Hepatitis B: Prevention and Vaccination for Children in Taiwan

Hepatitis B

The prevalence of hepatitis B among the population causes considerable concern.
Children who stay and eat outside often may have received the vaccine in childhood, but does this guarantee they will never contract hepatitis B? What preventive measures should be taken? Your guidance would be greatly appreciated.

wu, 40~49 year old female. Ask Date: 2000/11/27

Dr. Yang Guojun reply Internal Medicine

The hepatitis B vaccine is effective for ten years.
If your child is over 10 years old, please have their blood tested for HBsAg and HBsAb to determine if they still have immunity against hepatitis B.
Hepatitis B is not easily transmitted through food, but the incidence of liver cancer varies significantly worldwide.
It is recognized as one of the most common malignancies in humans.
In Taiwan, the incidence of liver cancer remains alarmingly high.
According to statistics from the Department of Health, the leading cause of death in 1995 was malignant tumors, with liver cancer ranking first among malignancies in men and second among women.
Approximately 5,000 people die from liver cancer each year, highlighting the severe threat it poses to public health.
Research in Taiwan has identified several risk factors for liver cancer, including long-term carrier infections of hepatitis B and C viruses, smoking, alcohol consumption, aflatoxin exposure, a family history of liver cancer, and elevated serum testosterone levels.
In the past, many patients only sought medical attention after symptoms appeared, often when the tumor had grown to the size of a papaya.
In such advanced cases of liver cancer, fewer than one in ten are eligible for surgical resection, and those who cannot receive treatment have a very poor prognosis, with an average survival time of less than six months.
This situation arises from the general public's lack of cancer prevention knowledge, leading to delays in seeking medical care.
Due to the high mortality rate associated with liver cancer, many people view it as a terminal illness.
When diagnosed with this disease, they often refuse conventional medical treatment in favor of alternative remedies, which can lead to tragic outcomes and accelerated death.
Therefore, early diagnosis and treatment are crucial in the prevention and management of liver cancer.

In recent years, the use of ultrasound and monitoring of serum alpha-fetoprotein levels has allowed for long-term follow-up of patients in specific high-risk groups, resulting in the detection of many asymptomatic small liver cancers.
These tumors are typically less than 5 cm in size, and the long-term survival rate is extremely high.
It is recommended that you regularly follow up with a gastroenterologist for monitoring.
Essentially, having hepatitis B increases the risk of liver cancer by a hundredfold compared to the general population.
There are now three new treatments available for hepatitis B.
You may consult Dr.
Yang Guojun at our internal medicine clinic, who has previously served as a research physician in the gastroenterology department at National Taiwan University Hospital.

Reply Date: 2000/11/27

More Info

Hepatitis B is a significant public health concern in Taiwan, where the prevalence of the virus is notably high. Understanding how to prevent and manage Hepatitis B, especially in children, is crucial for safeguarding their health.

Vaccination and Its Efficacy
The Hepatitis B vaccine is the primary method of prevention against the virus. In Taiwan, the vaccination program for infants typically begins at birth, with subsequent doses administered at 1 and 6 months of age. The vaccine is highly effective, with studies showing that it provides long-lasting immunity. However, it is important to note that while the vaccine significantly reduces the risk of infection, it does not guarantee lifelong immunity for everyone.
For children who were vaccinated, it is advisable to check their antibody levels (anti-HBs) around the age of 10 or older. If the antibody levels are low, a booster dose may be recommended. Regular monitoring is essential, especially for children who may be at higher risk due to family history or exposure to infected individuals.

Understanding the Risks
Hepatitis B is primarily transmitted through contact with infected bodily fluids, including blood, semen, and vaginal secretions. The risk of transmission from mother to child during childbirth is particularly concerning, with studies indicating that about 60-90% of infants born to HBsAg-positive mothers may contract the virus if no preventive measures are taken. This is why immediate postnatal intervention, including the administration of Hepatitis B immunoglobulin (HBIG) and the first dose of the vaccine within 24 hours of birth, is critical.

In the case of children who have been vaccinated but may have been exposed to the virus, such as through accidental contact with blood, the risk of infection remains low, especially if they have developed protective antibodies. However, it is still advisable to consult a healthcare provider for further evaluation and potential follow-up testing.

Preventive Measures
To further reduce the risk of Hepatitis B infection in children, several preventive measures can be taken:
1. Vaccination: Ensure that children receive all recommended doses of the Hepatitis B vaccine. If there are any concerns about the vaccine's efficacy, consult a healthcare provider for antibody testing.

2. Avoiding Exposure: Teach children about the importance of avoiding contact with blood and bodily fluids. This includes not sharing personal items like razors or toothbrushes that may come into contact with blood.

3. Safe Practices: If a child is in a situation where they may be exposed to blood (such as in a healthcare setting), ensure that proper safety protocols are followed, including the use of gloves and other protective equipment.

4. Regular Check-ups: Regular health check-ups can help monitor liver function and overall health, especially for children with a family history of Hepatitis B.

5. Education: Educate both children and parents about Hepatitis B, its transmission, and the importance of vaccination. Awareness can significantly reduce the stigma and fear associated with the virus.

Conclusion
While the fear surrounding Hepatitis B is understandable, especially in a region with high prevalence, proactive measures can significantly mitigate risks. Vaccination remains the cornerstone of prevention, and regular monitoring can help ensure that children maintain adequate protection against the virus. By fostering a culture of awareness and preventive health practices, families can better protect their children from Hepatitis B and its potential complications, including chronic liver disease and liver cancer. If there are any concerns or questions regarding vaccination status or potential exposure, consulting a healthcare professional is always the best course of action.

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