Hepatitis B – The Disease
Hepatitis B is caused by the hepatitis B virus. Infection doesn’t often cause symptoms but when it does it leads to flu-like symptoms, including tiredness, fever, loss of appetite, sickness and diarrhoea, tummy (abdominal) pain and yellowing of the skin and eyes (jaundice).
These symptoms usually appear two to three months after ‘exposure’ to the infection and normally pass after one to three months.
Hepatitis B is uncommon in the UK and so the risk of catching infection in the UK is low. The virus is present in the blood of infected people, and in some other body fluids which may be contaminated with tiny amounts of blood. The infection spreads by blood-to-blood contact – for example when the virus gets into your bloodstream through a cut, scratch, or a contaminated needle. It cannot be spread by kissing, holding hands, hugging, coughing, sneezing, or sharing crockery and utensils.
In the UK, the vaccine is offered to individuals who are at specific risk of being exposed to blood from an infected person. This includes the sexual partners, children and family member of infected individuals and a range of other groups such as laboratory staff health care workers, people who inject drugs, those travelling for medical treatment abroad, and men who have sex with men.
A course of hepatitis B vaccine involves three or more doses of vaccine completed over a few months. During the course, as protection from vaccine develops, it is important to continue to take other precautions against being exposed to the virus. In most individuals, delaying a dose of vaccine is unlikely to significantly increase the risk of acquiring infection. Doctors may advise that hepatitis B vaccine can be delayed until later if he or she believes that you should be able to avoid being exposed. Individuals can reduce their risk of contracting hepatitis B by taking care to avoid situations where they are exposed to blood or body fluid.
Hepatitis B can still be prevented if you are treated promptly following exposure. Stocks of vaccine will be kept protected to ensure that such treatment can still be offered.
It is important if you are offered a vaccine that you complete the full course and attend for follow up blood tests to check the immunity levels you have achieved as you may not have achieved protective immunity.
At work
Certain jobs can put people at risk because they involve contact with body fluids. This includes healthcare workers and others such as morticians, sewage workers, police and fire emergency services, tattooists, and acupuncturists. Ideally, you should avoid activities where you may be exposed to blood and body fluids until you are fully vaccinated. You should also protect yourself and others by taking care when handling and disposing of sharp instruments (e.g. by personal protective equipment such as gloves and eye protection if required). Ensure all surfaces are disinfected properly , hands are cleaned effectively and dispose of contaminated waste safely.
At home
If your partner is infected with hepatitis B, it is important to use condoms until you are fully protected by the vaccine. If your partner or another family member is infected, you should be very careful to avoid sharing toiletry items such as razors, toothbrushes, scissors, tweezers and hair clippers as there may be a small amount of blood left on them. It is important to maintain a high level of cleanliness, and wash clothes that may have blood or other bodily fluids on them at a hot cycle (at least 60 degrees) with detergent.
Whilst out and about
The risk of catching hepatitis B in the UK is extremely low, but you should avoid sharing needles (e.g. for injecting drugs) and take great care if you pick up discarded needles in the community. You should always use condoms if you are participating in casual or paid-for sex or have multiple partners. If you are having a tattoo or piercing, make sure you use a reputable beauty salon or tattoo parlour.
Travel
The virus can also be passed on from medical and dental treatment in countries where equipment is not sterilised properly, particularly where hepatitis B is more common. The best way to protect yourself is to ensure that disposable needles are used and that they come straight out of a sterile packet. A sterile medical equipment kit can be purchased for travellers visiting areas with poor health facilities. You should also avoid other high risk activities such as having unprotected sex, having tattoos, acupuncture or and piercings and/or participating in contact sports where bleeding commonly occurs. You should delay any travel for medical and dental treatment aboard or to undertake healthcare work in an endemic country until you have been fully vaccinated.
If, you have not been vaccinated and then you are exposed to hepatitis B infection (if, for example, you have an accident whilst abroad), you should seek urgent medical attention. Having a dose of vaccine promptly after the incident can still help to protect you from hepatitis B. If you think you might have been exposed to hepatitis B, before, during or even after a course of vaccine you should seek medical attention immediately.
If the exposure has occurred in work, you must contact Occupational Health on 01253 957950 (option 2).
Please use first aid and follow the needlestick policy below for immediate action.
NHS Choices - Hepatitis B - Hepatitis B - NHS
The British Liver Trust Hepatitis B - British Liver Trust
Health and Safety Executive Blood-borne viruses in the workplace: Guidance for employers and employees - Gov.UK
The National Travel Health Network and Centre (NaTHNaC) - NaTHNaC
