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 – how it is spread
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.
Who should have the vaccine
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.
Hepatitis vaccine – how it works
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.
How to reduce the risk of becoming infected
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.
What to do if you are exposed
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.
Links to other helpful information:
NHS Choices – Hepatitis B
http://www.nhs.uk/conditions/Hepatitis-B/Pages/Introduction.aspx
The British Liver Trust Hepatitis B
https://britishlivertrust.org.uk/information-and-support/liverconditions/
hepatitis-b/
Health and Safety Executive Blood-borne viruses in the
workplace: Guidance for employers and employees
https://www.hse.gov.uk/biosafety/blood-borne-viruses/hepatitis-bvaccination.htm
The National Travel Health Network and Centre (NaTHNaC)
http://nathnac.net/
