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Division of Public Health Services Disease Handbook for Childcare Providers Bureau of Infectious Disease Control REVISED –January 2018 HEPATITIS B Hepatitis B is a disease primarily of the liver caused by the hepatitis B virus. Who gets this disease? In the United States, hepatitis B is primarily a disease of young adults. Children can be infected during childbirth if the mother has the virus in her blood. How is it spread? Only blood, semen, vaginal fluids and saliva have been shown to be infectious. Most cases are transmitted by blood (i.e., getting blood from an infected person into the open skin or the eye, nose or mouth of anot her person), or through sexual contact. Note: salivary transmission has rarely occurred and generally through bites . The Hepatitis virus can live on the surface of objects for 7 days or more. What are the signs and symptoms? Hepatitis B signs and sympto ms include loss of appetite, tiredness, abdominal pain, nausea, vomiting, and sometimes rash or joint pain. Jaundice (yellowing of eyes or skin), may be present in adults but it is often absent in children. Symptoms vary from none at all to severe illness. Can a person have this disease without knowing it? Yes. Some people may not have the illness serious enough to seek medical attention. People who contract hepatitis B may become chronic carriers of the virus and continue to be infectious for life especially if they are infected as young children. What is the treatment? No medical treatment is effective for acute hepatitis B. Most adults recover from hepatitis B without intervention. How can the spread of this disease be prevented? 1. Hepatitis B vacci ne is required for all children in childcare and school attendance for all children born after January 1, 1993. The Advisory Committee on Immunization Practices (ACIP), recommends immunizing children against hepatitis B. The three dose series should be completed at birth, 1- 2 months of age, and 6- 18 months of age. (Please see Immunization requirements page for adult immunization recommendations). 2. Standard precautions should be in effect at all times. Disposable gloves should be used when dealing with an y bodily fluids (blood/body fluid- soiled items, surfaces or clothing), when administering first aid (nose bleeds, cuts, scrapes, etc). 3. Disinfect surfaces and objects that are contaminated with blood or other body fluids containing visible blood. One -part bleach to 10 parts of water can be used as a disinfectant for cleaning contaminated surfaces. The bleach mixture must be changed daily. 4. Wash hands immediately after contact with blood or other body fluids containing visible blood, even if gloves have been worn. Who should be excluded? Children and staff who have the hepatitis B virus in their blood may attend and/or work in childcare and schools. Hepatitis B carrier children with risk factors (e.g., biting, frequent scratching, generalized dermatitis) sh ould be assessed for exclusion on an individual basis. Reportable? Yes. Hepatitis B is reportable by New Hampshire law to the Division of Public Health Services, Bureau of Infectious Disease Control at (603) 271- 4496. |