Hepatitis B program helps cut infant infections
A program to prevent chronic hepatitis B infection in newborns seems to be working, according to a new study from researchers at the Centers for Disease Control and Prevention.
They found that more babies exposed to hepatitis B through their moms have gotten vaccinated right away, and fewer have ended up with chronic infections, since the program started in 1990.
That’s important because the virus can be passed between mother and child during birth, and over the long run chronic infection increases the risk of liver failure and cancer.
“The findings were very encouraging - they showed that most infants completed the (vaccination) series,” said Emily Smith, the lead researcher on the study.
“For the infants that were followed… they had great results and outcomes,” she told Reuters Health.
Still, Smith emphasized that there’s work to be done in making sure all new moms with hepatitis B are reported to the CDC’s program so that babies can receive the proper care to prevent infection.
40,000 NEW INFECTIONS PER YEAR
About one million people living in the United States have chronic hepatitis B infection, and an additional 40,000 are infected every year though bodily fluids such as blood and semen - as well as during birth.
Perinatal Hepatitis B Program
Perinatal exposure to HBsAg positive mothers is a continuing problem with acute and long term adverse effects for infants. The primary objectives of the perinatal program are:
- Test all pregnant women for the hepatitis B virus.
- Identify pregnant women who are positive (+) for hepatitis B.
- Ensure the newborn receives appropriate prophalaxis as well as sexual/household contacts.
The Perinatal Hepatitis B Prevention Program collaborates with laboratories, hospitals and local health departments to ensure all positive lab reports are reported to the Arizona Department of Health Services. Positive expectant mothers are identified, offered services and tracked by the perinatal program to ensure that exposed infants are appropriately treated with hepatitis B Immune Globulin (HBIG) and hepatitis B vaccine within 12 hours of birth and complete the hep B series in the appropriate time frame.
Additionally, the program offers free services to the sexual and household contacts of the positive mothers, to ensure that they are tested for the hepatitis B virus and if found susceptible, receive the hepatitis B vaccine series.
The CDC’s vaccine program calls for screening all pregnant women for hepatitis B and giving exposed babies antibodies and a vaccine against the virus within 12 hours of birth, followed by an additional two or three vaccine doses over the next year or so. Individual cities and states submit reports to the CDC on the number of hepatitis B cases identified in women and how their infants were managed, and those numbers are used to make nationwide estimates.
What are the signs and symptoms of hepatitis B?
About 7 out of 10 adults with acute hepatitis B have signs or symptoms when infected with HBV. Children under age 5 years who become infected rarely show any symptoms. Signs and symptoms of hepatitis B might include nausea, lack of appetite, tiredness, muscle, joint, or stomach pain, fever, diarrhea or vomiting, headache, dark urine, light-colored stools, and yellowing of the skin and whites of the eyes (jaundice). People who have such signs or symptoms generally feel quite ill and might need to be hospitalized. The case fatality rate among persons with reported cases of acute hepatitis B is approximately 1.5%, with the highest rates occurring in adults who are over 60 years of age.
How long does it take to show signs of illness after a person becomes infected with hepatitis B virus (HBV)?
The incubation period ranges from 45 to 160 days (average 120).
Can HBV be transmitted in daycare via saliva, e.g., drooling infants?
Though HBV has been found in saliva, there are no data to suggest that saliva alone transmits HBV infection. There have been reports of HBV transmission when an HBV-infected person bites another person. In these reports, bloody saliva was usually present in the infected person’s mouth and the blood was more likely the vehicle of transmission. HBV is not spread by kissing, hugging, sneezing, coughing, food or water, sharing eating utensils or drinking glasses, or casual contact.
Based on those reports, the researchers calculated that from 1994 to 2008, the number of women who screened positive for hepatitis B each year increased from about 19,000 to close to 26,000. And health care workers seemed to get better at making sure their babies were protect against the virus.
Over the study period, the number of exposed babies who got both hepatitis B antibodies and a vaccine within a day of birth increased from 92 percent to almost 97 percent.
What is the risk for transmitting HBV by oral sex?
There are no specific data on transmission of bloodborne viruses through oral-genital sex. Saliva has not been associated with HBV transmission unless biting has taken place. HBV is not spread by kissing, hugging, sneezing, coughing, food or water, sharing eating utensils or drinking glasses, or casual contact.
Can “French” kissing transmit HBV?
While HBV has been found in saliva, there are no data to suggest that kissing transmits HBV; however, there have not been studies to specifically look at “French” kissing.
Along with that, tracked infants who ended up with chronic hepatitis B infection fell from two percent to less than one percent by 2008, the researchers reported in Pediatrics.