1. Ready for Some Public Health Fun?
Pavitri Dwivedi, MPH
Public Health Program Manager
Hepatitis B Foundation
December 22, 2014

2. Today’s Agenda Overview of Hepatitis B Public Health
My journey from high school to now!

3. What is Hepatitis? Hepatitis – “inflammation” of the liver
Viral Hepatitis – caused by a virus
There are many different viruses that can cause hepatitis
Hepatitis A, B, C, D, E
Liver performs 500+ functions
Stores vitamins
Fights infections
Regulate the body’s energy

4. HBV Virus The world’s most common, serious liver infection
At least 100 times more virulent (ability to invade) than the HIV Virus
Can survive on surface up to 2 weeks
Found in liver, blood, and sexual fluids
Results in both acute (short-term) and chronic (lifelong) infections
Causes 80% of liver cancer worldwide

5. Transmission methods & myths
Direct Contact with Someone’s Blood
Close household contact: sharing razors, toothbrushes, earrings, nail clippers with infected person
Blood transfusions prior to 1992 screening protocols
Unsterile medical or dental equipment
Sharing IV drug equipment
Unclean needle sticks, piercings or tattoos
Sexual Transmission
From Infected Mother to Newborn Baby
During the labor and delivery process
Hepatitis B CANNOT be transmitted through hugging, coughing, sneezing, urine, tears, breast-milk, eating food prepared by an infected individual, or casual contact.

6. HBV IMPACT IN OUR WORLD! Worldwide:
2 billion infections (1/3 of all people)
400 million chronic infections
67% in Asia and Pacific Islands
1 million new infections annually
1 million deaths each year
(10th leading cause of death)
In the U.S.:
2 million Americans chronically infected
50,000-70,000 new infections annually
1,500 Perinatal infections annually

7. hepatitis B In Philadelphia
Approximately 5,000 new infections in PA each year
Prevalence breakdown:
Chinese community: up to 23.5%
Korean community: up to 4%
Vietnamese community: up to 8%
Cambodian/Indonesian/Laotian communities: up to 8%
AAPIs in Philly: 61% need vaccine

8. Hbv infection symptoms
Most individuals have NO symptoms!
About 30% will have some symptoms, including:
Feeling like you have the flu
Very tired, fever, sore muscles, headache, nausea
Loss of appetite and weight loss
Yellowed skin and eyes (jaundice)
Itchiness, rash
Dark urine and/or clay-colored stools
70% of those infected will have no symptoms

9. Chronic infection One in 4 infected could develop severe consequences
Chronic HBV infection greatly increases the risk/need of:
Fibrosis, cirrhosis, liver failure
Primary liver cancer (hepatocellular carcinoma, HCC)
Liver Transplantation
Premature Death

10. primary PREVENTION: VACCINATION!
There is a safe and effective vaccine
Three-doses of the vaccine
Given over 6 months
Offers safe and effective life-long immunity
The first “Anti-Cancer” vaccine
Routinely given to all babies and children in the U.S.
Does not help someone who already has hepatitis B infection

11. Secondary prevention: testing!
A single blood test will tell if you have hepatitis B
Contact Hep B United Philadelphia to find out where you or a friend/family/classmate/neighbor can get a free or reduced cost hepatitis B blood test:

12. Drug treatments Not everybody needs drug treatments!
3 criteria have to be met
Active virus
Certain amount of liver damage
(possibly) family history of liver cancer
Continuous disease management is important for identifying whether a patient needs drug treatment
Treatments are all expensive
$10,000-$30,000 each year
Drug assistance program can help!

13. Living with chronic hepatitis b
It is important that infected individuals:
Know their status
HBV is a silent infection, so those at risk must be tested to see if they are infected!
See a knowledgeable physician for medical care
Learn about living with chronic HBV
Healthy lifestyle to keep your liver healthy
Prevent the spread to others (i.e. vaccinate close contacts)

14. Hepatitis b foundation
The only national nonprofit organization dedicated to finding a cure and improving the quality of life for those affected by hepatitis B worldwide
Biomedical Research
Outreach & Education
Public Health Research
National Advocacy

15. HEP B UNITED PHILADELPHIA
Goals:
All high-risk people in Philadelphia are tested
All non-infected high-risk people are vaccinated
All people who have hepatitis B see a doctor and stay healthy
Establish infrastructure so doctors will routinely test high-risk patients for hepatitis B

16. campaign COMPONENTS Education and Awareness (like right now!)
Improve correct knowledge about hepatitis B
Help people to talk about hepatitis B with family, friends and doctors
Screening, Vaccination, and Linkage to Care
Offer free hepatitis B testing at community events
Help doctors to test and vaccinate their patients
Help infected individuals find good healthcare
Community Partnerships
Everyone can help: community members, corporate partners, businessmen and women, community leaders

17. National efforts CDC National Demonstration Site
May 2012-May 2013
Community Based Hepatitis B Care
Over 1,000 unique, high risk foreign-born individuals screened
Community vaccine clinics
All 3 doses for free
Provided at community sites instead of health centers
In-language patient navigation
National Capacity Building
HBF leading the national Hep B United coalition
Organize national capacity building webinars, panels, mentorship program, and mini-grants.

18. RESOURCES CDC’s Know Hepatitis B Campaign Hepatitis B Foundation
Knowledge for general population
Promotional materials
Hepatitis B Foundation
Technical Knowledge – medical, pharmaceutical
Resources for the infected
@HepBFoundation
Facebook fan pages

19. Game Time! How do you define health?
What are some of the fields you believe are in the healthcare field?
Why are you interested in the healthcare field?

20. Public health
“Public health refers to all organized measures (whether public or private) to prevent disease, promote health, and prolong life among the population as a whole. Its activities aim to provide conditions in which people can be healthy and focus on entire populations, not on individual patients or diseases.” – WHO

21. Public health umbrella
Community health
Health policy and management
Environmental health
Occupational health
Toxicology
Epidemiology
Patterns, causes, effects of diseases
Global health
Biostatistics
Lots of coding

22. My role as a manager Philadelphia National Coalition
Coordinate screening & vaccine events
Conduct linkage to care
Maintain communication among coalition partners
Establish relationships and partnerships
Provide health education*
Organize volunteers
Social & traditional media
National Coalition
Information dissemination – webinars, panels, newsletter
Know Hepatitis B campaign
Policy initiatives

23. Now and then Newington High School University of Connecticut
Molecular Cellular Biology- Major
Medical Anthropology- Minor
Boston University School of Public Health
Global Health, Monitoring and Evaluation Emphasis
Pharmaceutical Program

24. WORDS OF WISDOM DISCOVER TRAVEL STUDY ENGAGE
Personal interests, hobbies, marketable skills
TRAVEL
Learn about the life beyond your backyard
STUDY
Stay in school and do well, grades matter!
ENGAGE
Internships, jobs, volunteering opportunities

25. Time is essence

26. Questions?