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Tag Archives: Hepatitis B Outreach

A World Hepatitis Day Message from Dr. Philanbangchang, WHO South-East Asia

This World Hepatitis Day message by Dr. Philanbangchang, WHO South-East Asia addresses some of the many challenges of viral hepatitis in the South-East Asia region, and also applies to other areas of the world.

However, it is interesting to first note some fast facts specifically about hepatitis B…

 

 

  • The statistics on hepatitis B are staggeringTwo billion people worldwide have been infected with HBV.  That’s one in three people globally, and one in twenty in the U.S..  Four hundred million are chronically infected, and approximately two people die each minute as a result of hepatitis B.
  • Hepatitis B is transmitted through blood and bodily fluids.  It is readily transmitted from mother to child at birth, and children born with HBV have a 90% chance of life-long infection.
  • HBV is called the silent epidemic because it is often asymptomatic. Many have no idea how they acquired the virus.
  • Sadly, HBV leads to terrible discrimination and stigma throughout the world.  Family members, workers, and children are shunned and opportunities are denied.
  • Hepatitis B is not curable, but there are excellent treatments available. However, not everyone needs to be treated, but everyone needs to be monitored.
  • The good news is that hepatitis B is vaccine preventable.  Children must be vaccinated at birth to prevent the transmission from mother to child, and people at high risk must be screened before they are vaccinated.  The HBV vaccine does not work if you are already infected with HBV, but it will protect family, sexual partners and household members.  It would be great if the HBV vaccine were universally recommended, available and funded…
  • Practicing simple standard precautions is another way to prevent the transmission of infectious disease – especially those diseases for which there are no vaccines.  If you have hepatitis B, it is best to avoid coinfection with other infectious diseases such as HCV and HIV.  Practice safe sex.  Do not share needles and follow basic prevention methods.
  • With a safe and effective HBV vaccine, good treatments with new treatment protocols on the horizon, it is our hope that hepatitis B will soon be eradicated.
  • It is essential that everyone know the FAQs about hepatitis B.  It is a preventable disease, and we all need to do our part to ensure we prevent the spread of HBV, and treat those living with hepatitis B with the compassion they deserve.

And now a message from Dr. Philanbangchang…

Viral hepatitis kills more people than any other communicable disease in the South-East Asia Region. In the next 10 years, over five million people in the region is projected to die from this disease and its consequences.

Today, more than 130 million people in South-East Asia alone, carry the hepatitis B or C virus, even though they may appear healthy. It usually strikes people at their most productive age.

The hepatitis B virus is 50 to 100 times more infectious than HIV, and just as lethal. Hepatitis E results in 2700 still births every year. For such a major public health threat, hepatitis has a low profile, among policy-makers and the public.

Recognising hepatitis as a threat to public health, the World Health Assembly passed a resolution to prevent and control the disease last year. The World Health Organization has decided to observe July 28 this year as the world’s first ever World Hepatitis Day.

It is thus an opportune time to ask if we are doing enough to protect ourselves from this disease?

Many people recognise the symptoms of jaundice by the yellowing of the eyes and skin. Yet, jaundice is only the face of the disease and the common symptom for any of the four common types of viral hepatitis. These are easily contracted from drinking water to casual contact to sexual intercourse. Even then, not every infected person shows symptoms.

WHO is developing guidelines, strategies and tools for surveillance, prevention and control of this disease. Prevention and focussing on the source and mode of spread of the virus, is crucial to control this disease.

Chronic hepatitis B and C are among the leading causes of preventable deaths in 11 countries of the region. About 100 million hepatitis B carriers, and 30 million hepatitis C carriers, live in South-East Asia.

However, about 60 percent of the infected are unaware of their status until the disease manifests as cirrhosis or liver cancer – an aggressive cancer without a cure. Hepatitis C, in particular, has no vaccine or effective cure. Those who undergo blood transfusion, as well as injecting drug users, are at risk.

Due to lack of knowledge and resources among healthcare workers, many providers in the region do not comply with WHO’s and national guidelines and recommendations for hepatitis B and C screening, prevention, treatment and follow-up services. A patient requiring transfusion may receive blood that has been screened for HIV, but not for hepatitis B or C.

The hepatitis B vaccine can go a long way to prevent hepatitis B. It is more than 95 percent effective in preventing infections and their chronic consequences, and is the first vaccine that protects against a major human cancer. In WHO’s South-Asia Region, more than 130 million infants have received the three required doses of hepatitis B vaccine.

