What is Hepatitis B ?
Hepatitis B (HBV) is a viral infection that attacks the liver after entering the bloodstream; it is the most common liver infection in the world and can lead to both acute and chronic disease, causing serious consequences such as liver cancer and cirrhosis if left untreated.
What are the symptoms?
Following transmission and the average incubation period of 10 weeks (range of 2 to 6 months), some of those infected may have no symptoms – this is more common in children under 5 years of age. Between 30% and 50% of infected people older than 5 will experience gradually increasing fatigue, loss of appetite, nausea and pain in the right upper abdomen. A rash may present as one of the symptoms and also pain in the joints. These are followed by yellow discolouration of the skin (jaundice) and darkening of the urine. In a small number of cases, HBV infection results in rapid liver failure and death.
Up to 10% of adults and 30% of children who contract HBV will become chronic carriers; this means they will recover but will always remain capable of transmitting the disease. Most babies infected at birth will develop chronic hepatitis B infections and with it a higher risk of liver cancer or failure later in life.
Where is it found?
Hepatitis B prevalence is highest among some sub-Saharan African, East and Southeast Asian, and Pacific island populations but can also be found in high numbers in the Mediterranean countries, parts of Eastern Europe, Africa, and Central and South America. It is important to note that although there is a higher risk in certain countries or regions, hepatitis B occurs in all countries.
Some people may have a higher risk of contracting hepatitis B through their occupation, i.e. healthcare workers, police and other emergency services workers, funeral company employees, staff of residential care facilities, tattooists, acupuncturists, people who perform body piercings and sex workers.
Risk to travellers
While the risk of HBV infection is higher in individuals with greater exposure to bodily fluids and contaminated needles, it is also increased during adventure-style activities, where the risk of injury is higher.
Australian children are vaccinated against hepatitis B as part of the National Immunisation Program, but for unimmunised adults the best way to ensure protection when visiting countries at higher risk of hepatitis B is through vaccination. All travellers should consider hepatitis B vaccination.
How is Hepatitis B transmitted?
HBV is transmitted through contact with body fluids, such as blood, saliva, vaginal secretions and semen, as can occur when sharing needles, with needle-stick injuries, through sexual contact, but also from an infected mother to her baby at birth. The infection can also be contracted through tattooing and even via contaminated instruments used in medical or dental procedures. The virus can survive in the environment for seven days or more and remains capable of infecting a non-immune person (i.e. unvaccinated).
How is Hepatitis B treated?
Immunoglobulin, a passive immunisation, can be administered within 12 hours of an at-risk exposure to help prevent HBV infection. Treatment for chronic disease is through the use of antiviral medications and interferon. A liver transplant may be necessary in the event of severe liver damage.
Immunisation is the best way to prevent hepatitis B.
Travelvax urges travellers to take common sense precautions to avoid exposure to the hepatitis B virus. The risk of infection is increased during travel however as 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 STIs and HIV-AIDS), also needles may be re-used.
What is Hepatitis B Vaccination?
Australian children are vaccinated against Hepatitis B as part of the standard childhood immunisation schedule.
- Recombinant vaccine with adult and paediatric formulations (Engerix-B / HB VaxII)
- Combined vaccine with Hepatitis A with adult and paediatric formulations (Twinrix)
- Combination vaccines used in the childhood immunisation schedule (Infanrix Hexa, Hexaxim)
Contraindications: Anyone who has had anaphylaxis after a previous dose of any hepatitis B vaccine or any component of a Hep B vaccine, or to yeast.
The primary childhood immunisation series is given from birth: healthy babies receive their first hepatitis B vaccine soon after birth (and preferably within the first 24 hours), followed by three doses of a combination Hep B-containing vaccine at 2, 4 and 6 months of age (the 2 month dose may be given at 6 weeks of age).
Standard regimen for adults who did not receive a childhood vaccination series is one dose given at 0, 1 and 6 months.
School age children may have been administered a 2-dose schedule of adult hepatitis vaccinations. This regimen is only appropriate for children aged between 11 and 15 years.
There are 2 accelerated schedules for adults: Months 0, 1, 2 and 12 months, and for those people at imminent risk of exposure: Days 0, 7 and 21 with a booster at 12 months.
Level of protection
Greater than 90% immunity after three doses, and immunity is life-long. (Australian immunisation experts do not recommend testing for immunity unless in a high-risk group).
Possible Side Effects
Usually infrequent and mild but ay experience: 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.
Where can I get a Hepatitis B vaccination from?
If you require vaccination against Hepatitis B, head to a Travelvax clinic near you. Staffed by trained professionals who have access to state-of-the-art equipment, we can help keep you safe on your next trip.
Australian Institute of Health and Welfare https://www.aihw.gov.au/reports/immunisation/vaccine-preventable-diseases/contents
Australian Immunisation Handbook https://immunisationhandbook.health.gov.au/vaccine-preventable-diseases/hepatitis-b