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Hepatitis B

Introduction

Hepatitis B is an infection of the liver. It is caused by a virus that is spread through contact with infected blood and bodily fluids.

Recommendations for travellers

You should arrange a travel health consultation from a suitably qualified healthcare professional, ideally 6 to 8 weeks before your trip, in order to undergo an individual risk assessment.

To reduce your risk of coming into contact with infected blood and body fluids, you should consider the following measures:

  • Avoid having unprotected sexual intercourse:
    • use condoms (including for oral sex) to provide protection
  • Limit drug and alcohol consumption:
    • this can impair your judgement meaning you might be more likely to partake in high risk behaviours, or suffer an injury requiring medical care
  • If there is a risk that equipment may not be clean and sterile, avoid high risk procedures such as:
    • tattooing
    • body piercing
    • acupuncture
    • dental and medical procedures
  • Avoid sharing devices that can break the skin such as:
    • needles and injection equipment
    • razors or toothbrushes
  • Having travel insurance might help you to access higher quality medical care and reduce your potential exposure to contaminated medical equipment or blood products if you have an accident or need for emergency medical treatment
  • Consider carrying a sterile medical equipment kit with you depending on your itinerary:
    • these kits contain sterile equipment suitable for various medical procedures (such as giving injections or intravenous medications, suturing wounds or dental care)
    • kits are available to purchase from some pharmacies and travel clinics
    • make sure the kit includes a certificate which lists the contents and reason for purchase; as this may be requested by customs and immigration during travel
    • see the first aid page for further information.

Vaccination

All children born in the UK after 1 August 2017 should receive hepatitis B vaccine as part of the routine UK vaccination schedule. Anyone born before 1 August 2017 is unlikely to be vaccinated routinely, so may be at risk of exposure through travel.

You should consider being vaccinated against hepatitis B if you will be visiting countries where the hepatitis B virus is common; and if your planned activities mean you might be high risk of exposure to the virus.

There are several brands of vaccine currently available in the UK 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 the hepatitis A vaccine for convenience. These combination brands are called Ambirix, Twinrix Adult and Twinrix Paediatric.

Overview of Disease

Hepatitis B infection is caused by exposure to the Hepatitis B virus which is found in blood and bodily fluids. The virus is most commonly spread through sexual intercourse, needle sharing, blood transfusions or from contaminated medical equipment. The virus can also be passed from an infected mother to her baby at birth. Tattooing, body piercing and acupuncture are other ways in which the virus can be spread.

The hepatitis B virus is highly infectious and can live outside the body for 7 days and still remain infectious.

Hepatitis B is a public health problem worldwide. Areas where there is a higher risk of exposure to hepatitis B include Africa, the Western Pacific, South East Asia, the Indian sub-continent and the Eastern Mediterranean.

The Illness

Hepatitis illness in all forms is similar. However, infection with hepatitis B virus is more serious than with hepatitis A virus. Some people may not experience any symptoms; others might develop symptoms gradually.

Symptoms of hepatitis B might include:

  • mild fever and/or flu like symptoms
  • gastrointestinal upset
  • nausea/vomiting
  • diarrhoea
  • abdominal pain
  • yellowing of the skin and eyes (jaundice)

Hepatitis B typically lasts for about six months in the acute stage of the illness. Occasionally, the virus can persist for longer than six months in individuals who become chronically infected. These individuals may be referred to as carriers. Up to a quarter of individuals who become carriers go on to develop progressive liver disease such as cirrhosis (scarring of the liver) and sometimes cancer of the liver.

Treatment

There is no specific treatment for acute hepatitis B. Keeping well hydrated if you are vomiting; maintaining a nutritious diet and getting plenty of rest is important to manage any symptoms. Your doctor may wish to keep a careful watch for any early signs of liver failure.

People who develop chronic infection may require treatment with medications such as interferon or antiviral tablets, to help reduce the presence of the virus in your system in order to reduce any long term risk of developing cirrhosis or cancer of the liver.

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