What are the key facts about Hepatitis B. How is Hepatitis B transmitted. Can Hepatitis B be prevented. What is the global burden of Hepatitis B. How does Hepatitis B affect different age groups. What are the long-term health risks of Hepatitis B.

Understanding Hepatitis B: A Global Health Concern

Hepatitis B is a viral infection that poses a significant threat to global health. This liver-attacking virus can cause both acute and chronic diseases, leading to severe complications if left untreated. With millions affected worldwide, it’s crucial to understand the nature of this infection, its transmission methods, and prevention strategies.

The Prevalence and Impact of Hepatitis B Worldwide

The World Health Organization (WHO) provides sobering statistics on the global impact of Hepatitis B:

• In 2019, an estimated 296 million people were living with chronic Hepatitis B infection.
• Approximately 1.5 million new infections occur each year.
• Hepatitis B resulted in about 820,000 deaths in 2019, primarily due to cirrhosis and hepatocellular carcinoma (primary liver cancer).

These numbers underscore the urgent need for increased awareness, prevention efforts, and access to treatment worldwide.

Regional Distribution of Hepatitis B

The burden of Hepatitis B infection varies significantly across different regions:

• WHO Western Pacific Region: 116 million people chronically infected
• WHO African Region: 81 million people chronically infected
• WHO Eastern Mediterranean Region: 60 million infected
• WHO South-East Asia Region: 18 million infected
• WHO European Region: 14 million infected
• WHO Region of the Americas: 5 million infected

This regional distribution highlights the need for targeted interventions and resources in areas with higher prevalence rates.

Modes of Hepatitis B Transmission

Understanding how Hepatitis B spreads is crucial for prevention. The virus can be transmitted through various routes:

Mother-to-Child Transmission

In highly endemic areas, perinatal transmission (from mother to child at birth) is a common route. This vertical transmission is a significant concern, as it often leads to chronic infection in infants.

Horizontal Transmission in Early Childhood

Children under five years old are at risk of horizontal transmission, particularly through exposure to infected blood from other children in close contact.

Blood and Body Fluid Exposure

Hepatitis B can spread through contact with infected blood or other body fluids, including:

• Saliva
• Menstrual fluid
• Vaginal secretions
• Seminal fluid

Healthcare-Associated Transmission

Unsafe medical practices can lead to Hepatitis B transmission, including:

• Needlestick injuries
• Reuse of contaminated needles and syringes
• Improper sterilization of medical equipment

High-Risk Behaviors

Certain activities increase the risk of Hepatitis B transmission:

• Unprotected sexual contact, especially with multiple partners
• Intravenous drug use with shared needles
• Tattooing or body piercing with unsterilized equipment

Age-Related Differences in Hepatitis B Infection

The age at which a person contracts Hepatitis B significantly influences the likelihood of developing chronic infection:

• Adults: Less than 5% of cases lead to chronic hepatitis
• Infants and young children: About 95% of cases result in chronic hepatitis

This stark difference underscores the critical importance of early childhood vaccination programs.

Prevention Strategies: The Power of Vaccination

Vaccination stands as the most effective method to prevent Hepatitis B infection. The Hepatitis B vaccine offers remarkable protection:

• 98% to 100% effectiveness in preventing infection
• Safe for use in all age groups
• Widely available globally

Implementing comprehensive vaccination programs, especially focusing on infants and children, is crucial in reducing the global burden of Hepatitis B.

Importance of Early Vaccination

Given the high risk of chronic infection in infants and young children, prioritizing vaccination in these age groups is paramount. Early immunization can prevent the development of chronic hepatitis and its associated complications later in life.

Long-Term Health Risks of Hepatitis B

Chronic Hepatitis B infection can lead to severe health complications:

• Cirrhosis: Scarring of the liver that impairs its function
• Hepatocellular carcinoma: Primary liver cancer
• Liver failure: In severe cases, may require transplantation

Early detection and appropriate management of Hepatitis B can significantly reduce the risk of these life-threatening conditions.

Global Efforts in Combating Hepatitis B

The fight against Hepatitis B requires a coordinated global effort. Key strategies include:

• Universal vaccination programs, especially for newborns and infants
• Improved blood screening and safe injection practices in healthcare settings
• Increased public awareness about transmission risks and prevention methods
• Enhanced access to testing and treatment for those infected
• Research into new treatments and potential cures for chronic Hepatitis B

By implementing these strategies, the global health community aims to significantly reduce the burden of Hepatitis B and its associated mortality.

