Hepatitis B

The Disease

Hepatitis B (HBV) is a viral infection of the liver. In infected individuals the virus is present in body fluids such as blood, semen and vaginal secretions and is usually transmitted through sexual contact, intravenous drug use, prolonged close contact with infected individuals or from an infected mother during birth. HBV can be transmitted through accidental needle-stick injuries, tattooing, ear-piercing, nicks from infected razors, acupuncture and dental procedures. It is not transmitted through contaminated food or water.

HBV has an average incubation period of 10 weeks (range 2-6 months) and causes gradually increasing fatigue, loss of appetite, nausea and pain in the right upper abdomen. There may also be a rash and pain in the joints that are followed by yellow discolouration of the skin (jaundice) and darkening of the urine. As with Hepatitis A, mild or asymptomatic infections occur, but less frequently. One important difference is that 10% of adults and 30% of children who contract Hepatitis B will become chronic carriers; that is, they will recover, but will always remain capable of transmitting the disease. Some carriers will develop chronic hepatitis that can later lead to liver failure or liver cancer. In a small number of cases, HBV results in rapid liver failure and death.

Risk to travellers

Most individuals have some degree of risk of contracting Hepatitis B. High-risk behaviour includes:

• Unprotected sex.
• Multiple sexual partners or encounters with sex workers.
• Intravenous drug use.
• Exposure to blood products or needles (i.e. dental work, tattoos, body piercing, acupuncture).
• Living/travelling in regions where there is a high number of HBV carriers. This risk is accentuated for travellers engaging in adventure-style activities, where the risk of injury is higher.
• Health care and aid workers.

Travelvax urges travellers to take common sense precautions to avoid exposure to the Hepatitis B virus. However, accidents and injuries may require medical treatment, and in many third world countries blood transfusions may not be adequately screened for Hepatitis, as well as STI's and HIV-AIDS. Needles may be re-used

Vaccination

Type:

• Synthetic vaccine* (Engerix-B / HB Vax)
• Combined vaccine with Hepatitis A* (Twinrix)

Standard Schedule:

• Three doses at 0, 1 and 6 months.

Accelerated schedule (currently approved only for adults):

• Days 0, 7 and 14, with a booster at 12 months. (Approved for Engerix-B and Twinrix only).

Alternate schedules for schoolchildren are available. Consult with a medical practitioner for details.

Level of protection:

• Greater than 90% immunity after three doses.
• Immunity is life-long. (NHMRC does not recommend testing for seroconversion unless in a high-risk group).

Possible side effects:

• Usually infrequent and mild.
• Redness, swelling, a hard lump or bruising around the injection site.
• Feeling unwell, headache, dizziness, tiredness.
• Muscle aches and pains.
• Coughing, sore throat, runny nose, mild fever, swollen glands, chills or sweating.

As with all vaccines, there is a small risk of allergic reaction.

More information on Hepatitis B is available during your pre-travel consultation with Travelvax. Call 1300 360 164 for the location of the clinic nearest to you.