What is Hepatitis B?

Hepatitis B is an infection of the liver caused by the Hepatitis B virus. It can be Acute (lasting for less than six months) or Chronic (more than six months). The virus is found in the blood and bodily fluids of an infected person.

Which Jobs are at risk of contracting Hepatitis B?

Any job where there is a chance of accidental exposure to blood or blood products may be at risk. Vaccination may be a consideration to prevent contracting Hepatitis B. I have included a list of jobs below. The list is not exhaustive.

Aesthetic Practitioners e.g. Botox and Fillers.

Beauticians e.g. Eyebrow tattoos.

Bin Men (needle stick and wounds)

Laboratory Staff

Medical Personnel e.g. doctors/ nurses/ pharmacists and others.

First Aiders

Morticians and Embalmers

Tattooists

Soldiers

Sports People.

Police

Security

Hairdressers

Sewage Workers

Dentist and dental workers

Prison Staff

Hospital Porters

Caretakers

Special Needs Staff

Migrant Workers

Child Foster Carers

Asylum Workers

Chefs

Builders

Acupuncturists

What are the symptoms of Hepatitis B – Acute Illness?

Weight loss, nausea, ache in the right upper abdomen. There can also be severe tiredness. Patients develop jaundice and this results in dark urine and lightening of the faeces.

Some patients may not develop symptoms and their condition can only be diagnosed using liver function tests.

What are the Symptoms of Chronic Hepatitis B?

Chronic Hepatitis B mainly affects babies and younger children.

Symptoms tend to be mild and may not always be present.

If left untreated they can develop into scarring of the liver (cirrhosis) and cancer.

How is Hepatitis B Spread?

It can be transmitted in a number of ways.

  1. Through vaginal or anal sex.
  2. It can be passed from a mother to her unborn child.
  3. It can be passed from blood to blood contact. This could be drug users sharing needles or from needle stick injuries.
  4. Sharing toothbrushes or razors contaminated with infected blood.
  5. Transmission from being bitten by an infected person is rare.
  6. The incidence from infected blood products during a transfusion is very rare in the UK due to updated “cleaning” processes.
  7. Having a tattoo, body piercing, medical or dental treatment in an unhygienic environment with unsterilized equipment.

Do you need a booster dose of Hepatitis B vaccine if you are at Occupational Risk?

Blood tests can give you your antibody response to the Hepatitis B virus. If your anti-HB levels are above 10 IU/ml you are generally considered as being covered against infection. However, because tests can vary a score of 100 IU/ml is considered sufficient to not need further booster vaccinations. Healthcare and laboratory workers whose results are between 10 – 100 IU/ml are currently (Oct.19) advised having a booster at 5 years.

Do Patients with Renal Failure need extra doses of the Hepatitis B Vaccine?

As long as blood tests show anti-HBs at a level of 10 IU/ml or more patients are generally considered as protected. If levels fall below, patients may require a booster dose. Also, if dialysis patients are traveling abroad, especially countries where Hepatitis B is endemic, they would be advised to have a booster. This would more so if they were planning on receiving hemodialysis in the country of travel.

How Effective is the Hepatitis B Vaccination?

The vaccine gives an adequate response in about 90% of adults. At age 40 and over response start to decline. Poor response is also found in obesity and smokers, alcohol dependency and liver disease. If you are immunocompromised or on dialysis you may need extra doses of the vaccine.

How Long does the Hepatitis B vaccination provide protection?

Immunity can last a lifetime. Blood tests can tell you your level of immunity. Some patients may need more regular monitoring and more frequent vaccination depending on their immune status and risk of infection.

How Many vaccinations do you need?

This depends on a number of factors such as:

  1. The brand of vaccine.
  2. Your age?
  3. If you need to be vaccinated in a hurry eg. Travelling abroad on short notice.
  4. If you are on medication that reduces your immune system.

How can we stop the spread of Hepatitis B?

Health Education programs have had good success in reducing the number of infected people. There are a number of ways that you can keep yourself safe.