Living with Hepatitis B: Management and Care

For individuals diagnosed with Hepatitis B, proper management is crucial:

• Regular medical check-ups to monitor liver health
• Antiviral medications to suppress viral replication in chronic cases
• Lifestyle modifications, including alcohol avoidance and maintaining a healthy diet
• Vaccination against other hepatitis viruses to prevent additional liver damage
• Psychological support to cope with the challenges of living with a chronic condition

With appropriate care and treatment, many people with Hepatitis B can lead healthy, productive lives.

Importance of Early Detection

Early diagnosis of Hepatitis B is crucial for effective management. Regular screening for at-risk populations can lead to timely intervention and improved outcomes.

The Role of Public Health Education in Hepatitis B Prevention

Public health education plays a vital role in preventing the spread of Hepatitis B. Key focus areas include:

• Raising awareness about transmission routes and risk factors
• Promoting safe sex practices and the use of clean needles
• Educating pregnant women about the importance of prenatal Hepatitis B screening
• Encouraging vaccination for those at risk
• Dispelling myths and stigma associated with Hepatitis B

Effective public health campaigns can significantly reduce new infections and improve outcomes for those affected by Hepatitis B.

Targeting High-Risk Groups

Public health efforts often focus on groups at higher risk of Hepatitis B infection, including:

• Healthcare workers
• People who inject drugs
• Men who have sex with men
• Sex workers
• Travelers to high-prevalence regions

Tailored education and prevention strategies for these groups can have a significant impact on reducing transmission rates.

Innovations in Hepatitis B Research and Treatment

The field of Hepatitis B research is continually evolving, with promising developments in several areas:

• New antiviral medications with improved efficacy and fewer side effects
• Gene therapy approaches targeting the Hepatitis B virus
• Immunotherapies to boost the body’s natural defense against the virus
• Advanced diagnostic tools for earlier and more accurate detection
• Research into potential curative treatments for chronic Hepatitis B

These advancements offer hope for improved management and potential eradication of Hepatitis B in the future.

The Promise of Functional Cure

Researchers are working towards developing a functional cure for chronic Hepatitis B. This would involve suppressing the virus to undetectable levels and eliminating the need for lifelong treatment.

Economic Impact of Hepatitis B

The global burden of Hepatitis B extends beyond health concerns to significant economic impacts:

• Healthcare costs for chronic disease management
• Lost productivity due to illness and premature death
• Strain on healthcare systems, particularly in high-prevalence regions
• Cost of implementing vaccination and prevention programs

Investing in prevention and treatment of Hepatitis B can lead to substantial long-term economic benefits for individuals and societies.

Cost-Effectiveness of Vaccination

Despite the initial investment required, Hepatitis B vaccination programs have proven to be highly cost-effective in the long run, reducing the overall economic burden of the disease.

Challenges in Hepatitis B Elimination

Despite progress in prevention and treatment, several challenges remain in the global effort to eliminate Hepatitis B:

• Limited access to vaccination and treatment in low-resource settings
• Stigma and discrimination associated with the disease
• Lack of awareness about transmission and prevention methods
• Difficulties in reaching certain high-risk populations
• Emergence of drug-resistant strains of the virus

Addressing these challenges requires a coordinated effort from governments, healthcare providers, and international organizations.

The Role of Global Health Initiatives

International collaborations and initiatives, such as the WHO’s Global Health Sector Strategy on Viral Hepatitis, play a crucial role in coordinating efforts to combat Hepatitis B on a global scale.

Hepatitis B in Special Populations

Certain populations require special consideration in Hepatitis B prevention and management:

Pregnant Women

Screening and appropriate management of Hepatitis B in pregnant women is crucial to prevent mother-to-child transmission. This may include antiviral therapy during pregnancy and immunization of newborns.

Healthcare Workers

Healthcare professionals are at increased risk of exposure to Hepatitis B. Vaccination, proper use of personal protective equipment, and adherence to safety protocols are essential in this group.

Immunocompromised Individuals

People with weakened immune systems, such as those with HIV or undergoing chemotherapy, may have an increased risk of complications from Hepatitis B and require specialized management.

Travelers

Individuals traveling to regions with high Hepatitis B prevalence should consider vaccination before their trip to reduce the risk of infection.

