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Reducing Hepatisis B risk: Health workers get vaccine

By Vision Reporter

Added 5th August 2007 03:00 AM

GLAXOSMITHKLINE, the largest pharmaceutical company in the world, has donated 3,450 doses of Engenix B, a type of Hepatitis B vaccine worth $63,000 (about sh104m) to healthcare workers.

GLAXOSMITHKLINE, the largest pharmaceutical company in the world, has donated 3,450 doses of Engenix B, a type of Hepatitis B vaccine worth $63,000 (about sh104m) to healthcare workers.

By Halima Shaban

GLAXOSMITHKLINE, the largest pharmaceutical company in the world, has donated 3,450 doses of Engenix B, a type of Hepatitis B vaccine worth $63,000 (about sh104m) to healthcare workers.

Speaking during the vaccination exercise at Mulago Referral Hospital recently, the
Glaxosmithkline country manager, Nathan Wasolo, said over 1,150 workers in seven hospitals countrywide will receive the vaccine. It will be administered in three phases.

“Hepatitis B infection is a contagious liver infection caused by the Hepatitis B Virus (HBV) and is easily spread through contact with the blood or body fluids of an infected person.

The infection is one possible outcome, which may result into permanent liver damage,” Dr. Ben Khingi, a specialist surgeon and coordinator of the programme, says.

“Healthcare workers do not receive Hepatitis B vaccine, yet they work with blood everyday. This increases the risk of spread, if they are exposed to the disease.

It is upon this background that we deemed it necessary to solicit help for our colleagues, so as to protect their lives and those of whom they attend to, as they execute their medical roles,” he explains.

The beneficiaries include Mulago, Mbarara, Entebbe, Masaka, Kayunga, Jinja and Mbale hospitals.
Khingi says the vaccine is given as a series of three intramuscular doses, with the second administered after four weeks and the third, six months after second.

Studies have shown that the vaccine is 95% effective in preventing children and adults from developing chronic infection, if they have not yet been infected.

He says in many countries where 8% to 15% of children used to become chronically infected with HBV, the rate of chronic infection has been reduced to less than 1% in immunised groups of children.

According to the World Health Organisation (WHO), Hepatitis B leads to more than 100 million deaths every year. Of the two billion people who have been infected with the virus, more than 350 million have chronic infections.

These people are at high risk of death from cirrhosis of the liver and liver cancer — diseases that kill about one million people each year.

Dr. Heather Patterson, a physician and emergency doctor at Foothills Medical Centre in Canada, who is also travelling with the team, says: “Hepatitis B is a serious global public health problem, 50%-100% more infectious than HIV, yet contracted in more or less the same manner.”

“It is preventable with safe and effective vaccines that have been available since 1982. Although the vaccine will not cure chronic hepatitis, it is 95% effective in preventing chronic infections from developing and is the first vaccine against a major human cancer,” she says.

Patterson says 90-95% of the people who receive the vaccine become immune for life after the third dose.

Khingi says children in the poorest countries, who need the vaccine the most, have not been receiving it because their governments cannot afford it.

Fortunately, the Hepatitis B vaccine will soon be available in these countries with the assistance of the Global Alliance for Vaccines and Immunisation and the Global Fund for Children’s Vaccines.

Anybody above the age of 12, can receive vaccination though getting half the dose does not guarantee immunity and will make one susceptible to the infection.

“Also at high risk are persons in the police force as they are involved in rescue missions of accident victims, the army, sexually active persons who do not use protection during sexual intercourse, children during child birth and people who get admitted, as they can get infected by the health workers who may be carriers,” Khingi said.

He says Hepatitis B immunisation has been incorporated into the child immunisation schedules making only children below the age of three, the only safe group in Uganda as the initiative was only introduced three years ago.

“The vaccine is available in some private healthcentres, but not in the public ones,” he says.
Wasolo says, according to WHO, the infection rate of the East African region is between 8%-12%, which means Uganda is at high risk. He says a complete dose of the vaccine costs about sh48,000.

One dose costs sh16,000 at the GlaxoSmithKline office in Kampala and major private health centres. There is a safe and effective vaccine for hepatitis B. It is the most common serious liver infection in the world. It is thought to be the leading cause of liver cancer.

What causes hepatitis B?
The Hepatitis B Virus that attacks the liver

The virus is transmitted through blood and bodily fluids that contain blood

This can occur through direct blood-to-blood contact, unprotected sex and illicit drug use.

It can also be passed from an infected mother to her new-born child during delivery

Does the virus always pose a health threat?

It is thought that about one in three of the world’s population is infected by the virus

However, about 50% of those who carry it never develop any symptoms

But about 5%-10% of infected adults will become chronic Hepatitis B carriers, often without even knowing it

What are the symptoms/characteristics?

The virus can cause a range of problems, including fever, fatigue, muscle or joint pain, loss of appetite, nausea and vomiting

Chronic carriers have an increased risk of developing a liver disease such as cirrhosis or liver cancer, which leads to corrosion of the liver walls because the Hepatitis B Virus steadily attacks the liver, causing inflammation

About 1% of the people who are infected develop an extreme form of disease called acute fulminant hepatitis.

This condition can be fatal if not treated quickly. Sufferers may collapse with fatigue, have yellowing of the skin and eyes (jaundice) and develop a swelling in their abdomen

How is it treated?

Hepatitis B. patients may be put on a four-month course of injections of the drug interferon

An alternative treatment is a drug called lamivudine, which is taken orally once a day. Treatment is usually for one year. Sometimes lamivudine is combined with interferon

Chronic patients may require a liver transplant

Can it be prevented?

Yes, by the use of a safe and effective vaccine. However, for those who are already carriers of the virus, the vaccine is of no use, but may develop immunity on recovery after appropriate treatment.

Reducing Hepatisis B risk: Health workers get vaccine

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