From: "Meryl Dorey" <meryl@avn.org.au>
-----Original Message-----
From: karin schumacher [mailto:via@access1.net]
Sent: Thursday, 12 August 1999 4:34
To: via
Subject: HEPATITIS A AND B VACCINES
Hepatitis Vaccines (HBV); Hepatitis B Vaccine Protects Kids and Families
August 11, 1999
Hepatitis Weekly: Beginning July 1, 1999, students headed into the seventh grade in Los
Angeles County, California, first had to stop by the doctor's office to be vaccinated
against hepatitis type B. The vaccination is already required for entry into
kindergarten and daycare centers, but the new law ensures that all children are immunized
before reaching adulthood.
Deborah Lehman, MD, Cedars-Sinai Medical Center, said hepatitis B is rarely seen in
children but the vaccination program is the best way to protect kids from the disease as
they grow older. Hepatitis B is usually transmitted by sexual contact with someone
who is infected or by contact with blood that might occur in IV drug abuse and the sharing
of infected needles. In the past, receiving a blood transfusion significantly increased
risk, but the blood supply has been screened for hepatitis B since 1975.
"The young infants we're immunizing are not IV drug abusers, they're not sexually
active, and household contact is a very infrequent cause of transmission," said
Lehman. "But in about one-fourth of cases of hepatitis B, the cause is unknown. And
the disease is probably the most common cause of chronic hepatitis, cirrhosis, and liver
cancer. Furthermore, the earlier a person is infected in life, the more likely they are to
develop these life- threatening illnesses as an adult.
Therefore, immunizing children today against hepatitis B is a preventive measure. In the
long term, we're preventing liver cancer." Although sexual activity and drug
involvement may not pose immediate threats to children, many adolescents are involved in
two seemingly innocent activities - body piercing and tattooing - that increase their risk
for acquiring hepatitis B and hepatitis C. Few if any sterilization regulations
exist within these industries, and the viruses can be spread though a very small amount of
infected blood. Therefore, even getting ears pierced in a store that does not properly
clean or dispose of contaminated equipment can increase the risk of transmission.
The term "hepatitis" refers to any inflammation of the liver, which can result
from such diverse events as viral infections, exposure to toxic chemicals, or long-term
alcohol abuse. Hepatitis B is caused by a specific virus. Type A, caused by a different
virus, does not lead to the degenerative liver disease associated with hepatitis B, but it
can cause sudden, violent illness that quickly spreads through an entire family or
community. Strangely, while children often spread the disease, they tend to remain
symptom-free while the adults they contact become ill.
"Hepatitis A causes serious flu-like symptoms, including severe stomachache,
diarrhea, vomiting, and fever. The liver becomes inflamedand infected and loses its
ability to process bilirubin, which causes the yellowing of eyes and skin called
jaundice," said Lehman. "Infected people often have to be hospitalized, for a
couple of reasons. First,because they are unable to tolerate anything by mouth, patients
become dehydrated. Also, because an infected liver may not be able to properly manufacture
clotting factors, there is a tendency to bleed, which can be dangerous."
Hepatitis A infection can be sufficiently severe to cause acute liver failure, requiring
transplantation for survival. On the other hand, patients who become infected but
recover will be immune to future infection. According to Lehman, all adults and
children in Los Angeles County may be required to receive hepatitis A vaccinations in the
near future because the area is considered to have a high rate of infection - more than 20
cases per 100,000 population. In the meantime, however, vaccination is urged for people in
high-risk categories, such as those who travel internationally; American Indians, native
Alaskans, and others in highly affected communities; homosexual and bisexual men; and
patients such as those with hemophilia who receive clotting factor.
"Many people are understandably hesitant when they hear about new vaccines. It seems
like there's a new one every couple of months," said Lehman. "But in the big
picture, two shots for hepatitis A over six months is a minor inconvenience compared to
the possibility of hospitalization, the possibility of an entire family being infected,
and the possibility of death. These vaccines are very safe and very effective, and there
will probably be a combination hepatitis A/hepatitis B vaccine available in the future,
reducing the number of injections that will be required."
The virus for hepatitis A is transmitted through fecal/oral contamination. In even less
glamorous terms, a microscopic amount of the secretion from an infected person must
somehow get into the another person's mouth for the virus to be passed. This is why food
preparers must wash their hands after using the restroom, and why an outbreak of hepatitis
A can occur very quickly in a daycare center.
"Truthfully, little kids aren't very careful about washing their hands after they use
the bathroom," said Lehman. "And, of course, kids put things in their mouths all
the time. This can be a big problem in a daycare center where kids are running around in
leaky diapers and putting their hands in their mouths. With hepatitis A being quite
contagious, it can go through a community at a fairly rapid rate." In fact, the
kids may pass the disease around, remaining asymptomatic, then take the virus home to
their relatives who become violently ill. For this reason, vaccinating the children may
help protect not only their health but that of their older, less robust family members, as
well.
To reduce the risk of infection of either hepatitis A or hepatitis B, Lehman urges parents
to have their children immunized against both viruses. Also, because there is a chance
that organisms, including the virus that causes hepatitis B, can be transferred from one
person to another through small amounts of contaminated blood, children should be
cautioned against sharing toothbrushes and other personal items. "There are
playground accidents and other circumstances in which kids are exposed to other people's
blood. I think it's a good idea for parents to take the initiative to teach kids about
taking precautions and using good hygiene, " said Lehman. "It isn't necessary to
make them excessively anxious but it is important for kids to learn such things as washing
their hands after using the bathroom."
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Karin Schumacher
Vaccine Information & Awareness (VIA)
619-484-3197 (phone/voicemail)
619-484-1187 (fax)
via@access1.net (email)
http://www.909shot.com (NVIC website)
http://www.access1.net/via (VIA website)
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We Must Have The Freedom To Choose & Respect Everyone's Choice
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Any information obtained here is not to be construed as medical
OR legal advice. The decision to vaccinate and how you
implement that decision is yours and yours alone.
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