The Future of Hepatitis B Control

The global health community’s vision for Hepatitis B control includes:

• Achieving universal vaccination coverage
• Developing more effective treatments for chronic infection
• Improving access to testing and treatment worldwide
• Reducing stigma and discrimination associated with the disease
• Ultimately, eliminating Hepatitis B as a public health threat

Realizing this vision will require sustained effort, innovation, and global cooperation.

The Importance of Continued Research

Ongoing research into Hepatitis B is crucial for developing new prevention strategies, improving treatments, and working towards a cure. Continued investment in this field is essential for long-term success in controlling the disease.

Conclusion: A Call to Action

Hepatitis B remains a significant global health challenge, but with effective vaccines, improving treatments, and comprehensive public health strategies, there is hope for controlling and eventually eliminating this disease. By raising awareness, promoting vaccination, and ensuring access to testing and treatment, we can work towards a world free from the burden of Hepatitis B. Each individual, community, and nation has a role to play in this important global health effort.

Hepatitis B

Hepatitis B

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• Hepatitis B

Key facts

• Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease.
• The virus is most commonly transmitted from mother to child during birth and delivery, as well as through contact with blood or other body fluids during sex with an infected partner, unsafe injections or exposures to sharp instruments.
• WHO estimates that 296 million people were living with chronic hepatitis B infection in 2019, with 1.5 million new infections each year.
• In 2019, hepatitis B resulted in an estimated 820 000 deaths, mostly from cirrhosis and hepatocellular carcinoma (primary liver cancer).
• Hepatitis B can be prevented by vaccines that are safe, available and effective.

Overview

Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus (HBV). It is a major global health problem. It can cause chronic infection and puts people at high risk of death from cirrhosis and liver cancer.

A safe and effective vaccine that offers 98% to 100% protection against hepatitis B is available. Preventing hepatitis B infection averts the development of complications including chronic disease and liver cancer.

The burden of hepatitis B infection is highest in the WHO Western Pacific Region and the WHO African Region, where 116 million and 81 million people, respectively, are chronically infected. Sixty million people are infected in the WHO Eastern Mediterranean Region, 18 million in the WHO South-East Asia Region, 14 million in the WHO European Region and 5 million in the WHO Region of the Americas.

Transmission

In highly endemic areas, hepatitis B is most commonly spread from mother to child at birth (perinatal transmission) or through horizontal transmission (exposure to infected blood), especially from an infected child to an uninfected child during the first 5 years of life. The development of chronic infection is common in infants infected from their mothers or before the age of 5 years.

Hepatitis B is also spread by needlestick injury, tattooing, piercing and exposure to infected blood and body fluids, such as saliva and menstrual, vaginal and seminal fluids. Transmission of the virus may also occur through the reuse of contaminated needles and syringes or sharp objects either in health care settings, in the community or among persons who inject drugs. Sexual transmission is more prevalent in unvaccinated persons with multiple sexual partners.

Hepatitis B infection acquired in adulthood leads to chronic hepatitis in less than 5% of cases, whereas infection in infancy and early childhood leads to chronic hepatitis in about 95% of cases. This is the basis for strengthening and prioritizing infant and childhood vaccination.

The hepatitis B virus can survive outside the body for at least 7 days. During this time, the virus can still cause infection if it enters the body of a person who is not protected by the vaccine. The incubation period of the hepatitis B virus ranges from 30 to 180 days. The virus may be detected within 30 to 60 days after infection and can persist and develop into chronic hepatitis B, especially when transmitted in infancy or childhood.

Symptoms

Most people do not experience any symptoms when newly infected. However, some people have acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain. People with acute hepatitis can develop acute liver failure, which can lead to death. Among the long-term complications of HBV infections, a  subset of persons develops advanced liver diseases such as cirrhosis and hepatocellular carcinoma, which cause high morbidity and mortality.

HBV-HIV coinfection

About 1% of persons living with HBV infection (2.7 million people) are also infected with HIV. Conversely, the global prevalence of HBV infection in HIV-infected persons is 7.4%. Since 2015, WHO has recommended treatment for everyone diagnosed with HIV infection, regardless of the stage of disease. Tenofovir, which is included in the treatment combinations recommended as first-line therapy for HIV infection, is also active against HBV.

Diagnosis

It is not possible on clinical grounds to differentiate hepatitis B from hepatitis caused by other viral agents, hence laboratory confirmation of the diagnosis is essential. Several blood tests are available to diagnose and monitor people with hepatitis B. They can be used to distinguish acute and chronic infections. WHO recommends that all blood donations be tested for hepatitis B to ensure blood safety and avoid accidental transmission.

