Hepatitis A, B, and C Its prevention, nursing management, and medical treatment Presented by: Dave Jay S. Manriquez RN.

HEPATITIS A

PREVENTION If already infected with HAV If already infected with HAV 1.Wash your hands thoroughly every time you use the bathroom, before touching or preparing food, and before touching others. Wash carefully with soap and warm water and dry thoroughly. 2.Contaminated surfaces should be cleaned with household bleach to kill the virus. 3.Heat food or water to 185°F or 85°C to kill the virus. NOTE: Strict personal hygiene and hand washing help prevent transmission of HAV to others.

PREVENTION… If NOT yet Infected with HAV If NOT yet Infected with HAV 1.Wash your hands carefully with soap and warm water several times a day, including every time you use the bathroom, every time you change a diaper, and before preparing food. 2.Do not eat raw or undercooked seafood or shellfish such as oysters from areas of questionable sanitation (just about everywhere). 3.Travelers to developing countries should not drink untreated water or beverages with ice in them. Fruits and vegetables should not be eaten unless cooked or peeled.

Vaccines that Work against HAV –contain no live virus and are very safe –given in a series of 2 shots. The second is given 6-18 months after the first. –protection starts about 2-4 weeks after the first shot. The second dose is necessary to ensure long-term protection. –thought to protect from infection for at least 20 years –must be given before exposure to the virus

Groups Recommended to have the HAV Vaccine All children older than 2 years who live in communities where the number of HAV infections is unusually high or where there are periodic outbreaks of hepatitis A All children older than 2 years who live in communities where the number of HAV infections is unusually high or where there are periodic outbreaks of hepatitis A People who are likely to be exposed to HAV at work People who are likely to be exposed to HAV at work. Travelers to developing countries (it must be given at least 4 weeks before travel). Travelers to developing countries (it must be given at least 4 weeks before travel) Men who have sex with men Men who have sex with men People who use illegal drugs People who use illegal drugs people with impaired immune systems or chronic liver disease people with impaired immune systems or chronic liver diseaseliver diseaseliver disease People with blood-clotting disorders who receive clotting factors People with blood-clotting disorders who receive clotting factors

MEDICAL TREATMENT No specific medicines to cure infection with hepatitis A No specific medicines to cure infection with hepatitis A 1.Bed rest during the acute stage and a diet that is both acceptable to the patient and nutritious are part of the treatment and nursing care. 2.During the period of anorexia, the patient should receive frequent small feedings, supplemented by fluids. 3.If dehydration occurs, IV fluids are being prescribed to help the patient feel better.

Dietary Management 1. Recommend small, frequent meals. 2. Provide intake of 2,000 to 3,000 kcal/day during acute illness. 3. Although early studies indicate that a high-calorie diet may be beneficial, advise patient not to force food and to restrict fat intake. 4. Drink plenty of clear fluids to prevent dehydration. 5. If anorexia, nausea and vomiting persist, enteral feedings may be necessary. 6. Instruct patient to abstain from alcohol during the acute illness and for 6 months after recovery. 7. Advise patient to avoid substances (medication, herbs, illicit drugs and toxins) that may affect liver function. 8. Be very careful about personal hygiene to avoid fecal-oral transmission to other members of the household.

HEPATITIS B

Groups Recommended to have the HBV Vaccine 1. All children younger than 18 years, including newborns-- especially those born to mothers who are infected with HBV. 2. All health care and public safety workers who may be exposed to blood 3. People who inject illegal drugs 4. People with chronic liver disease such as hepatitis C 5. People who have multiple sex partners or have ever had a sexually transmitted disease sexually transmitted diseasesexually transmitted disease 6. Men who have sex with men

Other ways to protect yourself from HBV infection Safe Sex Safe Sex Don't share needles or other sharp equipments such as razors Don't share needles or other sharp equipments such as razors Health care workers should follow standard precautions and handle needles and sharps safely Health care workers should follow standard precautions and handle needles and sharps safely Think about the health risks if you are planning to get a tattoo or body piercing Think about the health risks if you are planning to get a tattoo or body piercingtattoopiercingtattoopiercing

MEDICAL TREATMENT… Chronic hepatitis B infection Chronic hepatitis B infection –Treatment: antiviral drugs antiviral not appropriate for everyone with chronic HBV infection. It is reserved for people whose infection is most likely to progress to chronic hepatitis B. not appropriate for everyone with chronic HBV infection. It is reserved for people whose infection is most likely to progress to chronic hepatitis B. If liver damage is severe enough, the only treatment that will help is liver transplant If liver damage is severe enough, the only treatment that will help is liver transplant