Hepatitis B (HBV)

Identification: Usually slow with abdominal discomfort, nausea, vomiting, etc., often progressing to jaundice. Fever may be mild or absent. Rashes and joint pain may also occur.

Diagnosis: Confirmed by laboratory finding of hepatitis B surface antigen or recent development of antibodies in patient's serum.

Transmission: Infectious blood, saliva, semen, and vaginal fluids. Percutaneous exposure through contaminated needles, syringes, and other intravenous equipment, especially among drug users. Sexual contact. Health care workers exposed through percutaneous or mucous membrane exposure to patient's blood or saliva.

Incubation Period: Average 60 to 90 days with range of 45 to 180 days. The period of communicability may occur many weeks before onset of symptoms and last through acute clinical stage. Carrier state may last for years.

Preventive Measures^12: Vaccinate health care personnel and HOT students likely to come in contact with blood. Use new syringe and needle for each individual requiring skin tests, other parenteral inoculations, or venipuncture. Advise/encourage students to use condoms during sexual activity.

Control Measures:

Reporting: Report each case to S/LHD and to the Regional Office with a copy to the National Office.

Isolation: Isolate patient on center if acutely ill; otherwise send home or hospitalize. If health staff handles blood and body fluids, use universal precautions.

Immunization of Contacts: As soon as possible, immunize contacts with HBIG 0.06 ml/kg IM and initiate HBV series. Possible contacts for HBV are unvaccinated health providers, sexual contacts, and persons sharing syringes, needles, and other illicit drug equipment.

Food Handlers: Not at special risk.

Control of Outbreaks: Same as for HAV, but HBIG is not required for all on center.

Admission/Readmission: Same as for HAV.

¹² Also refer to PRH-5, Section 5.13 (R8), Bloodborne Pathogen Control Plan. This plan, required by the Occupational Safety and Health Administration, must be available on center.