As of 2019, 30.4 million people (10.5% of all people estimated to be living with hepatitis B) were aware of their infection, while 6.6 million (22%) of the people diagnosed were on treatment. According to latest WHO estimates, the proportion of children under five years of age chronically infected with HBV dropped to just under 1% in 2019 down from around 5% in the pre-vaccine era ranging from the 1980s to the early 2000s.

In settings with high Hepatitis B surface antigen seroprevalence in the general population (defined as >2% or >5% HBsAg seroprevalence), WHO recommends that all adults have access to and be offered HBsAg testing with linkage to prevention and care and treatment services as needed.

Treatment

There is no specific treatment for acute hepatitis B. Therefore, care is aimed at maintaining comfort and adequate nutritional balance, including replacement of fluids lost from vomiting and diarrhoea. Most important is the avoidance of unnecessary medications. Acetaminophen, paracetamol and medication against vomiting should be avoided.

Chronic hepatitis B infection can be treated with medicines, including oral antiviral agents. Treatment can slow the progression of cirrhosis, reduce incidence of liver cancer and improve long term survival. In 2021 WHO estimated that 12% to 25% of people with chronic hepatitis B infection will require treatment, depending on setting and eligibility criteria.

WHO recommends the use of oral treatments (tenofovir or entecavir) as the most potent drugs to suppress hepatitis B virus. Most people who start hepatitis B treatment must continue it for life.

In low-income settings, most people with liver cancer die within months of diagnosis. In high-income countries, patient present to hospital earlier in the course of the disease, and have access to surgery and chemotherapy which can prolong life for several months to a few years. Liver transplantation is sometimes used in people with cirrhosis or liver cancer in high-income countries, with varying success.

Prevention

WHO recommends that all infants receive the hepatitis B vaccine as soon as possible after birth, preferably within 24 hours, followed by 2 or 3 doses of hepatitis B vaccine at least 4 weeks apart to complete the vaccination series. Protection lasts at least 20 years and is probably lifelong. WHO does not recommend booster vaccinations for persons who have completed the 3-dose vaccination schedule.

In addition to infant vaccination, WHO recommends the use of antiviral prophylaxis for the prevention of hepatitis B transmission from mother-to-child. Implementation of blood safety strategies and safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms), also protect against transmission.

WHO response

In May 2016, the World Health Assembly adopted the first Global health sector strategy on viral hepatitis, 2016–2020. The strategy highlighted the critical role of universal health coverage and sets targets that align with those of the Sustainable Development Goals. The strategy proposed the elimination of viral hepatitis as a public health threat by 2030 (defined as a 90% reduction in new chronic infections and a 65% reduction in mortality, compared with the 2015 baseline), and included a roadmap towards elimination by implementing key prevention, diagnosis, treatment and community interventions strategies. In May 2022 the 75th World Health Assembly noted a new set of integrated global health sector strategies on HIV, viral hepatitis and sexually transmitted infections for the period of 2022–2030. Based on these previous and now new strategies, a broad range of Member States have developed comprehensive national hepatitis programmes and elimination strategies guided by the global health sector strategy.

To support countries in achieving the global hepatitis elimination targets under the Sustainable Development Agenda 2030, WHO is working to:

• raise awareness, promote partnerships and mobilize resources
• formulate evidence-based policy and data for action
• increase health equities within the hepatitis response
• prevent transmission
• scale up screening, care and treatment services.

WHO organizes the annual World Hepatitis Day campaign (as 1 of its 9 flagship annual health campaigns) to increase awareness and understanding of viral hepatitis. For World Hepatitis Day 2022, WHO focuses on the theme “Bringing hepatitis care closer to you” and  calls for simplified service delivery of viral hepatitis services, bringing care closer to communities.

