are – either you are a chronic carrier or just have previous exposure, whether you are positive for this antigen called Hepatitis B e or/and surface antigen also the level of your HBV Dna. The best person to explain and assess your expected individual risk to develop liver cancer or Hepatitis B related liver cirrhosis would be a gastroenterologist or liver specialist. So I would advise that you see a doctor who specialise or knowledgeable about Hepatitis B infection to assess your individual risk to get liver cancer.
I hope this answer helps.
Salam Dr,
Thank you for the explanation. So far I am doing yearly liver function check up (the dr took my blood and sent to lab). When the result is out all he always said “you’re good girl. everything is normal. nothing to worry about”. Hehehe maybe next time I will ask him to explain a bit in a layman language.
Dear Zakirah ,
Chronic hepatitis B infection can be either active or inactive.To know whether you are active or inactive you need to check your hepatitis B envelope antigen (HBeAg) and antibody (HBeAb) status.If your HBeAg negative & HBeAb positive means that your hepatitis B is inactive.Chronic hepatitis B inactive carrier carries a risk of the virus to become active too and there is a risk of liver cancer.Depends on your age and family history.If you have family history of liver Cancer means that you are at high risk of getting liver Cancer therefore you need to have every 6 monthly ultrasound of the liver for liver cancer screening , on the other hand if you have no family history you only need 6 monthly utlrasound of liver when you reach age of 50 years. If your liver enzyme (ALT) remain normal , you do not need any treatment.
how about your family (husband and children)?Your husband need to check his hepatitis B antibody level every year and the hepatitis B level should be more than 100 to prevent him from getting the infection from you.
In conclusion , you need to be on regular follow up with doctor .You need to check your liver function test and ultrasound of liver .
I hope this explanation will assist you and your family.
Dr Hamiza
Hepatologist (Liver Specialist)
Hi Doctor,I am giving birth soon but just found out that the full time nanny who is currently living with us has chronic hepa B virus. I intend for my baby to get the vaccine at birth. Should I get a new nanny since a lot of sites mention that the effectivity of the vaccine is after 3 doses which will be when my baby is 6 months? Our baby will be circumcised at birth so I am worried his open wound will make him susceptible to the virus from his nanny. Thanks!
Hello veronica
I am assuming your nanny is a chronic Hepatitis B carrier – her infectivity to your child depends on her Hep B status – whether she is HepBe antigen +ve or not.
She cant infect your baby through hugging, kissing, drinking or eating from the same utensils, coughing or sneezing. Hepatitis B is primarily infects through blood contact so she needs to be cautious whenever she have a fresh wound or bleeding from her skin/mouth/nose.
I would advise the nanny to wear gloves when handling your baby during diapering, not to share items like needles, nail clippers, razor or toothbrush with other people in the family.
It is good for you to vaccinate your child. As for your baby’s immunity – after the 1st dose of HBV vaccine, there can be up to 50% protection. After the 2nd dose of HBV vaccine, there can be up to 80% protection. After the final 3rd dose there can be up to 100% protective effect and protective effect has been found even up to 15 years of immunisation.
Whether you like to continue to employ your nanny – I leave that decision to you. To me as long as she adhere to the usual standard and universal precaution, her risk of infecting your child with hep B is minimal.
Hope that helps
hi doctor,
this is an interesting topic. If someone is recognized as a hep b carrier will he becomes
1) a hep carrier for the rest of his live?
2) should he take hep b immunization?