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.