Hepatitis infection is also linked to personal hygiene, sanitation and urban health – hepatitis A and E are both commonly spread through eating or drinking contaminated food or water. Pregnant women are at high risk of hepatitis E. Hepatitis E acquired during pregnancy is also associated with prematurity, low birth weight and an increased risk of perinatal mortality.

In countries of WHO’s South-East Asia Region, more than 6.5 million people are infected with hepatitis E annually accounting for half the cases worldwide, leading to an estimated 160 000 deaths.

Hepatitis E outbreaks often occur in urban areas when leaky underground water pipes are contaminated with sewage. In developing countries, with increasing population pressure and rapid urbanisation leading to people living in close, unsanitary conditions, such diseases are likely to increase rapidly.

So what can be done to prevent and control hepatitis?

To begin with, all countries, especially those urbanising rapidly, need to make hepatitis a health priority. Lives could be saved through simple preventive measures such as hand washing, eating cooked food and boiled water, using condoms and not sharing needles.

Countries need to make screening of all blood and blood products for hepatitis B and C mandatory. Governments should ensure that children are adequately immunised against hepatitis B. Healthcare workers, and the public, need to be educated on the risks and the surveillance system for hepatitis needs to be strengthened.

Unless we act now to create greater awareness among policymakers, healthcare workers, and the public, viral hepatitis will remain a major public health threat.

Dr Samlee Plianbangchang
Regional Director
WHO South-East Asia

 

Got Hepatitis B? Share Your Favorite Liver Specialist with the HBV Community

Do you have a favorite liver specialist that you’d like to share with the Hepatitis B Foundation and friends living with HBV?  Friends with HBV live all over the globe, and we are interested in liver specialists with Hepatitis B treating experience from all over.  Pediatric patients are a special sub-population with special treating needs, too.  We’d love to hear from all of you!  Here’s what we’re looking for…

The Hepatitis B Foundation maintains a database of liver specialists that have experience treating patients with HBV.  Based on your recommendations, we would love to extend an invitation to your liver specialist to participate in our directory of liver specialists.  If your liver specialist replies, we will add his/her name to the list.

We’ve had some wonderful, new HBV friends on facebook from Africa and other continents, and we would encourage all of you to send us your liver specialist’s contact information.  Our international database is a little sparse, so we really need your input!  This would also include parents of children with HBV that are living abroad.  So, if you’ve got experience with a treating specialist that you’d like to share, you can be sure others will benefit from your advice.

Here is what the Hepatitis B Foundation needs to know:

  • Residing country
  • Adult or pediatric specialist
  • Liver specialist’s name and contact information  – including name, address, telephone number and email address (if available)
  • Anything else you’d like to share!

Email this important information to directory@hepb.org .  Please keep in mind that the information you provide is offered as a courtesy to others in the HBV community.  Your name will not be associated, and the addition of your physician does not make you responsible in any way.  This is not a physician referral service, but rather an opportunity for those living with HBV to share resources.  (Please note the disclaimer.)

Thanks to all who participate.  The entire HBV community benefits from your input!

 

Gearing up for World Hepatitis Day!

World Hepatitis Day is July 28th!  What are you doing to raise awareness and educate others about hepatitis B?  I asked this on HBF’s facebook page, and a friend from Ghana wondered what he could do to help raise awareness.  Another friend replied about his concern with HBV in Malawi.

When you consider the scope of hepatitis B, globally, it is indeed sobering.  Statistically, two billion people have been infected with hepatitis B worldwide, and 400 million are chronically infected.  Don’t let these numbers discourage you from your efforts.

When I returned from China in 2003, my heart was heavy with the burden the Chinese people experience on a day-to-day basis, living with HBV.  At the time I was providing infectious disease training for specific groups of Chinese people, but of course in the scheme of things, the outreach effort seemed minimal when compared to the burden.  I had to focus my efforts one-person-at-a-time.  I couldn’t let the sheer numbers discourage me from my mission to educate and raise HBV awareness at any level.

If you have the money or the connections to do something in a big way, that is wonderful.  Then many will benefit from your contribution.  However, I think it is important to note that hepatitis B education and awareness is fundamentally carried out at a grassroots level, where small numbers of individuals band together to make a difference.   Organizations like the Hepatitis B Foundation are crucial due to their ability to reach out and impact larger numbers of people through research, outreach, education and increased HBV awareness.  Utilize their website, social media channels and outreach to gain and share educational information, and help raise awareness.

