What you may not know is that hepatitis is also a bloodborne pathogen and is fast becoming a major health problem in the United States. The three strains of the hepatitis virus, A, B, and C, attack the liver and cause varying degrees of illnesses. Hepatitis C (HCV) infection is the most deadly strain of the disease. Hepatitis B (HBV) is almost as deadly; hepatitis A (HAV) causes discomforting symptoms, but rarely results in death. Vaccinations are available for HAV and HBV, but, unfortunately, no vaccination currently exists for HCV.

Many Customs employees are at risk for infection with HBV because of the work they perform. Employees who conduct examinations of persons, baggage, or cargo, subdue violent and combative individuals, and handle potentially infectious evidence can contract HBV. Just the tiniest amount of hepatitis-infected blood on common, everyday objects like a toothbrush, razor, or manicure instrument, can carry enough of the virus to infect a person if it enters his or her bloodstream.

Training and immunization are proactive measures we have put in place to protect our employees who are at greatest risk for exposure to bloodborne diseases. Customs has been providing free vaccinations since 1993. To ensure a consistent nationwide effort, HBV vaccinations are now being coordinated by the Human Resources Management, Safety and Assistance for Employees Division. - Acting Commissioner Charles Winwood Hepatitis - Strains of the virus and their dangers Hepatitis C (HCV) - no cure, no vaccine Over 4 million Americans have been infected with HCV, the most virulent strain of the hepatitis virus. Fortunately, education, coupled with identification of infected individuals, has significantly reduced the incidence of HCV in the U.S. There are approximately 30,000 new cases annually, compared to over 200,000 annually in the 1980s. HCV attacks the liver and usually leads to long-term infection, chronic liver disease, and cirrhosis of the liver. Because of damage to the liver, symptoms may include yellowing of the eyes or skin, loss of appetite, nausea, fever, vomiting, stomach or joint pain, and extreme fatigue. Between 8,000 to 10,000 people who contract HCV die annually from liver cancer or cirrhosis. The primary means of transmission, as with all bloodborne pathogens, is contact with the blood or other bodily fluids of an infected person. This can happen in a variety of ways, from injection of street drugs, accidental needle sticks, transfusion of blood containing the virus, unprotected sex with someone who is HCV positive, and less common, infection of an infant by the mother during childbirth. The few drugs that are available to treat the disease such as Interferon, are only moderately effective, are costly, and often induce severe side effects that may actually hasten liver deterioration in HCV-positive patients with cirrhosis. Hepatitis B (HBV) - no cure, vaccine available The rapid worldwide transmission of HBV is fast becoming a worldwide health crisis. HBV is actually more infectious than AIDS and more common! There are an estimated 1 million carriers of HBV in the U.S. alone with approximately 125,000 new cases annually. Though treatable, 4,000 to 5,000 people die yearly in the U.S. due to liver cancer and cirrhosis of the liver from infection with HBV. Like HCV, there is no cure; however, the importance of getting vaccinated against HBV cannot be overstated: people who become chronically ill with HBV never fully recover from the disease. Sadly, many of these people will spend the rest of their lives at risk for transmitting the disease to others. The good news is that there is a vaccine to prevent HBV, and Customs is providing it free of charge to high-risk employees (see sidebar). Hepatitis A (HAV) - no cure, vaccine available HAV is most often contracted by drinking water or eating food contaminated with fecal matter containing the virus. It is rarely caused by exposure to infected blood. An estimated 150,000 people in the U.S. are infected with HAV annually. People who travel to, or work in, countries where questionable sanitary conditions exist are at risk for exposure to this strain of the disease. HAV is a liver disease with symptoms such as jaundice, fatigue, abdominal pain, loss of appetite, nausea, and diarrhea. However, some people who have the virus display no symptoms at all. While there is no cure for HAV, most people recover within six months without suffering any serious long-term health problems. While Customs is not providing its employees with a vaccination for HAV at this time, you are encouraged to ask your doctor if an HAV vaccination may be right for you or your family members. Don't wait for hepatitis to strike - take precautions now. For more information on bloodborne illnesses, contact the Centers for Disease Control and Prevention (CDC) at (404) 332-4555 or visit their Web site at www.cdc.gov. You may also want to call the American Liver Foundation at (800) GO LIVER or visit their Web site at www.liverfoundation.org.

All about the HBV vaccination . . . Which Customs employees are eligible for the free HBV vaccination? The employees at greatest risk who are eligible for free vaccinations are Customs inspectors, criminal investigators, Customs patrol officers, marine enforcement officers, canine enforcement officers, pilots, air interdiction officers, aviation enforcement officers, mail technicians, and seized property officers. As an eligible employee, how can I get the HBV vaccination? The free vaccination comes in a series of three injections. These shots will be provided at a medical facility close to Customs work sites and in some cases, at those work sites. Customs has contracted with Federal Occupational Health (FOH) to provide vaccinations to employees. Ask your supervisor about how to arrange for your HBV vaccination. I was vaccinated against HBV a few years ago, should I be vaccinated again? If you've already received the complete HBV vaccination series, you should not be vaccinated again. Does the HBV vaccination have any side effects? The side effects of HBV immunization are minor. Local soreness has been reported, along with such general symptoms as headache, abdominal pain, and fatigue. Interestingly, these symptoms are identical to those experienced by individuals who have received placebo vaccinations. Nervous system problems such as Guillain-Barre disease, which can cause a short-term paresthesia, muscle weakness, and sometimes paralysis, have been reported but are extremely rare. What if I'm not eligible to receive the HBV vaccination? If you're not in one of Customs covered occupations, consult your physician for advice about the vaccination.

All about required training on bloodborne pathogens . . . Are employees who are at greater risk of exposure to bloodborne pathogens required to receive training? Yes, to comply with the requirements of the Occupational Safety and Health Administration (OSHA) as outlined in OSHA Standard 29 CFR 1910.1030, Customs implemented Directive 099 5290-009, Occupational Exposure to Bloodborne Pathogens (available on Info Base). This directive requires employees who are at risk of exposure to receive training at the time of their initial employment, and at least annually thereafter, on work place practices and controls to prevent occupational exposure to bloodborne pathogens. The HRM, Safety and Occupational Health Branch, based in Indianapolis, will conduct annual ongoing training through Customs Service Satellite Broadcasts. The broadcasts are provided several times a year. Look for the announcements on Customs TPX, Satellite, Training, HQ, and Indianapolis electronic bulletin boards. What is included in the bloodborne pathogens training? The training includes: A general explanation of the symptoms, modes of transmission, the exposure control plan, methods of recognition of tasks associated with exposure, methods of reducing the risks of exposure, and personal protective equipment. Information about the HBV vaccine and the benefits and risks of vaccination. Information on the appropriate action and person to contact in an emergency. An explanation of procedures to follow if an exposure incident occurs, methods of reporting, and medical follow-up. An explanation of the signs and labels and/or color-coding required by OSHA Standard CFR 1910.1030. An opportunity for interactive questions and answers with the experts conducting the training.