 

Global hepatitis report, 2017

World Hepatitis Day

Global health sector strategy on viral hepatitis


Guidelines & manuals

• Hepatitis B treatment
• Monitoring and evaluation of hepatitis B and C
• Manual for the development of national viral hepatitis plans

More about hepatitis

• WHO’s work on hepatitis 
• Global Hepatitis Programme

Publications

• WHO’s publications

Epidemiology and prevention of hepatitis B virus infection

1. Beasley RP, Hwang LY. Hepatocellular carcinoma and hepatitis B virus. Semin Liver Dis. 1984;4:113–121. [PubMed] [Google Scholar]

2. Stevens CE, Beasley RP, Tsui J, Lee WC. Vertical transmission of hepatitis B antigen in Taiwan. N Engl J Med. 1975;292:771–774. [PubMed] [Google Scholar]

3. Seeger C, Mason WS. Hepatitis B virus biology. Microbiol Mol Biol Rev. 2000;64:51–68. [PMC free article] [PubMed] [Google Scholar]

4. Chisari FV, Ferrari C, Mondelli MU. Hepatitis B virus structure and biology. Microb Pathog. 1989;6:311–325. [PubMed] [Google Scholar]

5. Margolis HS, Alter MJ, Hadler SC. Viral hepatitis. In: Evans AS, Kaslow RA, editors. Viral Infections of Humans: Epidemiology and Control. 4th ed. New York: Plenum Publishing Corporation; 1997. pp. 363–418. [Google Scholar]

6. Hwang SH, Kim JH, Kang JH, Hur JK, Lee KL, Oh JH, et al. Follow-up of children with chronic hepatitis B virus infection. Korean J Pediatr Infect Dis. 2004;11:73–80. [Google Scholar]

7. Okada K, Kamiyama I, Inomata M, Imai M, Miyakawa Y. e antigen and anti-e in the serum of asymptomatic carrier mothers as indicators of positive and negative transmission of hepatitis B virus to their infants. N Engl J Med. 1976;294:746–749. [PubMed] [Google Scholar]

8. Beasley RP, Trepo C, Stevens CE, Szmuness W. The e antigen and vertical transmission of hepatitis B surface antigen. Am J Epidemiol. 1977;105:94–98. [PubMed] [Google Scholar]

9. Beasley RP, Hwang LY, Lee GC, Lan CC, Roan CH, Huang FY, et al. Prevention of perinatally transmitted hepatitis B virus infections with hepatitis B virus infections with hepatitis B immune globulin and hepatitis B vaccine. Lancet. 1983;2:1099–1102. [PubMed] [Google Scholar]

10. Hutin Y, Stilwell B, Hauri AM, Margolis H. Transmission of blood-borne pathogens through unsafe infections and proposed approach for the safe infection global network. In: Margolis HS, Alter MJ, Liang TJ, Dienstag JL, editors. Viral Hepatitis and Liver Disease: Proceedings of the 10th Interational Symposium on Viral Hepatitis and Liver Disease; London: International Medical Press; 2002. pp. 219–227. [Google Scholar]

11. Goldstein ST, Alter MJ, Williams IT, Moyer LA, Judson FN, Mottram K, et al. Incidence and risk factors for acute hepatitis B in the United States, 1982-1998: implications for vaccination programs. J Infect Dis. 2002;185:713–719. [PubMed] [Google Scholar]

12. Alter MJ, Margolis HS. The emergence of hepatitis B as a sexually transmitted disease. Med Clin North Am. 1990;74:1529–1541. [PubMed] [Google Scholar]

13. Wright TL, Lau JY. Clinical aspects of hepatitis B virus infection. Lancet. 1993;342:1340–1344. [PubMed] [Google Scholar]

14. McMahon BJ, Alward WL, Hall DB, Heyward WL, Bender TR, Francis DP, et al. Acute hepatitis B virus infection: relation of age to the clinical expression of disease and subsequent development of the carrier state. J Infect Dis. 1985;151:599–603. [PubMed] [Google Scholar]

15. Hyams KC. Risks of chronicity following acute hepatitis B virus infection: a review. Clin Infect Dis. 1995;20:992–1000. [PubMed] [Google Scholar]

16. Dienstag JL. Immunopathogenesis of the extrahepatic manifestations of hepatitis B virus infection. Springer Semin Immunopathol. 1981;3:461–472. [PubMed] [Google Scholar]

17. Hoofnagle JH, Carithers RL, Jr, Shapiro C, Ascher N. Fulminant hepatic failure: summary of a workshop. Hepatology. 1995;21:240–252. [PubMed] [Google Scholar]

18. Lok AS, Lai CL. A longitudinal follow-up of asymptomatic hepatitis B surface antigen-positive Chinese children. Hepatology. 1988;8:1130–1133. [PubMed] [Google Scholar]

19. Liaw YF, Chu CM, Su IJ, Huang MJ, Lin DY, Chang-Chien CS. Clinical and histological events preceding hepatitis B e antigen seroconversion in chronic type B hepatitis. Gastroenterology. 1983;84:216–219. [PubMed] [Google Scholar]

