Hepatitis B Case Studies

Hepatitis B Vaccine
Medical Assistant
Gladys Maria Shafer
February 19, 2013

Hepatitis refers to an inflammation of the liver, which is swelling that occurs when the tissues of the body become injured or infected. “Hepa” means liver and “itis” refers to inflammation. The Hepatitis B virus spreads through blood or direct contact with any body fluids from someone who already has a Hepatitis B infection and the virus enters the body unnoticed (Center of Disease Control and Prevention, 2009). Hepatitis B vaccine is important because the disease is considered an occupational threat to healthcare workers like us who have high risk of blood exposure and other body fluids. The vaccine
will protect us from exposure to contaminated blood or body fluids and protect us from getting the liver infection that causes Hepatitis B, which is considered a life threatening disease. The Center of Disease Control and Prevention or CDC (2009) indicates that acute Hepatitis B is a short term illness and it lasts up to 6 months while chronic Hepatitis B is a long term disease and will remain inside the body. So, the vaccine shot defends against these illnesses of both acute and chronic viral infections. According to CDC and Prevention (2009), there are 3 common types of hepatitis: Hepatitis A, Hepatitis B, and Hepatitis C.
These diseases are cause by viruses. Each disease has similar signs and symptoms, but every virus has a different method of transmission, and it affects the liver in a different way. Since Hepatitis A is acute, it will not develop into a chronic disease. A person diagnosed with Hepatitis A improves without medication; however, Hepatitis B and C start with acute infections and become chronic over a period of time because the virus stays inside the person’s body. The Center of Disease Control and Prevention or CDC (2009) and World Health Organization or WHO (2013) indicate that there is a vaccine for Hepatitis A and B; unfortunately, there is no vaccine available for Hepatitis
C. The number of acute Hepatitis B cases in the United States is very low, and the illness goes away after 2-3 weeks and the patient returns to normal again. Moreover, acute hepatitis requires no need of further treatment other than careful monitoring of their liver, and other body functions with blood tests, according to National Center for Biotechnology Information (2013). National Center for Biotechnology Information (2013) encourages acute hepatitis patients to get plenty of rest, drink plenty of fluids, and to have healthy diets. However, chronic Hepatitis B patients are estimated from 800,000 to 1.4 million people who have been diagnosed with long term liver infection (CDC and Prevention, 2009). Around the globe, more than 240 million people have chronic disease and there are an estimated of 620,000 deaths each year (CDC and Prevention, 2009). The World Health Organization (2013) shows that Hepatitis B is commonly found in Asian and Pacific island nations; in addition, the eastern and central part of Europe and developing countries like South America and Africa have a high rate of chronic infections. When planning travel to other countries where hepatitis B is common, try to get the vaccines before going on a trip abroad. The WHO (2013) explains that the common symptoms of Hepatitis B are: ➢ fever, abdominal pain, and joint pain ➢ fatigue and loss of appetite ➢ yellowing of eyes and skin (also known as jaundice) ➢ nausea and vomiting ➢ dark color urine and clay colored bowel movements. For some people, the chronic Hepatitis B shows few signs. Others have no indication of symptoms and as a result they do not know that they already have the virus inside their body; however, they may still spread the disease to others. But over the time, people who are considered to be a “carrier” may start showing the symptoms of chronic disease. Be cautious and seek immediate help from medical professionals if symptoms occur. Early diagnose and treatment can help prevent the severe liver damage that leads to liver failure. According to WHO (2013) and National Center for Biotechnology Information (2013), the common modes of transmissions of Hepatitis B are the following: • birth (from infected mother to baby) • direct blood to blood contact (health care setting - hemodialysis) • semen and vaginal fluids from an infected individual • sex with multiple partners • blood transfusion (not common in the U.
S.) • sharing needles, syringes, or other drug paraphernalia • sharing personal items (like razors, nail clippers, and toothbrush) from an infected person • tattoo or pierced with unsterilized instruments that were used on an infected person Sexual contact or practicing unsafe sex among adults is a cause of widely spread Hepatitis B in the United States; although, the illness does not spread through social contact, such as holding hands, sitting, and hugging an infected person. Sharing spoons, forks, drinking glasses, food, water, coughing, and sneezing will not pass on the chronic disease to other person (CDC and Prevention, 2009 and National Center for Biotechnology Information, 2013). But in rare case, Hepatitis B spread to a baby when an infant received food pre-chewed by an infected person. It is a standard precaution to always use gloves, especially for healthcare workers, when there is a possibility of direct contact with body fluids and cleaning up of any blood spills, to avoid getting any
