L16: Viral Hepatitis Flashcards
1
Q
Def of Viral Hepatitis
A
- It is an acute viral infection of the liver, and a group of infectious diseases that affect millions of people
worldwide.
2
Q
Number of acute & Chronic Cases & Deaths HBC & HVC worldwide in 2015
A
- 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.
3
Q
In 2015 According to DHS
- The prevalence of HCV
DHS is In Egypt
A
The prevalence of HCV was
- 4.4% for age group 1 - 59 years &
- 0.2% for age group 1-14 years
4
Q
In 2015 According to DHS
- rate of infection
A
- in men was 5.3% and
- in women 3.6%, and
it increased by age in both men and women.
5
Q
In 2015 According to DHS
- The infection with HCV is ……. in rural areas (…..%) compared with urban areas (….%)
A
- More
- 5%
- 3%
6
Q
In 2015 According to DHS
-The percentage was ….. in upper Egypt compared to lower Egypt (….. in Upper Egypt, ….. in Lower Egypt)
A
- higher
- 5.6%
- 3.4%
7
Q
In 2015 According to DHS
- it was ….% in urban governorates and ….% in borde governorates.
A
3, 1.6
8
Q
In 2015 According to DHS
- The prevalence of (HBV)
A
1% for age group 1 - 59 years old.
9
Q
Suspected Case of Viral Hepatitis
A
10
Q
Probable Case of Viral Hepatitis
A
11
Q
Confirmed Case of Viral Hepatitis
A
12
Q
Hepatitis A
A
(infectious/ epidemic)
13
Q
No. of worldwide cases of HAV
A
1.4 million people worldwide each year are infected
14
Q
What predisposes for HAV?
A
More prevalent in unsanitary environment, poor areas and bad hygienic conditions
14
Q
Incidence of HAV
A
- 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
15
Q
Incidence of HAV in Egypt
A
number of reported cases in 2014 is 3.037 .
16
Q
Epidemic Threshold of HAV
A
not known
17
Q
Causative Agent of HAV
A
Hepatitis A virus, that can live for several months outside the body
18
Q
Reservoir of HAV
A
human
- case (sub clinical or clinical)
- carriers: incubatory
19
Q
MOT of HAV
A
food and water born disease
Exit: Stool & Blood in stage of Viremia
20
Q
IP of HAV
A
21
Q
Infectivity Period of HAV
A
22
Q
Susceptible age for HAV
A
23
Q
Susceptible Sex for HAV
A
Both sex are susceptible
24
Immunity by **HAV**
Lifelong immunity
25
What Environmental Factors predispose for **HAV**?
poor sanitation, water and food born epidemic may occur
26
General Prevention of **HAV**
Revise general epidemiology
27
Specific Prevention of **HAV**
- Active Immunization
- Sero-Prophylaxis
28
Active Immunization of **HAV**
29
Nature of Active Immunization of **HAV**
29
Dose of Active Immunization of **HAV**
30
Effect of Active Immunization of **HAV**
31
Indications of Active Immunization of **HAV**
32
Sero prophylaxis in **HAV**
33
Nature of Sero prophylaxis in **HAV**
34
Dose of Sero prophylaxis in **HAV**
35
Indications of Sero prophylaxis in **HAV**
36
Case control measures in **HAV**
37
Contact control measures in **HAV**
38
Epidemic Measures in **HAV**
Outbreak investigation to trace source of infection.
## Footnote
**VIP**
39
International Measures in **HAV**
It is recommended to vaccinate travelers to countries where the disease is endemic.
40
Realtion of **HEV** to **HAV**
Similar As VAH except its fatal in pregnancy
41
Viral B hepatitis
Serum hepatitis
42
Epidemeology of **HBV**
43
Causative Agent of **HBV**
Hepatitis B virus
44
Reservoir of **HBV**
only humans
45
MOT of **HBV**
46
Peri-natal transmission of **HBV**
47
IP of **HBV**
6 weeks-6 months
48
Infectivity Period of **HBV**
49
Susceptibility to **HBV**
50
Immunity by **HBV**
lifelong immunity in those who do not become chronic carriers.
51
High-Risk Groups for **HBV**
52
general Prevention of **HBV**
53
Specific Prevention of **HBV**
- Active Vaccinaction
- Sero-Prophylaxis
- Combined
54
Vx for **HBV**
55
Nature of Vx for **HBV**
56
Dose of Vx for **HBV**
57
Indication for Vx for **HBV**
58
Post Vx Testing for Vx for **HBV**
59
Protective Value of Vx for **HBV**
60
Sero-prophylaxis for **HBV**
61
Nature of Sero-prophylaxis for **HBV**
62
Dose of Sero-prophylaxis for **HBV**
63
Indication of Sero-prophylaxis for **HBV**
64
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.
65
Case Control Measures for **HBV**
66
Contact Control Measures for HBV
❶ Enlistment by age, vaccination history.
❷ Surveillance
❸ Specific preventive measures to immunity and susceptibility
67
Epidemic Measures for **HBV**
❶ Strict precaution in blood banks, for blood and blood products
❷ Health education of public
68
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
69
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
70
CA of **Viral C Hepatitis**
- Hepatitis C virus
- In Egypt (genotype 4a) is the most prevalent
71
Reservoir of **Viral C Hepatitis**
- Human cases (75% are subclinical)
- Carriers: all types (usually temporary)
72
MOT of **Viral C Hepatitis**
**as hepatitis B**
- Mainly percutaneous
- Rarely perinatal & sexual transmission .
73
IP of **Viral C Hepatitis**
6 weeks- 6 months
74
75
76
77
77
78
79
Infectivity Period of **Viral C Hepatitis**
Weeks before symptoms continue during the period of HCV positivity
80
Susceptibility for **Viral C Hepatitis**
Susceptibility is general
81
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
82
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.
83
General Prevention of **Viral C Hepatitis**
revise general epidemiology
84
Specific Prevention of **Viral C Hepatitis**
No vaccine available & antiviral Ig not recommended for prophylaxis .
85
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)
86
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
87
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
88
Done
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