Hepatitis B prevention and control

Resource person : Dr. Vijay Khanal

Presented by : Sandeep Mandal

Modes of infection

Blood and body fluids Transfusion Needle stick accidents IV drug abuse Unsafe sexual activity Tattoos Vertical transmission

Complications

Acute hepatitis Chronic hepatitis Fulminant hepatitis Cirrhosis Hepatocellular carcinoma

General prevention
STANDARD PRECAUTIONS Uses of gloves Protective garments Mask & eye protective Disposal needle Bleach solution to decontaminate work surface Autoclaving for metal objects

Specific prevention

PASSIVE IMMUNIZATION
Standard IG 2. HBIG
1.

Reduces frequency of clinical illness but doesnt prevent infection

ACTIVE IMMUNIZATION
Firstly Introduced in 1982 Derived from plasma of healthy human HBsAg carrier

In 1987 genetically engineered vaccine Recombinant yeast Nonglycosylated HBsAg

Pre exposure prophylaxis

Three IM (Deltoid ,not gluteal) inj. at 0,1,6 months. Adult dose: 1ml , Children: 0.5 ml

Now this vaccine is included in EPI at 6,10,14 wks along with DPT & Oral polio and Haemophilus b vaccines.

Post exposure prophylaxis

Combination of HBIG + Hepatitis B vaccine

For

perinatal exposure

Single dose HBIG,0.5ml ,IM in thigh immediately after birth followed by complete 3 doses of hepatitis B vaccine started with in first 12 hours

For blood products exposure

Single

IM dose of HBIG ,0.06 ml/kg as soon after exposure as possible followed by complete course of hepatitis B vaccine to begin with in first week

For sexual exposure

Single IM dose of HBIG ,0.06ml/kg within 14 days of exposure, followed by complete course of hepatitis B vaccine

Control
Screening of blood before transfusion

Vaccinate the mother and child with hepatitis B vaccine

Control of Hepatitis B

Avoid multiple sex partners and use condoms

Do not share razors , used needles

Needle exchange programs

A Needle exchange program was conducted on September 9 ,1995 in Kathmandu to prevent the transmission of blood borne diseases among the Intravenous Drug Users(IDU). Efforts were made to provide sterile syringes and education to the IDU.

Awareness programs
World Hepatitis Alliance in association with WHO organized various campaigns on 28th July 2013 to spread awareness regarding Hepatitis infection in different parts of the world. Various programs were organized in Kathmandu on the occasion to raise awareness by Micro Point Nepal (MPN).

WORLD HEPATITIS DAY

See No Evil , Hear No Evil, Talk No Evil

Rally on World Hepatitis Day

THANK YOU

Harrisons principles of internal medicine , 18th edition http://www.ncbi.nlm.nih.gov/pubmed/852 7080 www.worldhepatitisday.info

References