diseases. The National Center for Biotechnology Information (2013) mentions that chronic Hepatitis B is a very serious disease because it can lead to long term health issues including cirrhosis, liver damage, and can lead to death. Cirrhosis refers to the scaring of the liver. Patients who are diagnosed with cirrhosis will be given prescription medication to reduce the production of the virus. In some cases, patients suffer liver damage to the extent that a transplant of the malfunctioning liver is necessary (National Center for Biotechnology Information, 2013). Many physician advice carrier patients with chronic Hepatitis B to avoid alcohol consumption because it can harm the liver more, and patients should always check with their healthcare professional before taking over-the-counter medication such as acetaminophen, aspirin, or ibuprofen, vitamins, and herbal supplements (National Center for Biotechnology Information, 2013). Hepatitis B does not discriminate for race, gender, and age. The CDC (2009) stated “The younger a person is when infected with Hepatitis B virus, the greater his or her chances of developing chronic Hepatitis B.” CDC (2009) expresses that in the U. S., approximately 90% of infected infants will develop chronic infection; although, the risk goes down as a child gets older. Approximately 25% - 50% of children infected between the ages 1 to 5 years will develop chronic hepatitis, but the risk drops to 6%- 10% when a child is infected over 5 years of age. Globally, most people with chronic Hepatitis B were infected during birth or early childhood. Hepatitis B is only diagnosed through blood test. The test is done at a doctor’s office or outpatient facility. The CDS and Prevention (2009) experts report that people with Hepatitis B should not donate blood, organs, or semen because it can put the recipients at high risk for getting the hepatitis. Additionally, the American National Red Cross or ANRC (2011), mention that Hepatitis B is considered a blood borne pathogen, in which the viruses are present in blood and other body fluids. ANRC (2011) suggest individuals follow safety precautions to help prevent the spread of blood borne pathogens, and other diseases whenever there is a risk of exposure to blood and body fluids. Furthermore, the American National Red Cross (2011) developed control plan guidelines, which are available to health care employees and facilities, on how to prevent the spread of infectious diseases. It is very important for us, as a medical assistant, to wear gloves before providing care and change gloves whenever seeing different patients. It is also advisable to wear protective coverings, such as a mask, eyewear, and gown, if there is blood or other body fluids that might splash. Avoid touching the soiled part of the gloves when removing them, and dispose of them in a proper container. Always wash your hands immediately after providing care to patients. The American National Red Cross (2011) suggests that all used gloves, bandages, or contaminated materials must be disposed in a biohazard disposal bag, which has a biohazard warning label and it is a red color plastic bag. However, all sharp instruments such as needles or syringes must be placed in sharps disposal containers that has also biohazard label as well. A healthcare worker faces many challenges to avoid contracting the illnesses of their patients. The Hepatitis B vaccine is essential for health care workers. However, the first line of defense is to always be diligent in adhering to safety precautions, such as wearing gloves, masks, and other protective clothing as appropriate to avoid personal contact with a patient’s blood or body fluids and to always dispose of contaminated items properly. Furthermore, the Hepatitis B vaccine is also highly recommended for anyone who may be in a situation that puts them at risk of exposure to the Hepatitis B virus.

Reference

Centers for Disease Control and Prevention. (2009). Retrieved on February 12, 2013 from http://www.cdc.gov/hepatitis/B/bFAQ.htm#

National Center for Biotechnology Information. (2013). Retrieved on February 15, 2013 from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001324/

Read Cross. (2011). Retrieved on February 19, 2013 from

http://www.redcross.org/images/MEDIA_CustomProductCatalog/m4240177_PreventingSpreadBloodbornePathogensFactandSkill.pdf

World Health Organization. (2013). Retrieved on February 15, 2013 from

http://www.who.int/mediacentre/factsheets/fs204/en/