L16: Viral Hepatitis Flashcards
Def of Viral Hepatitis
- It is an acute viral infection of the liver, and a group of infectious diseases that affect millions of people
worldwide.
Number of acute & Chronic Cases & Deaths HBC & HVC worldwide in 2015
- The number of acute and chronic injuries worldwide has been estimated by (WHO 2015) 32 million cases of hepatitis B, C and 1.34 million people died from it.
In 2015 According to DHS
- The prevalence of HCV
DHS is In Egypt
The prevalence of HCV was
- 4.4% for age group 1 - 59 years &
- 0.2% for age group 1-14 years
In 2015 According to DHS
- rate of infection
- in men was 5.3% and
- in women 3.6%, and
it increased by age in both men and women.
In 2015 According to DHS
- The infection with HCV is ……. in rural areas (…..%) compared with urban areas (….%)
- More
- 5%
- 3%
In 2015 According to DHS
-The percentage was ….. in upper Egypt compared to lower Egypt (….. in Upper Egypt, ….. in Lower Egypt)
- higher
- 5.6%
- 3.4%
In 2015 According to DHS
- it was ….% in urban governorates and ….% in borde governorates.
3, 1.6
In 2015 According to DHS
- The prevalence of (HBV)
1% for age group 1 - 59 years old.
Suspected Case of Viral Hepatitis
Probable Case of Viral Hepatitis
Confirmed Case of Viral Hepatitis
Hepatitis A
(infectious/ epidemic)
No. of worldwide cases of HAV
1.4 million people worldwide each year are infected
What predisposes for HAV?
More prevalent in unsanitary environment, poor areas and bad hygienic conditions
Incidence of HAV
- 1.4 million people worldwide each year are infected.
- More prevalent in unsanitary environment, poor areas and bad hygienic conditions
- Most children in developing countries (90 %) exposed to hepatitis A virus
- Outbreaks are unusual and Fulminant Hepatitis rarely occurs
Incidence of HAV in Egypt
number of reported cases in 2014 is 3.037 .
Epidemic Threshold of HAV
not known
Causative Agent of HAV
Hepatitis A virus, that can live for several months outside the body
Reservoir of HAV
human
- case (sub clinical or clinical)
- carriers: incubatory
MOT of HAV
food and water born disease
Exit: Stool & Blood in stage of Viremia
IP of HAV
Infectivity Period of HAV
Susceptible age for HAV
Susceptible Sex for HAV
Both sex are susceptible
Immunity by HAV
Lifelong immunity
What Environmental Factors predispose for HAV?
poor sanitation, water and food born epidemic may occur
General Prevention of HAV
Revise general epidemiology
Specific Prevention of HAV
- Active Immunization
- Sero-Prophylaxis
Active Immunization of HAV
Nature of Active Immunization of HAV
Dose of Active Immunization of HAV
Effect of Active Immunization of HAV
Indications of Active Immunization of HAV
Sero prophylaxis in HAV
Nature of Sero prophylaxis in HAV
Dose of Sero prophylaxis in HAV
Indications of Sero prophylaxis in HAV
Case control measures in HAV
Contact control measures in HAV
Epidemic Measures in HAV
Outbreak investigation to trace source of infection.
VIP
International Measures in HAV
It is recommended to vaccinate travelers to countries where the disease is endemic.
Realtion of HEV to HAV
Similar As VAH except its fatal in pregnancy
Viral B hepatitis
Serum hepatitis
Epidemeology of HBV
Causative Agent of HBV
Hepatitis B virus
Reservoir of HBV
only humans
MOT of HBV
Peri-natal transmission of HBV
IP of HBV
6 weeks-6 months
Infectivity Period of HBV
Susceptibility to HBV
Immunity by HBV
lifelong immunity in those who do not become chronic carriers.
High-Risk Groups for HBV
general Prevention of HBV
Specific Prevention of HBV
- Active Vaccinaction
- Sero-Prophylaxis
- Combined
Vx for HBV
Nature of Vx for HBV
Dose of Vx for HBV
Indication for Vx for HBV
Post Vx Testing for Vx for HBV
Protective Value of Vx for HBV
Sero-prophylaxis for HBV
Nature of Sero-prophylaxis for HBV
Dose of Sero-prophylaxis for HBV
Indication of Sero-prophylaxis for HBV
Combined active & Passive Vx for HBV
❶ Prevention of Mother to child transmission
❷ Combined seroprophylaxis & vaccination to infants born to infected mothers
❸ Health care worker
❹ Non-responders who have not completed a second 3-dose vaccine series.
❺ For those who previously completed a second vaccine series but failed to
respond, two doses of HBIG are preferred.
Case Control Measures for HBV
Contact Control Measures for HBV
❶ Enlistment by age, vaccination history.
❷ Surveillance
❸ Specific preventive measures to immunity and susceptibility
Epidemic Measures for HBV
❶ Strict precaution in blood banks, for blood and blood products
❷ Health education of public
Global Epidemeology of Viral C Hepatitis
- Worldwide, over 3% of the population is currently living with HCV .
- WHO estimates about 1.75million new cases and 399.000 deaths annually
National Epidemeology of Viral C Hepatitis
- High prevalence in Egypt: 10-15% .
- Prevalence is high in Lower Egypt, lower in Upper Egypt and low in cities
- High mortality in Egypt annual mortality= 45,8 per 1000
CA of Viral C Hepatitis
- Hepatitis C virus
- In Egypt (genotype 4a) is the most prevalent
Reservoir of Viral C Hepatitis
- Human cases (75% are subclinical)
- Carriers: all types (usually temporary)
MOT of Viral C Hepatitis
as hepatitis B
- Mainly percutaneous
- Rarely perinatal & sexual transmission .
IP of Viral C Hepatitis
6 weeks- 6 months
Infectivity Period of Viral C Hepatitis
Weeks before symptoms continue during the period of HCV positivity
Susceptibility for Viral C Hepatitis
Susceptibility is general
Degree of immunity in Viral C Hepatitis
- degree of immunity is not known.
- One can re-infected or co-infected with another hepatitis C genotype/subgroup
High Risk group for Viral C Hepatitis
❶ I.V drug users.
❷ Patients with blood transfusions.
❸ Exposure to tattooing, ear piercing, etc.
❹ Health care workers (risk from needle stick is 3%).
❺ Children of HCV +ve mothers (6% vertical transmission rate).
❻ Heterosexual, very rarely homosexual.
General Prevention of Viral C Hepatitis
revise general epidemiology
Specific Prevention of Viral C Hepatitis
No vaccine available & antiviral Ig not recommended for prophylaxis .
Case Control Measures for Viral C Hepatitis
❶ Early case finding among high risk groups
❷ Notification to local health office
❸ Segregation (no isolation) with standard precautions to blood & body fluids
❹ Treatment: as recommended by physician
❺ Disinfection: concurrent (for blood, serum,
contaminated articles, dressings) Terminal (using chlorine solution & potent disinfectants)
Contact Control Measues for Viral C Hepatitis
❶ Enlistment by age, vaccination history.
❷ Surveillance
❸ Investigation to detect source of infection.
❹ Post-exposure Management for HCV: Follow-up
Epidemic Measures for Viral C Hepatitis
❶ Strict precaution in blood banks, for blood & blood products
❷ Researches & survey studies for additional cases
❸ Health education of the public
Done
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