What is hepatitis?

Hepatitis is a group of viral infections. It affects your liver and causes swelling. There are three main forms: hepatitis A, B, and C. Though related, each form has its own specific virus. People can get hepatitis from diseases, drug use, alcohol abuse, and poisons.

Hepatitis A is mainly an acute (short-term) disease. People can be cured with or without treatment. Hepatitis B and C often are chronic (long-term) diseases. Hepatitis A and B can be prevented with vaccines. There is no vaccine for hepatitis C.

Path to improved health

Because hepatitis is a viral infection, it is contagious. It is most often transferred through blood or body fluids. It also can be passed from mother to baby at birth. The risk is higher for women who have hepatitis B and C. If you are pregnant and have hepatitis, you should tell your doctor.

The American Academy of Family Physicians (AAFP) recommends that all pregnant women be screened for hepatitis B at their first prenatal appointment. Although the Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force (USPSTF) recommend screening for hepatitis C in pregnancy, currently the AAFP does not. The AAFP only recommends hepatitis C screening for people who have a high risk of the infection. This includes women who have:

• Used drugs
• Been exposed to needles
• Received a blood transfusion
• Have HIV (human immunodeficiency virus)

A pregnant woman who tests positive for hep B should get a dose of immune globulin (IG). This injection helps to treat the virus and protect your baby. After delivery, the baby should get a dose of IG, as well as the hep B vaccine. The Centers for Disease Control and Prevention (CDC) recommends that all babies receive the hep B vaccine at birth.

Unlike hep B, there is no medicine to help prevent a pregnant woman from passing hep C to her baby. Pregnant women who have hep B or C will receive extra prenatal care. This may include blood tests, liver tests, and medicine to reduce symptoms.

Things to consider

Women who have hep B or C while pregnant can have several problems. One is acute fatty liver. This is a rare disease that affects the liver’s ability to process fatty acids. It often occurs in late pregnancy and can be severe. In these cases, the doctor may want to deliver the baby right away. This allows treatment to start and helps prevent the baby from getting the virus.

Another potential problem is gallstones. These can occur if fluids from your liver build up in your gallbladder. The stones can cause pain, swelling, and jaundice, which is when your skin and eyes turn yellow. If the gallstones are severe, you may need surgery.

Pregnant women who have hep B or C should contact their doctor right away if they have any complications.

Women who use the medicine Rebetron (a combination of the medicines Rebetrol and Intron A) should not try to become pregnant. If you use this medicine and become pregnant, stop taking it and see your doctor. It can cause severe birth defects. It also should not be used by women who breastfeed. Talk to your doctor about other medicines that may be harmful. These include prescriptions and over-the-counter drugs.

Questions to ask your doctor

• How do I know if I have hep B or C?
• What is the cause of my hepatitis?
• If I have hep B or C and am pregnant, what is the best form of treatment?
• Are there any lifestyle changes I should make?
• What is the risk that I will pass the virus to my baby at birth?

Resources

American College of Obstetricians and Gynecologists, Hepatitis B and Hepatitis C in Pregnancy

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Vaccinations are as important for adults as they are for children. Just because you’re grown doesn’t mean you’re immune from certain illnesses. Vaccinations are important in staying healthy. Unfortunately, many adults don’t know they need vaccines.

Certain vaccines may be more important based on your job or lifestyle. For example, vaccines are recommended for those who are in the military, gay and bi-sexual men, health care workers, people with certain health conditions, travelers, and pregnant women.

