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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 approximately 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.
- IV drug use.
- Exposure to
blood products or needles (i.e. dental work, tattoos, body piercing,
acupuncture et al).
- 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 STDs and HIV-AIDS.
Needles may be re-used
Vaccination
Type:
- Synthetic
vaccine* (Engerix / 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 practioner for
details.
Level of
protection:
- 90% immunity
after three doses.
- A blood test is
recommended 2 to 3 months after third dose to confirm immunity
(NHMRC do not recommend unless in a high-risk group). Immunity is
life-long.
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.
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