  1. Vaccination.
  2. Practice safe sex.
  3. Using sterile needles for injecting drugs and not sharing needles.
  4. If you are traveling abroad, carrying a sterile pack of needles and syringes, especially when backpacking or when you are planning to go off the beaten track, or if planning to travel to high-risk countries

How should I store my Vaccination prior to injection?

If you are storing it at home keep it in a refrigerator.

The vaccine is best stored in a Medical Refrigerator between 2-8 ℃.

Medical fridges are better at keeping their temperature than a domestic fridge, where the temperature range can fluctuate widely. Do not let the vaccine freeze because this can cause cracks in the glass vial and can also affect the potency of the vaccine.

What is the Incidence of Hepatitis B?

The World Health Organization (WHO) estimates that 250 million people are infected with chronic Hepatitis B. In the UK incidence of acute infection is very low about 600 cases per year since 2009. This is mainly due to public health campaigns and AIDS awareness that has led to such things as increased condom use. The highest prevalence in the UK used to be drug injectors but is now in heterosexuals, followed by sex between men.

What types of Vaccinations are there for Hepatitis B?

There are two types –

  1. Active immunity
  2. Immunoglobulin – passive and temporary immunity while awaiting a response to a vaccine.

Is the Hepatitis B vaccine a live vaccine?

No, it is an inactivated vaccine prepared from yeast cells. This means that you cannot get the disease that you are trying to protect against.

Can I use Hepatitis B vaccine even if I have been exposed to the virus?

Yes. Although the vaccine should be given as soon as possible after exposure (ideally within 24 hours post-exposure) it can be given up to a week after exposure.

Do I still need the Immunoglobulin if I have been infected?

As the vaccine gives good protection against the Hepatitis B virus, the HBIG is only used in high-risk patients and those that are known non-responders to the vaccine.

What is Hepatitis B immunoglobulin (HBIG)?

These are antibodies that an infected person has developed against the Hepatitis B virus. This is obtained from the plasma of immunised screened donors. Donors are screened for HIV, Hepatitis B, and Hepatitis C.

Can I get vCJD from the HBIG?

There is a theoretical risk of transmission from plasma products.

I am taking Blood Thinning Medication; can I still be vaccinated?

Yes, but the Injector will use a different technique to normal to reduce the likelihood of bleeding.

Which groups of people are most likely to develop Chronic Hepatitis B?

Most adults infected with Hepatitis B will fight off the infection in a few months. However, some will develop a chronic condition.

Chronic Hepatitis B affects around:

            90% of babies with Hepatitis B

            20% of older children with Hepatitis B

            5% of adults with Hepatitis B

What is the Difference Between Hepatitis A, B, and C?

Hepatitis A, B, and C are all caused by different viruses that attack the liver. Hepatitis A is mainly passed on through poor sanitary conditions. Hepatitis B is passed on through the blood and body fluids of infected patients. Hepatitis C is mainly transmitted through infected blood.

How long after I am infected, do I get symptoms of Hepatitis B?

It can take between 40 to 160 days before the symptoms appear, however, the average time is 60 to 90 days.

Which Jobs are at risk of contracting Hepatitis B?

Any job where there is a chance of accidental exposure to blood or blood products may be at risk. Vaccination may be a consideration to prevent contracting Hepatitis B. I have included a list of jobs below. The list is not exhaustive.

Aesthetic Practitioners e.g. Botox and Fillers.

Beauticians e.g. Eyebrow tattoos.

Bin Men (needle stick and wounds)

Laboratory Staff

Medical Personnel e.g. doctors/ nurses/ pharmacists and others.

First Aiders

Morticians and Embalmers

Tattooists

Soldiers

Sports People.

Police

Security

Hairdressers

Sewage Workers

Dentist and dental workers

Prison Staff

Hospital Porters

Caretakers

Special Needs Staff

Migrant Workers

Child Foster Carers

Asylum Workers

Chefs

Builders

Acupuncturists

Who should definitely not receive the Hepatitis B Vaccine?

