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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.