Path to improved health

The Center for Disease Control and Prevention (CDC) recommends the following vaccines for adults:

• Flu: All adults should receive a seasonal flu shot once a year. It can reduce the risk of flu by up to 50%. How well it works depends on the type of flu that is spreading. It takes about two weeks after vaccination to protect against flu. The best time to get vaccinated is early fall. This is before flu season begins. The CDC recommends that people get a flu vaccine by the end of October. While getting the vaccine earlier is better, getting it later is still effective. Getting the vaccine even in January or February can still provide some protection. New strains of flu, such as the coronavirus, or COVID-19, don’t always have a vaccine available when it first spreads. Developing vaccines for new types of flu can take 18 months or longer.
• Tdap: This vaccine protects against tetanus, diphtheria, and These bacterial infections can be prevented with a vaccine. It’s typically given at age 11 or 12. If you did not receive it as a child, you need it as an adult. If you are a family member of someone expecting a new baby, it is important to get the Tdap before the baby is born.
• Td: This vaccine protects against tetanus and diphtheria. These are bacterial infections. If you got the vaccination as a child, you need a booster dose every 10 years. If you haven’t had one for a while, get one if you’ve experienced a severe or dirty wound or burn. Everyone needs a Td booster dose every 10 years.
• Zoster: This vaccination protects against the shingles. The shingles virus causes a painful rash. It appears as blisters that develop on one side of the body. It often appears on the face or torso. It can result in long-term pain even after the rash goes away. Older people are most at risk for the virus. The CDC recommends adults 50 years and older get two doses of the vaccine. The doses should be 2 to 6 months apart.
• Pneumococcal Conjugate: This vaccine protects against pneumonia. Pneumonia is a serious bacterial infection. It spreads from close, person-to-person contact. The infection is common in adults. Beyond children, adults 65 and older are urged to get the vaccine. It also may be recommended by your doctor that you get this vaccine if you have a chronic condition, such as diabetes or COPD.
• HPV: This vaccine protects against human papillomavirus (HPV). People who are sexually active are at risk of HPV. The vaccine is given to pre-teens. However, adults can benefit from getting it later in life. The vaccine requires three doses. If you only got one or two doses as a child, you need still need the final dose.
• Meningococcal: This vaccine protects against meningococcal disease. This bacterial infection affects the lining of the brain, spinal cord, and bloodstream. It is spread through coughs, kissing, and living in close quarters. Your doctor will tell you if you should receive this vaccine.
• MMR: This vaccine protects against measles, mumps, and rubella. Adults born after 1957 who never got the vaccine should get it.
• Varicella: This vaccine protects against chickenpox. Adults who have not had chickenpox or the vaccine should get it.
• Hepatitis A: This is a highly contagious liver infection. It is spread through contact with feces (poop). Adults who are at risk for the infection should get the vaccine. Risk factors include living or traveling to areas of the world where the infection is common, exposure to childcare centers, and living with someone who has Hep A.
• Hepatitis B: This is an infection of the liver. It is spread through contact with blood and bodily fluids. Adults exposed to certain risk factors should get the vaccine. Risk factors include jobs that expose you to others with the infection, a diagnosis of diabetes, end-stage kidney disease, chronic liver disease, or drug/sexual behavior that increases risk.
• Hib: Haemophilus influenzae type b (Hib) is a bacterial infection. It infects the lining of the brain and causes meningitis. Adults with certain risk factors should get the vaccine. This includes people with a diagnosis of sickle cell disease, HIV/AIDS, removal of the spleen, bone marrow transplant, or cancer treatment.

Things to consider

Most private health insurance plans cover the cost of vaccines. Medicare and Medicaid will cover certain vaccines. This includes the flu, pneumococcal, and Hep B vaccines. Other portions of the plans may cover zoster, MMR, and Tdap vaccines.

If you are pregnant, check with your doctor before getting any vaccine.

If you can’t remember which vaccines you’ve had, ask your doctor about repeating the vaccine or the need for booster doses. Most vaccines have few side effects. The negative effects of the diseases itself is far worse than the vaccine. You may experience slight pain and redness near the vaccine injection site.

Questions to ask your doctor

• How do I find out which vaccines I’ve already had?
• Can a blood test determine if I had a vaccine or an antibody to certain illnesses?
• If I had chickenpox as a child, do I still need the vaccine?
• If I had shingles, do I still need the vaccine?
• Is it too late to get a vaccine after I’ve been exposed to a disease or infection?

