General Information
In the general population, hepatitis B is considered primarily a sexually transmitted disease. It is also transmitted in blood and, prior to the availability of hepatitis B vaccine, health care professionals such as doctors, nurses, and emergency personnel were at risk for contracting hepatitis B. Because it is easily transmitted by blood (one virus particle can cause disease), intravenous drug users who share needles and syringes are at extremely high risk. The other common mode of transmission is from hepatitis B infected mothers to the fetus prior to birth. There are many different viruses that cause hepatitis including hepatitis A, hepatitis C, Delta factor hepatitis, and hepatitis E. The initial course for hepatitis A and B may be similar but it is hepatitis B that can have long term consequences. Once infected with the hepatitis B virus, approximately 10% of the people develop a chronic permanent infection. In this group, a small proportion of people will develop slow but progressive liver damage leading to cirrhosis or Hepatocellular cancer . Hepatitis B is thought to be the leading cause of liver cancer in the United States. Hepatitis B has a long incubation period, occasionally taking up to 6 months to manifest itself.
Symptoms
Early symptoms may be a variety of skin rashes and achy joints. Systemic symptoms include fever, malaise, and abdominal pain or discomfort. Ultimately the yellow color of jaundice appears, first in the whites of the eyes and then the skin. Jaundice is usually associated with dark urine and light or clay colored stools. Hepatitis B is a serious disease and death rate during the acute stage is approximately 1%. The overall incidence of reported hepatitis B is 2 per 10,000 individuals, but the true incidence may be higher, because many cases do not cause symptoms and go undiagnosed and unreported. Pregnant women are now routinely screened for hepatitis B and, as it is a reportable disease, more accurate figures are available. One in 1,000 pregnant women are chronic carriers of hepatitis B.
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Prevention
You can protect children from hepatitis B by getting them vaccinated with three doses of hepatitis B vaccine. Newborn babies whose mothers either are infected with the hepatitis B virus or have not been tested should get their first shot within 12 hours of birth, the second shot at 1-2 months of age, and the third shot at 6 months of age. Other babies can get their first shot between birth and 2 months of age, the second at 1-4 months of age and the third at 6-18 months of age. The second shot should always be given at least one month after the first shot, and the third shot at least 2 months after the second and 4 months after the first. Your doctor or clinic will tell you the best time to get these shots. If you miss a dose or get behind schedule, there is no need to start over. Just get the next dose as soon as possible and continue on schedule. After the third shot, most children will be protected. Also people who have sex with multiple partners, homosexuals, sexual contact with an infected person, injection drug users, and household contacts with chronically infected persons.
Treatment
A vaccine is a drug that you take when you are healthy that keeps you from getting sick. Vaccines teach your body to attack certain viruses, like the hepatitis B virus. A drug called interferon is given through shots. Most people are treated for 4 months. Over 90% of those infected with hepatitis B recover. What infected individuals need is support. They also need to definitely stay away from alcohol and other substances that make the liver work harder than necessary. Chronic hepatitis B infection is another story. Though there is no cure for the disease, there are a variety of treatments available for the chronic carrier
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