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HepatitisBrevised.pptx

Hepatitis B

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Hepatitis B
A liver infection arising from Hepatitis B Virus
The liver infection may become chronic, a life-threatening situation because it may yield to liver failure or liver cirrhosis (Drobeniuc & Kamili, 2019)
Unlike children who may easily develop a chronic hepatitis B, most adults fully recover from the disease although the symptoms are often severe
A vaccine is needed to prevent Hepatitis B from occurring
It is often spread through blood, semen and other body fluids

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Ways of Identifying Hepatitis B
The various signs and symptoms of Hepatitis B often range from mild to severe (Wiwanitkit, 2015)
Abdominal pain
Dark Urine
Nausea and Vomiting
Fever
Weakness and Fatigue

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Classification of Hepatitis B using the Epi Triangle
The Epi triangle comprises of the Agent, Host and Environment
Agent factors for the disease depicts that the infection in form of virus is spread by cases of carriers, can survive for days in the environment.
In regards to the host factors, development of chronic infection is inversely related to age (Vaillant, 2015)
Environmental factors are implicated in HBV pathogenesis often facilitated by alcohol and aflatoxin.

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History of Hepatitis B
Researchers cited that the HBV genotypes D and A originated from North Africa and Middle East
From the World Health Organization data, the main cause of liver disease is a global health concern with approximately 257 million living with it
Epidemiological history of HBV-D and HBV-A is unclear due to lack of relevant studies
Paraskevis noted that the initial spread of HBV-A’s began in Central Africa, which later spread to eastern and southern Africa, and eventually to Brazil, Haiti and the Indian subcontent (ELife, 2018).

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1990 Hepatitis B Outbreak
CDC reported the first documented outbreak in 1990, characterized with infections associated with assisted monitoring of blood glucose
The affected persons in the assisted living facility in US were 26
The outbreak was associated with the reuse of fingerstick devices for capillary blood sampling on several patients
The outbreak was controlled by offering Hepatitis B Immune Globulin immediately after the patients came into contact with the virus
It is necessary to ensure that reusable fingerstick devices are only dedicated for single patient use to control infections (Bender et al., 2012)
Assisted monitoring of blood glucose ought to be utilized to guarantee self-monitoring of blood glucose especially to persons with diabetes

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Outbreak of Hepatitis B in Modasa Town
An outbreak occurred on 10th February 2009 in Modasa town after the suspected case was suspected on 26th January 2009 in Modasa hospital (Dash & Das, 2013)
by 27th March 2009, the cases had risen to 137 and 43 persons had died, that is 31% mortality rate
This outbreak claimed94 deaths out of the 593 total confirmed cases
Control measures taken into place include Mass- vaccination of the affected persons and also instituting antiviral drug
A significant lessons learned is attributed to ensuring safe injection practices to prevent such incidences because all the victims had a history of receiving injection from one physician before the signs and symptoms developed

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Hepatitis B Outbreak due to Mass-Casualty Incident in Australia
47 Afghan asylum seekers and 2 Indonesia suffered from an explosion in Australian waters yielding to mass casualties, on 16 April 2009
23 individuals ended with significant burns and were taken in for hospitalization
At Royal Perth Hospital, one patient showed signs of Hepatitis B, and later 4 patients
To control the transmission, detainees were reeducated about the mode of transmission as well as appropriate control measures (Italiano et al., 2011)
Those who were found to lack the necessary immune were offered HBV vaccination
Developing and implementing monitoring and evaluation tools is significant when it comes to preventing viral transmissions

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Future Perspectives of Hepatitis B
The disease is still a serious worldwide problem and its significant prevention control strategy is the use of vaccination
Most countries are likely to adopt a universal vaccination program to totally eradicate the life-threatening disease
The developed third generation vaccines with pre-S protens looks promising in ensuring full prevention of the HBV infection in future
It would be necessary in future to improve the vaccine efficacy by intradermal administration with cytokines as they would be effective for non-responders (Tajiri & Shimizu, 2015)

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References
Bender, T. J., Wise, M. E., Utah, O., Moorman, A. C., Sharapov, U., Drobeniuc, J., … Patel, P. R. (2012). Outbreak of hepatitis B virus infections associated with assisted monitoring of blood glucose in an assisted living Facility–Virginia, 2010. PLoS ONE, 7(12), e50012. doi:10.1371/journal.pone.0050012
Dash, B., & Das, R. (2013). Outbreak of hepatitis B in Sabarkantha district of Gujarat: A case-control study. International Journal of Medicine and Public Health, 3(2), 119. doi:10.4103/2230-8598.115188
Drobeniuc, J., & Kamili, S. (2019). Hepatitis, viral. Control of Communicable Diseases. doi:10.2105/ccdml.2868.067
ELife. (2018, August 7). Scientists shed new light on hepatitis B virus origins. Retrieved from https://elifesciences.org/for-the-press/2bc7c0e1/scientists-shed-new-light-on-hepatitis-b-virus-origins
Italiano, C. M., Speers, D. J., Chidlow, G. R., Dowse, G. K., Robertson, A. G., & Flexman, J. P. (2011). Hepatitis B outbreak following a mass-casualty incident, Australia. The Journal of Infectious Diseases, 204(3), 400-407. doi:10.1093/infdis/jir269
Tajiri, K., & Shimizu, Y. (2015). Unsolved problems and future perspectives of hepatitis B virus vaccination. World Journal of Gastroenterology, 21(23), 7074-7083. doi:10.3748/wjg.v21.i23.7074
Vaillant, A. (2015). Viral factors and host immune response to hepatitis B virus. Textbook of Hepato-Gastroenterology, 176-176. doi:10.5005/jp/books/12555_20
Wiwanitkit, V. (2015). Hepatitis G, hepatitis SEN, hepatitis TT and hepatitis TT-like viruses: New emerging hepatitis viruses in pediatric patients. Journal of Pediatric Infectious Diseases, 01(02), 083-088. doi:10.1055/s-0035-1557071

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