Resources

Centers for Disease Control and Prevention: The Adult Vaccine Assessment Tool

U.S. Department of Health and Human Services, vaccines.gov: Vaccines for Adults

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As a health care worker, you may be exposed to sources of infection. These may be transmitted in three ways. First, you can come into contact with an infected person’s blood or body fluids. This also includes droplets from a cough or sneeze. You can come into contact with infectious materials. The last way infections are spread is through the air.

Path to improved health

You can protect yourself from infection by:

• Following the infection control guidelines in your workplace.
• Using protective gear, such as gloves, goggles, and/or masks.
• Treating all blood and body fluids as though they are infectious.
• Handling and disposing of needles and sharp instruments correctly.
• Getting immunized for necessary vaccines.

Infections and diseases can spread through certain body fluids. The main sources are blood, vomit, semen, vaginal discharge, breast milk, and pus. Internal fluids, like those from the lungs, heart, or stomach, also can transmit disease. Clear fluids, such as tears, saliva, sweat, and urine, contain little or no threat for infection. They cannot transmit infection unless mixed with blood.

For a skin or mucus splash, your risk is lower. Exceptions are if your skin has a wound, rash, or crack. Also, if the blood or fluids splash into your mouth or eyes. For a needlestick injury or cut, your risk is higher. In all cases, wash the affected area and get medical care right away.

A doctor will assess and test you for infection. They also may want to test the infected person (source).

• If the source has HIV, you may need to take preventive medicines. These should be started within hours of the incident.
• If the source is infected with hepatitis B, you will get hepatitis B immune globulin. This is if you haven’t been immunized or don’t have immunity.
• If the source has hepatitis C, you may need antiviral medicines.
• If the source has syphilis, you’ll be treated with antibiotics.

You may need follow-up or repeat testing to check for infection. This will depend on the source and the type of disease.

Things to consider

Some infections are more serious, including HIV, hepatitis B and C, and syphilis. However, you should protect yourself against all infections and viruses. To help with this, you can get vaccines.

If you haven’t had chickenpox, you should have a blood test. It will check your immunity to varicella, the virus that causes chickenpox. Most adults are immune, even if they haven’t had chickenpox. If you aren’t immune, you should have the 2-shot varicella vaccine series. Without the vaccine, you’re at risk of getting chickenpox and spreading it to others.

In rare cases, people can get chickenpox a second time. This can happen even if you’re immune to varicella. Chickenpox is usually milder the second time. If you get it again, tell your work so you can avoid contact with patients.

A Tdap vaccine is routinely given at age 11 or 12. It protects against tetanus, diphtheria, and pertussis (whooping cough). Pertussis is responsible for some coughs or cases of bronchitis that last longer than the usual cold. If your cold lasts more than 2 weeks, talk to your doctor. Pertussis can be life threatening to unimmunized infants. Anyone who did not receive the Tdap vaccine as a child should get it as soon as possible. Health care workers should get the Tdap booster for tetanus and diphtheria once every 10 years.

It’s important to know which patients might have tuberculosis. Those who are homeless or have immigrated from certain countries are at higher risk. They will have a chronic cough that lasts for weeks and brings up mucous or blood. They also may have fever, night sweats, or weight loss. You can catch this disease by breathing in droplets that get into the air when an infected patient coughs. Wear a protective mask if you work around patients who have tuberculosis. Infected patients also should wear masks to contain the infection. In an office setting, move them out of the waiting room. In a hospital setting, put them in isolation.

Questions to ask your doctor

• What other vaccines should I get to avoid infections at work?
• If I’m exposed to blood or body fluids in my workplace, what are the chances I will get infected?
• When and how will I know for sure if I’m infected?

Resources

National Institutes of Health, MedlinePlus: Infection Control

U.S. Department of Labor, Occupational Safety and Health Administration: Infectious Diseases

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