Hepatitis B is an acute infection of the liver. It is usually spread through contaminated blood via sexual intercourse, needle sharing, blood transfusions and injections. The virus can also be passed from mother to baby. Tattooing, body piercing and acupuncture are other ways in which the virus may be spread.
Hepatitis B is a public health problem worldwide. Areas where there is a higher risk of exposure to hepatitis B include Africa, India, China, South and Central America and Southeast Asia.
The illness in all forms of hepatitis is similar, however, infection with hepatitis B is more serious than hepatitis A. Symptoms include mild fever, gastrointestinal upset, nausea/vomiting, diarrhoea and abdominal pain. Jaundice may also occur.
The illness lasts for about six months. Occasionally, the virus can persist for more than six months in individuals who become chronically infected with hepatitis B. These individuals may be referred to as carriers. Up to a quarter of individuals who are carriers have progressive liver disease which can cause cirrhosis and cancer of the liver.
- Acute illness is treated symptomatically with a careful watch for early signs of liver failure.
- Chronic infection may require treatment with either interferon or oral antivirals to reduce the long term risk of cirrhosis or cancer of the liver.
Advice for Travellers
Travellers are advised to seek a travel health consultation for individual risk assessment from a suitably qualified healthcare professional ideally 6 – 8 weeks prior to their trip.
All travellers should avoid contact with blood and body fluids by:
- Avoiding unprotected sexual intercourse, condoms (including use for oral sex) provide good but not complete protection.
- Avoiding tattooing, piercing and acupuncture (where sterility of equipment cannot be guaranteed).
- Not sharing needles or any other injection equipment.
- Not sharing razors or toothbrushes.
- Having appropriate travel insurance. Any traveller can be at risk of an accident or require emergency treatment. Travel insurance may help ensure access to high quality medical service (including repatriation), reducing the chances of exposure to contaminated medical equipment.
- In many developing countries the re-use of medical supplies, including needles and syringes is common. A sterile medical equipment kit may be helpful for those travelling to resource poor areas. Sterile medical kits are available from some chemists and travel clinics, containing sterile injecting equipment for use in an emergency (e.g. when wounds require suturing, an intravenous drip or injections are required or for dental surgery). These needle kits should be supplied with a certificate showing contents and the reason for its purchase, useful for customs clearance.
Hepatitis B Vaccination
Travellers at risk should consider vaccination. This includes those who will be visiting areas where there is high risk of exposure to the virus.
As of 1st October 2017 children born after August 1st 2017 will be eligible to have hepatitis B vaccine as part of the routine UK national schedule of vaccination. Children born before 1st August 2017 are not eligible so may be at risk through travel.
There are several brands of vaccine available to protect against hepatitis B: Engerix B, Engerix B Paediatric, Fendrix, HBvaxPro 05, HBvaxPro 10 and HBvaxPro 40.
Hepatitis B vaccine is also available in a preparation that combines it with hepatitis A vaccine for convenience: Ambirix, Twinrix and Twinrix Paediatric.
Individuals should avoid risky behaviour e.g. unprotected sex, tattoos, piercings, visiting traditional barbers in high risk destinations. Dental and surgical procedures should also be avoided in high risk areas.
Combined vaccine preparations PILs
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