The Vaccine is contraindicated in patients who have had a confirmed previous anaphylactic (life-threatening allergic reaction) to the Hepatitis B vaccine or any other vaccine.

Can you give the Hepatitis B vaccine to someone who is not well?

If someone has a minor illness such as the sniffles, a little cough or a headache for example, but is generally fit and well, they can receive the vaccine. If patients have a fever or look acutely unwell, they should not receive the vaccine. This is more to not confuse any possible side effects of having the virus with the current illness.

Can Pregnant or Breast-Feeding Women receive the Hepatitis B Vaccine?

Since the vaccine is not a live vaccine there is no evidence that mother or child is at risk from having it.

Also, Hepatitis B infection in pregnant women can lead to severe disease for mother and chronic infection for the child.

If the mother is at high risk of hepatitis B infection she should be offered the vaccination.

Should HIV and Immunocompromised Individuals have the Hepatitis B Vaccination?

Yes. These patients are at a higher risk of infection and at increased risk of chronic infection. This patient group would generally require an increased number of doses.

What are the Side Effects of the Hepatitis B Vaccine?

The main side effects of the vaccine are similar to most vaccines. Redness and soreness at the site of injection. Other side effects that may or may not be due to the vaccine include fever, rash, malaise and an influenza-like syndrome, arthritis, arthralgia (joint pain), myalgia (muscle pain) and abnormal liver function tests.

Can the Hepatitis B vaccine cause more serious conditions such as Multiple Sclerosis (MS)?

The Global Advisory Committee on Vaccine Safety (GACVS) issued a statement in 2002 and concluded that there is no association between the administration of the Hepatitis B vaccine and MS.

What are the Side Effect of the Hepatitis B Immunoglobulin HBIG?

The vaccination is well tolerated. Anaphylactic reactions are very rare.

There have been no cases of blood-borne infection from HBIG designed for intramuscular use in any country.

Who is most at risk of contracting Hepatitis B?

  1. Babies born to Hepatitis B infected mothers.
  2. IV drug users who share needles.
  3. People who have ever injected drugs.
  4. People who have unprotected sex, including anal and oral sex. People with multiple sexual partners. Having sex with sex workers. Having sex with people from high-risk countries.
  5. If you live with an infected person or have regular and close contact with an infected person.
  6. If you were born or brought up in a country where infection is common.

What are the high-risk countries for Hepatitis B?

Sub-Saharan Africa.

East and Southeast Asia.

The Pacific Islands.

Parts of South America.

Southern parts of East and Central Europe.

The Middle East.

The Indian sub-continent.

Can I get Hepatitis B from Kissing?

Hepatitis B is not spread by kissing, coughing, sneezing, holding hands, hugging, or sharing crockery and utensils.

What is Liver Cirrhosis?

This is scarring of the liver and affects 20% of people with chronic Hepatitis B. There is currently no cure for cirrhosis. Symptoms do not appear until a large part of the liver is damaged. It can then cause the following symptoms: Tiredness, weight loss, nausea, itchy skin, loss of appetite, weakness, tenderness and/or pain and swelling of the stomach, swollen ankles. A liver transplant is sometimes required if liver damage is severe.

Can Hepatitis B cause Cancer?

Yes. About 20% of patients with Chronic Hepatitis B develop liver cancer. Symptoms of liver cancer include the following; unexplained weight loss, loss of appetite, feeling very full after eating even a small meal, nausea and vomiting, jaundice (yellow skin and eyes).

What is Fulminant Hepatitis B?

This is a serious and possibly life-threatening condition that affects 1% of patients with short-term (Acute) Hepatitis B. It is an auto-immune disease. This is where the bodys own immune system attacks the liver. Symptoms include; confusion, collapsing, severe jaundice, swelling of the stomach.

WE PROVIDE A FULL VACCINATION AND TRAVEL CLINIC. CONTACT THE PHARMACY IF YOU WANT TO BOOK AN APPOINTMENT OR HAVE ANY QUESTIONS REGARDING HEPATITIS B OR ANY OTHER VACCINATION

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