Hep A and B vaccines are a must!!!

Moderator: savanb

Hep A and B vaccines are a must!!!

Postby long_way » Fri Sep 12, 2008 8:44 pm

Let's start with a paragraph from Wikipedia ( http://en.wikipedia.org/wiki/Hepatitis_B_in_China ):

"Hepatitis B is recognized as endemic in China by the World Health Organization (WHO).[1] Roughly 400 million people are infected with hepatitis B virus (HBV) worldwide.[2] Over one-third of the world's population has been or is actively infected by hepatitis B virus (HBV). An estimated 130 million Chinese are infected with the disease, about 10 percent of China's total population and about one-third of the world's cases. Almost 1 million new cases were reported in China in 2005."

"Epidemiology

The disease has been classified as endemic in China, when a national survey in 2002 showed a 9% rate of HBsAg in the general population.[1]

Around 130 million people in China are carriers of HBV (almost a third of the people infected with HBV worldwide); 30 million people in the country are chronically infected.[3] During a 5-year period, 10–20% of patients with chronic hepatitis developed cirrhosis, and 20–23% of the cases with compensated cirrhosis progressed to decompensated cirrhosis. 6–15% of the people with cirrhosis and chronic hepatitis progressed to hepatocellular carcinoma (HCC). 5-year survival for compensated cirrhosis is 55%, that for decompensated cirrhosis is 14%, and that for HCC is less than 5%.[4] Every year, 300,000 people die from HBV-related diseases in China, including 180,000 patients with HCC.[5] However, the incidence of hepatitis B is still increasing, from 21.9 in 100,000 people in 1990 to 53.3 in 100,000 in 2003.[6] That increase has occurred despite a vaccination program for newborn babies since the 1990s, which showed good effectiveness for reducing chronic HBV infection in children.[7] The reason for this increased HBV infection is unknown, because hepatitis B has no clear transmission routes in many people in China, although both neonatal infection and horizontal transmission during early childhood are still the most common routes.

Public awareness

Public awareness of the disease, which is spread through the exchange of bodily fluids, is not as high as it is for HIV and AIDS. In some rural areas, doctors have reused syringes and unknowingly spread the disease, particularly among children."

"Transmission of Hepatitis B virus

Transmission results from exposure to infectious blood or body fluids containing blood. Possible forms of transmission include (but are not limited to) unprotected notallowedword contact, blood transfusions, re-use of contaminated needles & syringes, and vertical transmission from mother to child during childbirth. Without intervention, a mother who is positive for the hepatitis B surface antigen confers a 20% risk of passing the infection to her offspring at the time of birth. This risk is as high as 90% if the mother is also positive for the hepatitis B e antigen. HBV can be transmitted between family members within households, possibly by contact of nonintact skin or mucous membrane with secretions or saliva containing HBV.[16][17] However, at least 30% of reported hepatitis B among adults cannot be associated with an identifiable risk factor.[18]"


...and here is the article published in China Daily ( http://www.chinadaily.com.cn/china/2007 ... 073020.htm ):

"China 'has 120m hepatitis B carriers'

By Shan Juan (China Daily)
Updated: 2007-09-01 09:04

At least 120 million people in China have become carriers of the hepatitis B virus out of the 700 million people who once were infected with it, a senior health official said on Friday.

A baby held by its mom receives a free hepatitis B vaccine injection in a hospital in Yichang, Central China's Hubei Province in this June 26, 2006 file photo.

Hao Yang, deputy director of the Ministry of Health's disease control and prevention bureau, revealed the figure at a ceremony unveiling a free hepatitis B vaccination project for 320,000 primary school students in northwest China's Qinghai Province.

But he did not elaborate on details like major transmission channels and geographical distribution.

"Prevention should come first to contain this disease, which is highly preventable with efficient and the safe hepatitis B vaccine available since 1982," he told China Daily.

Since 2002, China has added the vaccine to its routine immunization programs, under which the government foots the bill for vaccines for all newborn babies.

In China, 40 percent of all infections are mother-to-child, according to Samuel So, director of the Asian Liver Center at Stanford University. Unfortunately, very few people are aware that a vaccine at birth is likely to stop the baby contracting the virus.

The vaccine, given as a series of three injections and costing roughly 60 yuan ($8) for each one, is the most cost-efficient and effective way to curb the epidemic, which causes hundreds of thousands of deaths and major economic losses to China every year, noted Wang Zhao, vice-president of China Foundation for Hepatitis Prevention and Control, which helped raise the $1 million funding for the project.

"Starting with children, the vaccine project is a step forward to help the nation finally shake off its notoriety as the 'major hepatitis B host.'" Wang added.

Hao stressed that discrimination against hepatitis B carriers in fields such as employment and education should be eradicated, citing the halt to compulsory hepatitis B tests for job applicants."


So hopefully by now you are scared enough to consider taking Hep A and B vaccines before you head to China. In North America Twinrix vaccine ( http://en.wikipedia.org/wiki/Twinrix ) is widely available however your doctor is the best person to discuss all questions regarding vaccinations and travel health.

Most restaurants (mid-range and up) offer disposable chopsticks however often you can see re-used chopsticks wrapped into new paper sleeves. Street vendors often use reusable bamboo chopsticks which are not very hygienic. Although blood transfusions or unprotected notallowedword contact is more likely to result in Hep B infection saliva is also one of the body fluids which can carry Hepatitis B viruses.

You can carry with you a pair of reusable chopsticks made of synthetic material which you can wipe with a paper towel (and/or one of those antiseptic serviettes) and even if you don't clean them properly after meal you can clean then later. Eating with such chopsticks is still better than sharing bamboo chopsticks with thousand of other people.

IMPORTANT!!!!!! ++++++++++++++++++++++++++++

In August of 2005 I was vaccinated against Hep A and B with "Twinrix" vaccine (0 - 1 - 6 months schedule) so I thought I had protection for 15 years as it said on the box. I went to China 3 times after that thinking I was protected.

In September of 2008 my doctor requested some liver tests and among them he wanted so see if I had antibodies for Hep B and to our surprise I DID NOT HAVE THEM (the count should have been at least 10 and my count was 5). In other words it appeared Twinrix vaccine did not work (the doctor said it does happen in 5-10% of cases). Fortunately I did not have Hep B either (and all other results were normal too).

Doctor recommended that I take another booster shot so I spent another $40 for a dose of ENGERIX - B. Now I hope my body will create antibodies for Hep B (I will have protection against Hep B).

Only after I returned home from the doctor's office I read that paper that was in the box with the vaccine and towards the bottom of the leaflet it said: "It is important to recognize that absence of detectable anti-HBs does not mean lack of protection, because immune memory persists. Booster doses in this situation are not indicated".

Go figure!

So now I have no idea if Twinrix was not effective or low count of antibodies was normal reaction (and I in fact had immunity).

The lesson I learned is: ONE NEEDS TO BE CAUTIOUS BECAUSE THE VACCINES MAY OR MAY NOT PROVIDE PROTECTION AGAINST HEP-B VIRUS.
long_way
 
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