1. Hepatitis ABC and more... Public Health and Health Improvement Unit

2. The liver zHepatitis affects the liver. The liver is the body’s chemical factory and performs hundred of complex functions. zNutrients from food pass through your intestine where they are absorbed into the bloodstream and transported to your liver. zHere the nutrients are either stored or broken down further, ready for the body to use.

3. Public Health and Health Improvement Unit The liver zThe liver produces quick energy when it is needed. zIt aids the digestive process by producing bile. zIt neutralises and destroys poisons. zIt helps the body resist infection by producing immune factors.

4. Public Health and Health Improvement Unit HEPATITIS C LABORATORY REPORTS England and Wales, By Region, 1992-2000

5. Public Health and Health Improvement Unit Hepatitis A transmission You can contract Hep A: zby being in close contact with someone with the virus zfrom eating contaminated food zby drinking contaminated water & ice cubes with sewage (usually abroad) zfrom blood-to-blood exposure (rare)

6. Public Health and Health Improvement Unit Prevention of HAV transmission You can AVOID contracting Hep A: zby being vaccinated before travelling to certain countries zby being vaccinated if you work in a high risk occupation or have a personal risk outside work zby always cooking shellfish well zby avoiding salads, shellfish, tap water, unpasteurised milk and ice cubes abroad

7. Public Health and Health Improvement Unit Hepatitis B You can contract Hep B: zby having unprotected sex zby sharing needles and other injecting equipment zfrom someone infected with the virus by coming into contact with their blood zby accidental injury with contaminated needles zby having medical or dental treatment in countries where blood is not screened or where medical equipment is not adequately sterilised

8. Public Health and Health Improvement Unit Hepatitis B You can AVOID contracting Hep B: zby not sharing any injecting equipment zby having safe sex zby being vaccinated if you are at risk or someone in your household is infected

9. Public Health and Health Improvement Unit Hepatitis C You can contract Hep C: zby sharing needles and other injecting equipment zpossibly by sharing personal items (razors/toothbrushes etc.) with an infected person zfrom infected blood or blood products received during medical treatment in countries where blood is not screened for hepatitis C zfrom blood transfusions and blood products in UK prior to September 1991

10. Public Health and Health Improvement Unit Avoiding HCV infection You can AVOID contracting Hep C: zby not sharing any injecting equipment zby using sterile needles for acupuncture, tattooing and body piercing zby having safe sex???? zby not sharing personal items (razors/toothbrushes etc.) with an infected person

11. Public Health and Health Improvement Unit Chronic Hepatitis C Routes of Transmission zBlood transfusion zBlood products zPerinatal zIntrafamilial zHemodialysis z Shared needles z Tattooing z Needle-stick and sharps injuries z Sexual z Saliva

12. Public Health and Health Improvement Unit Chronic Hepatitis C High Risk Groups zRecipients of multiple blood transfusions zHaemophiliacs zHaemodialysis patients zInfants of HCV+ mothers zIntravenous drug users zHealthcare workers

13. Public Health and Health Improvement Unit Symptoms zAll types of hepatitis have very similar symptoms- znone at all zflu-like ztiredness, feeling physically sick with loss of appetite and possibly diarrhoea zweight loss zmuscle or joint aches or vague abdominal pain zjaundiced appearance - eyes and skin turn yellowish and urine turns dark zskin may itch

14. Public Health and Health Improvement Unit Viral hepatitis, laboratory reports

15. Public Health and Health Improvement Unit Chronic Hepatitis C Incidence zAnti-HCV found: y<1% of blood donors y70-90% of injecting drug users y50-80% of haemophiliacs y6-15% of patients at GUM clinics y29% of female prisoners (Canada) Source: JID 1995;171 (April) Can J Infect Dis Vol 3 #1 Jan.Feb./92

16. Public Health and Health Improvement Unit Surveillance of viral infections Markers of infection detected in blood donations: England and Wales, 1996

17. Public Health and Health Improvement Unit Hepatitis B & C Seroprevalence in IVDUs zHCV yInternational reports 53 - 98% yCanadian reports 43 - 50% zHBV yInternational reports 45 - 86% Source: Dr. Launette Rieb M.D. M.Sc.