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Epidemiology Hepatitis

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Introduction The leading cause of death up to the 20th century has been communicable diseases (Maurer, 2013). With the advancement we have today in healthcare treatments, access to medical care and an expanded knowledge and understanding of diseases, it has lead to a significant decrease in the mortality rate sustained from communicable illnesses. Diseases such as hepatitis, tuberculosis, HIV, and influenza are all communicable diseases, meaning they can be spread from one person or thing to the next. This writing will present hepatitis B and how it affects individuals and the community. The roll of the community health nurse will be discussed in regards to hepatitis B.
Description of Hepatitis Hepatitis is simply an inflammation of the liver that is typically caused by a virus. It can be infectious or non-infectious. Viral hepatitis is contagious and is caused from a viral infection leading to liver inflammation. There are two types of hepatitis B. Acute hepatitis B is short lived, and chronic hepatitis B which produces long-term illness. Individuals who are exposed to hepatitis B in infancy or childhood likely will develop chronic hepatitis. Those who are exposed as adults will develop antibodies and typically have an acute hepatitis infection. Hepatitis B is contracted when a person comes in contact with infected blood semen or other body fluids enters their bodies. If a person has an exposure to hepatitis B, hepatitis B immune globulin (HBIG) can be given to suppress the development of the disease. In an acute infection, symptoms that can be experienced include nausea, vomiting, abdominal pain, fever, fatigue, dark urine, joint pain, jaundice, anorexia and clay-colored stools. The symptoms usually show up with in the first six months after the exposure and can last up to six months long. Chronic hepatitis B does not always illicit symptoms but some of the same symptoms can be experienced as in the acute cause. In certain cases, such as childhood exposure, acute hepatitis can develop and progress into chronic hepatitis and further progress to cirrhosis. Cirrhosis is a condition of the liver where the liver cells get replaced by fibrosis (scarring) and this leads to liver failure. If the cirrhosis advances, a liver transplant may be required and it can place a person at a higher risk of developing hepatic cancer and even death (Hepatitis B Faq’s for the Public, 2009). Hepatitis B is treated by controlling symptoms that develop such as the nausea and vomiting. The Hepatitis B Foundation has recommendations for treatment of chronic hepatitis B including the use and monitoring of antiviral medications which can help to offset liver damage. Educating patients about alcohol consumption, hepatotoxic medications, safe-sex, proper nutrition, and adequate sleep is important to help them manage their symptoms and prevent further damage (Acute vs. Chronic Hepatitis B, 2009).
Demographic and Determinants of Health Certain populations of people are at higher risk of contracting hepatitis B and they include: homosexual men, IV drug uses, health care workers, hemodialysis patients, those who live with someone who has the disease,and people who have more than one sexually transmitted disease (Hepatitis B Faq’s for the Public, 2009). Some people who contract the disease are symptom free and go undiagnosed which makes the actual prevalence much higher than what is reported. In 1990 there was an initiation of childhood vaccinations and since then hepatitis B has decreased by roughly 82%. Individuals who do not have access to vaccines are at a significantly higher risk than those who do. The United States has an estimated one million chronic hepatitis B cases, however worldwide there are roughly 350 million affected and over 600,000 deaths annually related to the disease (Hepatitis B Faq’s for the Public, 2009).
Epidemiologic Triangle The epidemiological triangle of transmission begins with the host. Typically this is a hepatitis B positive person. The virus is found in bodily fluids on the infected individual is only transmitted through serum or plasma. The exchange or transfer occurs with shared toiletries, sexual contact, birth, needle sharing, improper sterilization of tools used for medical, dental and tattoo purposes. Hepatitis B is impressive with its ability to survive outside of the host body. It can remain infectious for up to 7 days and any non-immune person is susceptible to the infection through percutaneous and mucosal exposure. Anyone who has a series of vaccinations is protected against the infection and those individual who have convalesced from acute Hep B have immunity for life. Those who are infected are highly contagious and should employ strict precautions be taken to prevent the spread of this infectious disease (Infectious Diseases Hepatitis B, 2007).
Role of the Community Health Nurse When there is a hepatitis B confirmed case, the community health nurse is notified. The nurse gathers information including: patient history, possible source of infection, treatment initiated, education and follow up needs. Along with educating and obtaining accurate information about the patient and how they obtained the disease, the nurse is looking at demographics and possible outbreaks. If an outbreak were detected, the nurse would report this to the Board of Health. Medical providers collaborate with the community to inform and educate in cases of possible outbreaks. National Organization In 1991 Dr. Baruch Blumberg, Nobel Prize recipient for discovering the Hepatitis B virus along with a couple who were affected by hepatitis B, started the Hepatitis B Foundation. This Foundation is a non-profit organization committed to finding a cure and helping those affected by the disease, promoting awareness, providing community support, promoting immunization and treatment plans. The Hepatitis B Foundation has been recognized for its accomplishments in research and raising awareness to hepatitis B over the last 20 years. Community support and improving the quality of life of those who are affected by this disease have been the driving force of this organization.
Conclusion

Health care workers and many others have worked very hard to decrease the number of hepatitis B cases being reported each year. Promoting vaccinations, reporting outbreaks and following strict measures to properly sanitize equipment is part of the health care workers responsibilities. It is with these efforts we have seen a dramatic decrease in the amount of reported hepatitis B cases. With organizations such as the Hepatitis B Foundation there has been an increased awareness to the spread and treatment of the disease. It is through each and every one of us and the commitment amongst health care workers that one by one we will be able to hopefully eradicate hepatitis B completely. Joining together to educate, promote vaccines and treat this disease will promote the health and wellness of the communities nurses across America serve. References

Acute vs.Chronic Hepatitis B (2009, October 21). Retrieved from Hepatitis B Foundation: www.hepb.org/patients/acute_vs_chronic.html
Hepatitis B Faq’s for the Public (2009, June p). Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/hepatitis?B/bFAQ.htm#overview
Infectious Diseases Hepatitis B (2007, February 10). Retrieved from State of Victoria Home.
Our Accomplishments (2014, January 2). Retrieved from Hepatitis B Foundation: www.hepb.org/about/our_accomplishments.html
Maurer, Frances., Smith, Claudia. Community/Public Health Nursing Practice, 5th Edition. Saunders, 2013. VitalBook file.…...

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