The ABC’s Of Hepatitis

As part of our occupational health and safety services, we provide a vaccination programme for hepatitis B

World Hepatitis Day on 28th July is observed to promote awareness of viral hepatitis.

According to the Department of Health, hepatitis A virus (HAV) and hepatitis B virus (HBV) are highly endemic in South Africa. As quoted in the National Guidelines For The Management Of Viral Hepatitis (2020), South Africa has one of the largest global HBV burdens, with an estimated 3.4 million infected individuals. The World Health Organization estimated that in 2019, about 296 million people were living with a hepatitis B infection and 58 million with hepatitis C globally.

Tshela Healthcare has a comprehensive approach to both individual employee and organisational health and wellness. Health screenings and counselling can be done through onsite and offsite clinics. Clinics can be established at company premises, especially in outlying areas where healthcare access may be limited, like mines. Vaccination programmes form part of these services. Immunisation is the most effective way of preventing HBV infection.

Overview of Hepatitis

About the liver. It is an essential organ that performs over 500 functions in the body. The liver is located at the top of the stomach, under the diaphragm, on the right side of the abdominal cavity.

What is hepatitis? An inflammation of the liver, caused by lifestyle choices (like heavy alcohol usage), toxins, some medications that can damage the liver and viruses. When the liver becomes inflamed or damaged, its function is impaired. Viral hepatitis A, B, C, D and E are caused by different viruses. Hepatitis A and hepatitis E are mainly spread through food or water contaminated with faecal matter (stool) from a person who has contracted the virus. Hepatitis B, C and D are bloodborne viruses.

Illness and treatment. Although hepatitis A is highly contagious, it is generally a mild illness and the person may not have symptoms. Those who contract hepatitis B and C may initially present with no symptoms, followed later by mild to more severe symptoms. Some infected patients with an acute infection (short-term) get better on their own or with treatment. In some cases, the virus causes long-term illness and patients are unable to clear the virus from their bodies, called a chronic condition. Patients with chronic hepatitis are at increased risk for liver damage, liver cancer and cirrhosis (chronic liver scarring/damage), and in severe cases, it can be life-threatening.

Prevention. A vaccine can be given to build immunity in the body before exposure to the virus, called preexposure prophylaxis. Vaccines against hepatitis A and B are safe and effective. There are no vaccines against hepatitis C, D and E. Adults may be offered vaccines for hepatitis A and B, depending on their risk of exposure.

Focus on Hepatitis B

HBV is transmitted when blood from an infected person enters the body of another person – either through sexual contact (the virus is found in semen and vaginal secretions) or sharing items that may be contaminated with blood, like needles, toothbrushes or razors, or through occupational exposure. It can also be transmitted from mother to child during childbirth. Hepatitis B is not spread through casual contact.

• Occupational risk

Employees who work in certain occupations are at greater risk for contracting hepatitis B. Those employed in the healthcare sector, waste management and sewerage workers, cleaners, tattooists, prison staff and mortuary workers are at greater risk for contracting hepatitis B in their places of employment.

• Symptoms

Hepatitis B may be acute (lasting under six months) or chronic – a long-term infection with greater health risks. After contracting the virus, the patient may not initially show symptoms, but after several months, symptoms may present. These include:

• Flu-like symptoms
• Fever
• Weight loss (loss of appetite)
• Nausea and vomiting
• Diarrhoea
• Fatigue
• Dark urine
• Yellow skin and whites of the eyes (jaundice)
• Clay-coloured stools

• Diagnosis

Hepatitis B is diagnosed after a blood test and further testing may be required after a positive result, to test for liver damage. Most people recover from the acute condition within a few months, but with the chronic condition, there is an increased risk for liver damage and liver cancer. In these cases, treatment is offered to keep the virus under control.

Clinic Services and Immunisation

Tshela Healthcare offers clinic services to companies wanting to promote awareness on hepatitis. Through this service, the employer can offer their employees screenings for hepatitis and preventative vaccines.  At one of Tshela’s company clinics at a mine in the Northern Cape, a total of 59 hepatitis vaccinations have been offered to different contractor employees.

What We Offer

• Employees that are identified as being at an increased risk for contracting hepatitis B in the workplace and new employees (in positions that may put them at added risk) visit the clinic.
• Tshela Healthcare workers screen employees and provide counselling on the importance of immunisation to prevent hepatitis B. The vaccine is offered to all at-risk employees.
• If an employee indicates they have been previously vaccinated, a blood test will be done to confirm immunity.
• Any employee who refuses the vaccine, will need to sign that they understand the risks of contracting hepatitis B and possible future health complications.

Immunisation schedule:

• The employee receives the first dose of the vaccine.
• Six weeks later, a second dose is given.
• Six months after the second dose, a third is given.
• Six weeks after the third dose is given, the employee visits the clinic for a blood test to test for the presence of antibodies against hepatitis B. If antibodies are present, that employee has immunity against the hepatitis B virus (life-long protection).
• If no antibodies are present after the blood test, the employee will be given a booster dose.
• Six months later, a blood test will be done to confirm the presence of antibodies.

Tshela Healthcare’s occupational health services are tailored to the unique needs of the organisation we are supporting. We partner with organisations to support them with workplace safety to ensure they meet their legal obligations and facilitate in the prevention of occupational injuries and disease.

To get involved with preventative healthcare programmes or for bespoke solutions for your company, contact us on 053 712 0016 or click on Contacts.

Resources: https://www.healthline.com/; https://www.cdc.gov/; https://medlineplus.gov/; https://www.who.int/; https://www.medicalnewstoday.com/; https://www.gov.za/; https://epicentre.org.za/; https://www.webmd.com/; https://sahivsoc.org/; https://www.nhs.uk/; https://news24.com; https://www.ccohs.ca/