Hepatitis A, B, CDirect Inoculation

Kristen Anderson, Natalie Beal, Lisa CabreraAzusa Pacific UniversityGNRS 587

● Inflammation of the liver

● Refers to viral infections of the liver

● Most common types:o Hepatitis A, Hepatitis B & Hepatitis C

● Viral Hepatitis is the leading cause of liver cancer and liver transplant

● Symptoms: loss of appetite, N/V, dark urine, fatigue, fever, grey-colored stool, abdominal pain, joint pain, & jaundice

What is Hepatitis?

Similarities and DifferencesViral Infection Acute vs. Chronic Transmission Vaccination

Hepatitis A (HAV)

Acute condition—usually last weeks to several months and resolves itself

Oral-Fecal Vaccination available:Series began in early childhood & rec. before travel to specific countries

Hepatitis B (HBV)

Can be both Acute (lasting a few weeks) or Chronic (leading to cirrhosis or liver cancer)

Bodily Fluids—sharing of needles and sexual intercourse

Vaccination available: recommended to begin vaccination series in early infancy

Hepatitis C (HCV)

Chronic condition—can lead to cirrhosis and liver cancer

Bodily Fluids—sharing of needles and sexual intercourse

No Vaccination

● Hepatitis Ao 15 to 50 days (average is 28 days)

● Hepatitis Bo 45 to 160 days (average is 120 days)

Virus can survive outside of body for 7 days

● Hepatitis Co 14 to 180 days (average is 45 days)

Incubation Period

● Continued presence of the Hepatitis virus without symptoms, but with the ability to transmit

● Asymptomatic carriers unaware they can pass on viruso Often do not seek treatment → continued spread of virus

● Hepatitis virus carriers are source of new infection● May be more chronic carriers of Hep. C due to lack of

vaccination● Increased incidence rate in developing countries● Lack of access to vaccinations and treatment

Issues with Carrier State?

● Reportable diseases & Confidential Morbidity Report (CMR) formo Hep A (Acute) within 1 working dayo Hep B & C (Specify Acute/Chronic) within 7 days

● Population-based surveillance ● Assessment● Client education on prevention● Assurance● Policy Development● Health Promotion & preservation

Public Health Nursing Roles (PHN)

1. Conduct notifiable disease surveillance and investigations, including implementation of disease control measures.● Monitor cases of hepatitis A.● Perform case investigations for chronic hepatitis B and C using

assigned protocols. ● Perform thorough, accurate and organized documentation of

outbreaks. ● Prepare written recommendations describing disease prevention and

control measures for the public in collaboration Medical Epidemiologist.

PHN Roles

2. Assist in developing disease investigation protocols and in assuring that questionnaires and educational material are current, complete, accurate, and reflect best practices.● Assist in monitoring the quality of processes involved in notifiable

disease reporting protocols and procedures.● Assist in creating and updating educational materials. ● Prepare written recommendations for prevention and control measures

PHN Roles

3. Participate in standardized evaluations of outbreak and disease response measures to identify areas for improvement and collaborate with other departmental partners. ( DOH)

PHN Roles

Hepatitis A:Educate about strict hand- washing and improve all over personal hygieneHepatitis A vaccine

Client Education and Prevention

Hepatitis B:Vaccinations important for:BabiesPeople with multiple partnersIV drug usersHIV diagnosed peopleTravelers to 3rd world countries

Client Education and Prevention

Hepatitis B Prevention

Hepatitis C● Do not share personal items that may have come into contact with

another person’s blood of body fluids- toothbrush, razor, nail clippers, and needles.

● Do not get tattoos or body piercing.● Cover open sores or other skin breaks.● Practice safe sex.● Routine screening.

•*** No vaccination currently available ***

Client Education and Prevention

● Principal means of assessing population’s health status ● Ongoing assessment, collection, analysis &

interpretation of data● Collaborative effort ● Monitor disease ● Estimate the magnitude and detect epidemics● Protocols or programs effective?● Main goal: reduce mortality & morbidity, improve health

Population-based Surveillance

1. Primary → Vaccination, education on hygiene, safe sex, sanitary conditions, safe food-handling, avoid IV drug use

2. Secondary → post-exposure immunoglobulins, partner notification, screenings for high-risk individuals

3. Tertiary → chronic liver disease and cancer

GOAL: reduce prevalence, eventually eliminate & eradicate communicable disease

Prevention & Control

● Center for Disease Control & Prevention. Retrieved February 27, 2015. http://www.cdc.gov

● Stanhope, M. & Lancaster, J. (2014). Foundations of nursing in the community: Community-oriented practice (4th ed.). St. Louis, MO: Elsevier.

● World Health Organization. Retrieved Februrar 28, 2015 http://www.who.int/en/

● Pasadena Public Health Department. Retrieved February 28, 2015. http://cityofpasadena.net/publichealth/

References

Questions?