DR. Dr.

Noormartany, SpPK-K; M Si

WHAT IS VIRAL HEPATITIS

?
HEPATITIS is a serious disease caused by virus
that attacks the liver .
There are various strains of viral hepatitis which
can cause lifelong infection, cirrhosis ( scarring)
of the liver , liver cancer , liver failure, and
death.

HEPATITIS A MARKER:
HAV-Total,
HAV-IgM,
Anti -HAV.

Hepatitis B
What are the clinical symptoms?

HEPATITIS B SEROLOGY:

HEPATITIS B MARKERS:
HBsAg:
Present in acute or chronic infection.

Anti HBs:
Present in recovery or immunization.

Anti -HBc:
May be Total (IgG&IgM) or IgM. Lifelong marker of
past
and active infection in either acute or
chronic.

HBeAg:
Acute infection, and extremely infectious.

Anti-Hbe:
Usually prognostic for resolution.

How to protect from becoming infected

with HBV at work??
The primary measure for

prevention of hepatitis B is
immunization
Hepatitis B can be prevented using
either preexposure prophylaxis with
hepatitis vaccine or postexposure
prophylaxis with hepatitis B
immune globulin and hepatitis
vaccine.

HBV is of greatest concern in the

occupational setting for several
reasons:
(1) there is a relatively high risk of becoming
infected following an exposure, exposure to
known contaminated source results in 37-62%
likelihood of infection.
(2) the chance of developing clinical hepatitis
following exposure is 22-31%.

(3) HBV not only transmitted through percutaneous

exposure , but also can be transmitted through
surface contact with dried blood or other
potentially infectious materials
(4) HBV infections that occur in workers with no
history of non occupational exposure or
occupational percutaneous injury might have
resulted from direct or indirect blood or body
fluid exposures that inoculated HBV into
cutaneous scratches, abrasions, burns, or other
lesions, or on mucosal surfaces

Hepatitis C Virus
(HCV)
Discovered in 1989 as a small RNA blood-borne virus

with a large reservoir of chronic carriers worldwide

Major cause of posttransfusion hepatitis prior to 1992

Major cause of chronic liver disease, cirrhosis, and

hepatocellular carcinoma worldwide

1990-2015: estimated 4-fold increase in the number of

patients diagnosed with HCV in the United States

Serologic Pattern of Acute HCV

Infection with Progression with
Recovery
anti-HCV

Symptoms +/Titer

HCV RNA

ALT
Normal
0

Months
Time after Exposure
Adapted from MMWR 1998; 47(No. RR19)

Years

Serologic Pattern of Acute HCV Infection with

Progression to Chronic Infection
anti-HCV

Titer

Symptoms +/-

ALT
Normal
0

Months
Time after Exposure
Adapted from MMWR 1998; 47(No. RR19)

Years

Specific Practices To Be Utilized in workplace !!!!!!!!!!!!

How to dispose of small amount of regulated
waste and remove gloves:

How to dispose a larger amounts of regulated waste:

Before removing disposable gloves,

gather all contaminated materials

together and put them in a biohazard
(red) bag.
Make sure the bag intact and that
there is no danger of leaking.
Strip off disposable gloves, drop them
into the red bag, close the bag by
handling only the clean outside
surfaces ,do not throw the biohazard
bag into the regular trash.
Wash hands with soap and water.
Inform your supervisor so he/she can
make arrangements to properly
dispose of the biohazard bag.

Place all sharps (Needles, Syringes, Broken Glass, Etc.)

into a sharps container.

How to wash hand

properly??
Proper handwashing is
one of the most
important infection
control Mesures for
employees working
with blood or OPIM.
Handwashing facilities
must be available
within the facility to all
employees with
occupational exposure.

Wet both hands and wrists with

soap and water.
Spread to the back of hands
and wrists. Clean the finger tips
and between the fingers .
Washing time should be at least
15 seconds.
Rinse hands and wrists well to
remove the soap.

How to clean spills or contaminated surfaces :

The first step is to contain the spill.
For small spill, gauze or paper
towels should be placed over the
blood or OPIM for containment and
adsorption.
Next, apply a disinfectant. This can
be a 0.5% solution of sodium
hypochlorite in water.

Use paper towels or a dust

pan and broom to remove
the materials.
Dispose of the
contaminated materials in a
properly labeled waste
container.
Once contaminated
materials are removed from
the surface, reapply the
sterilant and allow ten
minutes before wiping
again.

What the third fundamental components of an ECP?

Hepatitis B Vaccination:
The vaccin is given in three stages.
1. The initial injection.
2. A second injection one month later.
3. A third injection 6 months after the first

injection.

What is hepatitis B
vaccine?

Hepatitis B vaccine has been available since 1982.

Made with recombinant DNA technology, and

contain protein portions of HBV.

The vaccine administrated IM
usually given on schedule of 0,1,6 months

Who should be
vaccinated?

Everyone 18 years of age and younger

over 18 years of age who are at risk for HBV infection, which include :
sexually active heterosexual adults with more than one sex partner in
the prior 6 months, or have a history of sexually transmitted disease.
Homosexual and bisexual men
drug users
person at occupational risk of infection
Hemodialysis patients
household and sex contacts of persons with chronic HBV infection

Communication of
Hazards
This part of the ECP describes

labeling
The biohazard legend must be
placed on all containers of
blood or OPIM.
The container for storage ,
transport , or shipping shall
bear this label

Post exposure evaluation and

follow-up
An exposure incident is a specific eye, mouth, other mucous

membrane, non intact skin, or parenteral (e.g. needle stick)

Immediately wash the affected body part with soap and water
Notify your supervisor
It is essential to ensure the proper medical evaluation and follow up
HBV can be transmitted by sexual contact , hepatitis B is the only
sexually transmitted disease for which there is a vaccine that offers
protection
Infant born to women with HBV infection have a very high chance of
getting hepatitis B from their mothers
the hepatitis B vaccine is recognized as the first anti-cancer vaccine,
because it can prevent primary liver cancer caused by hepatitis B
infection.

FACTS:
Hepatitis B can be prevented with a safe

and effective vaccine.

even if a person infected with Hepatitis B
virus does not feel sick , he or she can still
infect others
Medicare will pay up to 80% of the cost for
hepatitis B vaccination for qualifying
individuals
HBV is found in blood and other body fluids
such as semen and vaginal secretions, it is
100 times more infectious than HIV

FACTS:
HBV can be transmitted by sexual

contact , hepatitis B is the only

sexually transmitted disease for which
there is a vaccine that offers protection
Infant born to women with HBV
infection have a very high chance of
getting hepatitis B from their mothers
the hepatitis B vaccine is recognized
as the first anti-cancer vaccine,
because it can prevent primary liver
cancer caused by hepatitis B infection.

Thank you for your

attention

54