Introduction
Chronic hepatitis B virus infection has been proved a usual source of death link to liver failure, cirrhosis and liver cancer. Internationally, more than 345 million individuals have chronic hepatitis B virus (HBV) with more than 619,000 individuals dying each year from hepatitis B virus associated liver illness.
Vaccination for HBV is greatly efficient for prevention of infection with hepatitis B virus and subsequent acute and severe liver illness. In the US, the cases of newly acquired hepatitis B virus infections have reduced significantly due to the success of public health management in the execution of an intensive national immunization policy. Nevertheless, the prevalence of hepatitis B virus infection is still high. In 2006, about one million residents of the United States were living with hepatitis B virus infection (Shetty, & Wu, 2009, pp. 34-38).
Moreover, hepatitis B virus infection is the current core reason behind an approximated 3,000 deaths annually in the US. Thus, more needs to be done to curb hepatitis B virus infection effectively. This paper discusses public health management of hepatitis B virus infection and gives some suggestions for medical assessment and administration of infected individuals and their contacts.
Public health management of hepatitis B virus infection
Hepatitis B cannot be transmitted through contaminated food and water or even kissing; hepatitis B virus is present in blood as well as body fluids like saliva, semen, vaginal discharges and breast milk and could be transmitted in the following manners (Zein, & Edwards, 2009, pp. 98-101).
- Kid-to-kid spreading through domestic contacts like biting
- Needle injuries in health care surroundings
- Re-utilization of unsterilized or poorly sterilized needles
- Sexual contact
- Sharing of personal things like razor blade, toothbrush and nail cutters
- Sharing of sharp tools like needles
Enhancing the recognition and public health management of individuals with chronic hepatitis B virus infection may assist in preventing severe liver illness and harmonize immunization policies to eradicate hepatitis B virus infection in the US. Individuals having severe hepatitis B virus infection may stay asymptomatic for a long time, unconscious of the infection as well as their risks for spreading the virus to other individuals and for having severe liver illness afterward in life.
Early recognition of individuals with hepatitis B virus infection allows the detection and vaccination of vulnerable family unit contacts as well as spouse with whom they have sexual contact (Zein, & Edwards, 2009, pp. 102-104). In this way, successful disruption of the potential infection is achieved. Every individual with chronic hepatitis B virus infection requires obtaining public health management to assess the inception and development of both liver cancer and liver illness.
Secure and efficient antiviral means are currently accessible to cure hepatitis B virus infections. This presents a higher standard of recognizing individuals that could gain from medical assessment, public health management, antiviral remedy as well as other treatment when designated.
The Food and Drug Administration (FDA) has endorsed most of the medications currently being employed for HBV treatment. For instance, FDA has endorsed two kinds of alfa 2 interferon and five oral nucleotide analogs whereas other medicines are in experimental tests.
Serologic trials for hepatitis B surface antigen (HBsAg) are the basic means of recognizing individuals with hepatitis B virus infection. Owing to the accessibility of efficient vaccine as well as post exposure prophylaxis (PEP), Centre for Disease Control (CDC) earlier suggested the significance of hepatitis B surface antigen testing for expectant females and children born by hepatitis B antigen-positive mothers.
Additionally, CDC recommended testing of family unit contacts and spouses of hepatitis B virus infected individuals, individuals living with human immunodeficiency virus (HIV) and individuals born in nations with hepatitis B surface antigen prevalence of more than 7 %.
Moreover, CDC suggested testing of individuals from who blood or other body fluid that could necessitate PEP comes, for instance, in case of needle injury to a public health care provider or in a sexual assault (Zein, & Edwards, 2009, pp. 99-102). Habitual hepatitis B surface antigen testing is currently recommended for individuals born in areas where its prevalence is more than one percent, in men who have sex with men (MSM) as well as in injected drug users (IDUs).
The present strategies to enhance patient safety and avoid transmission of hepatitis B virus in public health care environments include vaccination of vulnerable health care providers and the application of primary prevention (avoiding exposures and thus transmission) through stringent observance of the general principles of infection management safety measures.
More ways on this prevention include application of safer tools and the execution of public health practice managements (for instance, failure to re-cap needles) to curb injuries that present dangers for hepatitis B virus spread to both the patients and the care givers. Public health providers in the US anchor standard safety measures on the foundation that every blood as well as blood-having body fluids are liable of transmitting infections (Heather, Colvin, Abigail, & Mitchell, 2010, pp. 56-58).
From 1996, Centre for Disease Control has outlined the habitual application of standard safety measures that encompass utilization of protective tools in suitable situations, execution of both career practice measures and engineering managements, and observance of thorough standards for sterilizing and re-applying patient care tools.
For instance, using of double gloves is currently being done in different parts of the US and the world at large with the proof of illustrating the effectiveness and value of this and other interventions being wide-ranging.
Nevertheless, Centre for Disease Control has been able to discover some cases of patient-to-patient transmission of hepatitis B virus attributed to risky injection and dialysis processes, use of the same blood-sugar checking tools among patients in addition to other unhealthy practices. However, from 1991, minimal cases of hepatitis B spread attributed to public health providers have been detected in the US and in developed nations (Heather et al., 2010, pp. 57-59).
Recommendations
- All hospitals and medical institutions must have easily accessible written strategies and procedures for the detection and management of hepatitis B virus infected care givers, educators and students.
- Every health care giver and student ought to obtain HBV vaccine in accordance with the present Centre for Disease Control recommendations of 3 dose sequence. Immunization must be reinforced by evaluation of hepatitis B surface antibody to establish vaccination immunogenicity and re-immunization if possible.
- Standard safety measures must be followed thoroughly in every public health care setting for the safety of both patients and care givers (Heather et al., 2010, pp. 59-60).
Conclusion
Hepatitis B virus infection has been confirmed to be cause of death associated with liver illnesses. Enhancing detection and public health management of people with hepatitis B virus infection might aid in preventing severe liver illnesses and promote the success of immunization policies to eradicate hepatitis B virus infection.
Through adherence of safety precautions and given recommendations for public health assessment and management of infected individuals and other vulnerable individuals will assist in effectively preventing the spread of HBV.
References
Heather, M., Colvin, H. M., Abigail, E., & Mitchell, A. E. (2010). Hepatitis and liver cancer: a national strategy for prevention and control of hepatitis B and C. Washington, DC: National Academies Press.
Shetty, K., & Wu, G. Y. (2009). Chronic viral hepatitis. New York: Springer.
Zein, N., & Edwards, K. M. (2009). The Cleveland Clinic Guide to Liver Disorders. UK: Kaplan.