So what can you do as an individual?  First thing you need to do is get educated on viral hepatitis.  There is much confusion among people about how HBV is transmitted.  If you mention hepatitis B, someone will invariably say, “oh yes.  My uncle got that from eating contaminated food!”  Well, he did get NOT hepatitis B from food!  Know the ABC’s of viral hepatitis, and eliminate these myths.  Hepatitis B is not spread casually, or by sharing a meal, hugging or kissing someone with hep B.  However, HBV is non-discriminating, and we are all vulnerable if we are not vaccinated.

Learn the facts about HBV.  Know some of the statistics, and how it is transmitted.  Know the difference between an acute infection vs. a chronic infection.  Know that 90% of adults will clear an acute infection, while 90% of infants infected will surely live with hepB for life.  Be sure safe injection and medical practices are followed in health care settings.

To raise awareness and eliminate confusion, you don’t have to know the details of surface antigens, antibodies or how to interpret blood test results.  You can look that up on HBF’s website!   This detailed info comes with time.  Start with the hep B basics.  If you are educated, you can educate others.

Learn about the HBV vaccination.  Know that if you are in a high risk group, you should be screened before you are vaccinated.  The vaccine doesn’t work if you already have hepB!  If you are not infected, then get vaccinated.  Let everyone know why vaccination is necessary.  Encourage pregnant women to be screened for HBV.  Ninety percent of  mother-to-child transmission of HBV can be eliminated by ensuring an infant receives a birth dose of the hepatitis B vaccine, followed by the other two shots in the series.  If HBIG is available to newborns of infected mothers, that is even better.

Many believe that hepatitis B will not affect them because they may not have symptoms. They do not realize HBV is a silent epidemic.  They may not realize the importance of their non-complaining liver, and how HBV can destroy it over time.

If you or loved ones have HBV, be sure you are vaccinated for Hepatitis A.  Take care of your liver and abstain from alcohol and tobacco use.  Eat a healthy diet, and practice safe sex.  Practice standard precautions.  Use common sense!

Now for the outreach part… Depending on your hep B status, you might be reluctant to share your new found information with everyone.  Start with your family, friends and household contacts.  They may not understand the global significance of HBV.  It’s okay to start small.

If you’re ready to increase your effort, then reach out to your church, and your community.  Join with others and participate in local city or village health center and community awareness events.  Join an HBV support group, and if you’re interested, create a language specific group for your country.  Volunteer, speak out, and help educate the masses of people who are unaware that HBV is truly a silent epidemic.

Together we can make a difference!

B A Hero Flash Mob Event!

Participants Perform a B A Hero Chant
What a pleasure and inspiration is was to participate in Hep B Free Philadelphia’s “B A Hero Flash Mob” event at City Hall, this week, in Philadelphia. It was great to experience the energy of the event through the many students and participants.

The group gathered at 11:30 to listen to brief messages from former Philadelphia Health commissioner Dr. Walter Tsou; current Philadelphia Health Commissioner Dr. Donald Schwarz; along with Professor Raymond Lum, Drexel University School of Public Health; Chari Cohen, MPH, Associate Director of Public Health of the Hepatitis B Foundation, and Dr. Timothy Block, Volunteer President, Hepatitis B Foundation, and Professor, Drexel University College of Medicine, who addressed the group.  This was a great forum to raise awareness of Hepatitis B, and urge the public to be screened and vaccinated.

As the clock-ticked down to the final minutes, the sun beamed and particpants waited in anticipation to reveal their “secret” to the world.

Richard Liu, MPH, rallied the crowd….

“Everyone has a secret.
Someone you know has Hepatitis B.
You can fight hepatitis B and liver cancer.
Reveal your secret.
B A Hero!”

The bull-horn blew at noon, and the crowd stripped off their jackets and cover-ups, revealing their blue T-shirts emblazoned with a superman-like emblem with a big, red “B” in the shield, all the while chanting:

 “B A Hero!  Get Screened!  Get Vaccinated!”

B A Hero!

The crowd was charged with energy.  The chanting continued.  Some ran about with their B A Hero T-shirts, and red capes. 

One group of elderly adults quietly displayed their support, wearing their T-shirts.  Guest speakers were interviewed.  One group of students performed an educational, “Hep B Rap”.   

The message was clear.  Hepatitis B is a serious problem, and the public needs to be screened for hepatitis B.  There are effective drugs for those identified, and may be in need of treatment.  There is a safe and effective vaccine.  We need to ensure vaccination against hepatitis B for young and old, and especially those in high risk groups.

