Public Health Hepatitis B
Jorge Cruz Jr
Grand Canyon University

According to the Hepatitis B Foundation, the virus has infected about 2 billion people worldwide, which is about 1 person out of every three (Our Accomplishments, 2014). Hepatitis B virus or the HBV is a virus that can cause a lifetime of damage to the liver. “Hepatitis” on its own refers to the inflammation of the live, although there are many causes of inflammation of liver the family of the hepatitis viruses are the most common with Hep A, B, and C being most prominent of the family. Although the family of the hepatitis’ viruses are similar in structure, they differ in transmission and infection. For instances, Hepatitis A is transmitted fecal to oral, whereas Hepatitis B and C are transmitted through exchange of bodily fluids (Hepaitits B, 2008).
Hepatitis B can be spread when infected blood, semen, or any other bodily fluid comes in contact with a non-infected person’s bloodstream. The CDC, provides possible situation when this occurs, for example, during birth (mother is infected could pass down to infant), during sex, or when sharing items that come in contact with a infected person’s blood like toothbrush, needles, or razors. Since it is spread through bodily fluid people at risk for infection are those who come close contact with other people’s bodily fluid frequently this includes but not limited to healthcare workers, men who have sex with men, infants of infected mothers, people with multiple sex partners or drug users which share needles. Quick fact, the Hep B virus can live outside the body for about 7 days and during this time the virus still is able to infect a person if finds an entrance to a non-infected person’s bloodstream, so household cleaning solutions with bleach are recommended to rid of the virus (Hepaitits B, 2008).
After exposure of the virus, a person can either develop an acute infection, acute/chronic, or just a latent/chronic infection. Although, the CDC states that most people who become infected do develop some symptoms of acute hepatitis. Symptoms including fever, fatigue, loss of appetite, nausea, vomiting, and the classic liver failure signs (jaundice, clay colored stools, and dark urine). Incubation period for the virus could take up to three months and acute infection could last up to 6 months. Development of a chronic infection seems to depend on age of the person, the older the person is the less likely HVB will cause a chronic infection. To put it into numbers, approximately 90% of infants infected will acquire a chronic illness, rate drops about half for children between one and five, then significantly drops about to less than 10% for anyone over the age of five. Chronic infection of hepatitis B may display similar symptoms of acute infection, but for the most part many individual are symptom free for as long as 20-30 years. According to WHO, complications of hepatitis include cirrhosis, liver failure, liver cancer, and even death (Hepaitits B, 2008).
Treatment options for are limited as there is no definitive cure; usually supportive care is provided during acute infection. However is there a vaccine, which prevents infection from occurring, the vaccine is done in a series of 3-4 shots over a 6-month period that is usually done within the first year of life. This vaccine prevents creates immunity from infection with boosters occasionally needed throughout a person’s life.
According to the CDC, Asian and Pacific islanders have the highest infection rates in the United States, accounting for 50% of the population infected with chronic hepatitis B (Hepaitits B, 2008). Since many Asian and Pacific Islanders which immigrates to the United States do not have access to health services, their chronic infection goes unnoticed till complications starting occurring, liver cancer being the most common in this group. Death rate for this group is 7 times higher than American Caucasians in the U.S; this also may due to the lack of health services. As a result of rates of infection, the CDC recommends testing for groups of people from countries that high incident of Hep B infection, those who have not been vaccinated at birth, and those are living with someone with hepatitis B. (Hepaitits B, 2008). Also for prevention of infection of newborns, pregnant women are screened and the first series of hepatitis B is administered at birth to newborns.
As a community nurse your patient is the community and like with any other patient the same nursing outline is followed. For instance, the public health Department of LA County displays the nursing process in the course of a hepatitis B case. The first step is Assessment. During the Assessment phase the community health nurse must review the case, this includes clinical data and lab showing positive hep B, and reason of medical visit (to establish whether acute or chronic). Also reviewing over the case for any risk factors which could have lead to infection, for example, sexual activity, medical/dental work past 6 months, drug use with exposure of needles, living with any infected hepatitis patient, and many other. Next step is Diagnosis, this includes the nursing diagnoses and the establishment of interventions for the diagnosis. Then Outcome, this is the goal of the interventions for example the goal provide by LA County was the prevention of spreading hepatitis within family, hospital, community, and other sites. Next, Planning is obtaining data that relates to the case, for symptoms, mode of transmission, incubation period, control measure, and related cases to the current case. Also education and counseling on hepatitis B is done during this time. Lastly, it’s the implementation and then Evaluation of the interventions. During the last step, goals and interventions are analyzed, documentation, and satisfaction of client needs (ACDC, 2008).
The Hepatitis B Foundation is non-profit organization developed to for research, awareness, prevention, treatment, and prevention in order to rid this global issue. The foundation has been going strong for little over 20 years, in 1991 the organization was ignited by Paul and Jane Wittes and with the support of Dr. Baruch Blumberg, who won a noble prize for his discovery of Hepatitis B. Over the pass two decades the organization has made many breaks through, from the discovery of the new anti-viral vaccines to creation of partnerships and establishing a presence worldwide. With recent accomplishments of creating a friendly-user website for individuals who are suffering with liver cancer secondary to hepatitis B, www.livercancerconnect.com . Also the organization took action against discrimination of hepatitis B healthcare workers and students, their actions helped hepatitis B be to recognized under the American with Disabilities Act (ADA) in 2013. (Our Accomplishments, 2014).

References
ACDC: Hepatitis B Case. (2008, January 1). Retrieved March 1, 2015, from http://publichealth.lacounty.gov/phn/docs/ACDChepb12_08.pdf
Hepatitis B. (2008, April 1). Retrieved March 1, 2015, from http://www.cdc.gov/hepatitis/ChooseB.htm
Our Accomplishments. (2014, January 1). Retrieved March 1, 2015, from http://www.hepb.org/about/our_accomplishments.htm