It was great to have media coverage at the event.  We were thankful to have KYW News Radio, CBS, Fox and ABC in attendance to help spread the word to a broader, listening group.  This was a wonderful event for Hep B Free Philly, the Hepatitis B FoundationHepatitis Awareness Month and the community.

Now it’s time to do your part.  Be an educator, and help raise hepatitis B awareness.  Be sure everyone you know has been screened and vaccinated for HBV. 

B A Hero today!

Impressions of the Congressional Briefing and HHS Viral Hepatitis Action Plan Press Release

Last Thursday, May 12th, I attended the Congressional Briefing, and the Press Conference releasing the U.S. Department of Health and Human Services (HHS) Action Plan to Prevent, Care and Treat Viral Hepatitis, in Washington D.C..  The HHS Action Plan is in response to the 2010 Institute of Medicine (IOM) report on viral hepatitis.

I have been involved with viral hepatitis, specifically hepatitis B, from a patient perspective for over a decade, but my recent involvement in the political arena is new.   So, I’m still struggling with the numerous acronyms, political calendars and jargon…

It was encouraging to see members of Congress in attendance at the Congressional Briefing – hosted by U.S. Senator John Kerry (D-MA) and Rep. Mike Honda (D-CA), but it is clear that viral hepatitis needs more champions in Congress.  Congressional leaders who spoke included Rep. Honda (D-CA) , Rep. Cassidy (R-LA), Rep. Judy Chu (D-CA), Rep. Dr. Christensen (D-VI), Rep. Barbara Lee (D-CA), and Rep. Dent (R-PA).  Federal public health leaders Dr. Howard Koh, Assistant Secretary of Health, and Dr. Kevin Fenton, Director, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention of the CDC  spoke regarding the direction and implementation of the plan.

Congressman Honda’s message was loud and clear to the audience:  “You need to be the megaphone.”  As advocates we need to educate and get our representatives on-board. The other, clear message is that the plan is a strategy with the tactics not yet clearly defined.  More importantly, there is no clear funding dedicated to the roll-out.  Rep. Bill Cassidy, a hepatologist, tells us we must be “fiscally responsible”, and yet he also said “Sometimes you have to increase the budget to reduce the deficit”.  Rep. Donna Christensen, also a doctor, states:  “We can save money and reduce the debt” with the viral hepatitis plan.  As a hepatologist and physician, these representatives understand that money spent on patient education, screening, prevention and treatment will be cost effective over time.  I wonder how many Representatives truly understand the ticking time bomb of this silent epidemic.

The representation at the press conference in D.C. was encouraging –everyone in the room with the same goals.   Dr. Susan Wang, a doctor in NYC spoke of her patient base where one in eight patients are infected with HBV.  Michael Ninburg told his personal story with his fight with hepatitis C, and the successful prevention of HBV from his chronically infected wife to their newborn son.  Michael was cured with the new HCV drugs, and his son was protected by a safe vaccine.  All good.

The HHS Action Plan for Viral Hepatitis will roll out through 2013.  Some of the goals are more attainable than others, such as delivering the first birth dose of the HBV vaccine to infants prior to discharge.  Dr. Koh describes this as the “first shot of life.” Administering prophylaxis and vaccination to infants born to HBV infected mothers is also feasible.  Other goals are loftier, less clearly defined, and will require significant funding.

Dr. Fenton, of the CDC, tells us the viral hepatitis plan will be implemented as a collaborative effort, leveraging resources between government agencies such as HHS, HRSA (Health Resources and Services Adminstration , CDC (Centers for Disease Control), and CMS (Centers for Medicare and Medicaid Services). 

Portions of the plan are dependent on the Affordable Care Act (ACA) and Health Care Reform, which are under attack.  It will be important for these programs remain intact for the plan to be successful.

We are all well aware of shrinking budgets and the need to be fiscally responsible, keeping in mind the human component.  This plan cannot be implemented without collaboration and cooperation between government and community organizations and efforts, and most importantly – funding.

That’s where we, as voting Americans, fit into the equation.  We need to get educate our Representatives and Senators by raising their awareness of viral hepatitis.  We need to tell them there is a plan to combat viral hepatitis.  We need to personalize this, tell our stories, and let them know that we do NOT want funding for viral hepatitis cut from the budget.  

Was your Representative present at the briefing?  Mine was not…

Visit your Representative during Constituent Work Week.  Write a letter, send an email, call and speak to a health staffer, or tweet your Representative, today.

Read the HHS Action Plan to Prevent and Treat Viral Hepatitis.