20. Alward WL, McMahon BJ, Hall DB, Heyward WL, Francis DP, Bender TR. The long-term serological course of asymptomatic hepatitis B virus carriers and the development of primary hepatocellular carcinoma. J Infect Dis. 1985;151:604–609. [PubMed] [Google Scholar]

21. Liaw YF, Sung JJ, Chow WC, Farrell G, Lee CZ, Yuen H, et al. Lamivudine for patients with chronic hepatitis B and advanced liver disease. N Engl J Med. 2004;351:1521–1531. [PubMed] [Google Scholar]

22. McMahon BJ, Holck P, Bulkow L, Snowball M. Serologic and clinical outcomes of 1536 Alaska Natives chronically infected with hepatitis B virus. Ann Intern Med. 2001;135:759–768. [PubMed] [Google Scholar]

23. Shin HS, Han KH, Park SJ, Ahn SK, Chon CY, Moon YM, et al. The prevalence of hepatitis virus infection and clinical characteristics in patients with hepatocellular carcinoma. Korean J Med. 1994;46:467–476. [Google Scholar]

24. Beasley RP, Hwang LY, Stevens CE, Lin CC, Hsieh FJ, Wang KY, et al. Efficacy of hepatitis B immune globulin for prevention of perinatal transmission of the hepatitis B virus carrier state: final report of a randomized double-blind, placebo-controlled trial. Hepatology. 1983;3:135–141. [PubMed] [Google Scholar]

25. Hong WS, Kim CY. Seroepilemiology of type A and type B hepatitis in Seoul area. Korean J Intern Med. 1982;25:19–26. [Google Scholar]

26. Lee JJ, Kim IM. Intrafamilial spread of hepatitis B virus infection. Korean J Intern Med. 1982;25:1191–1198. [Google Scholar]

27. Sim JG, Seo JK, Suh SJ. Prevalence and its changes of hepatitis B viral markers from 1988 to 1993 in Korean children. J Korean Pediatr Soc. 1995;38:1535–1539. [Google Scholar]

28. Kim YJ, Kim SK, Park SH, Yang WS, Yoo BH. A study on distribution of hepatitis B virus ( HBV ) markers in families of HBsAg – positive blood donors. Korean J Intern Med. 1983;26:884–891. [Google Scholar]

29. Choung JM, Kim JC, Eun SH, Hwang PH, Nyhambat B, Kilgore P, et al. Study on vaccination state in children: Jeonbuk province, 2000. J Korean Pediatr Soc. 2002;45:1234–1340. [Google Scholar]

30. Korea Centers for Disease Control and Prevention (CDC) CDC web site (online), < http://www.cdc.go.kr/>. Cheongwon: Korea Centers for Disease Control and Prevention; 2007. 2006 Serosurvey of measles, mumps and hepatitis B; pp. 35–40. [Google Scholar]

31. Yim HJ, Chang YJ, Byun KS, Suh YS, Kim JH, Kim JY, et al. The changing patterns of acute hepatitis B infection in Korea in the early 2000’s. Korean J Med. 2005;69:601–607. [Google Scholar]

32. Patrick DM, Bigham M, Ng H, White R, Tweed A, Skowronski DM. Elimination of acute hepatitis B among adolescents after one decade of an immunization program targeting Grade 6 students. Pediatr Infect Dis J. 2003;22:874–877. [PubMed] [Google Scholar]

33. Wu JS, Hwang LY, Goodman KJ, Beasley RP. Hepatitis B vaccination in high-risk infants: 10-year follow-up. J Infect Dis. 1999;179:1319–1325. [PubMed] [Google Scholar]

34. Hsu HM, Lu CF, Lee SC, Lin SR, Chen DS. Seroepidemiologic survey for hepatitis B virus infection in Taiwan: the effect of hepatitis B mass immunization. J Infect Dis. 1999;179:367–370. [PubMed] [Google Scholar]

35. Jack AD, Hall AJ, Maine N, Mendy M, Whittle HC. What level of hepatitis B antibody is protective? J Infect Dis. 1999;179:489–492. [PubMed] [Google Scholar]

36. Hessel L, West DJ. Antibody responses to recombinant hepatitis B vaccines. Vaccine. 2002;20:2164–2165. [PubMed] [Google Scholar]

37. Szmuness W, Stevens CE, Harley EJ, Zang EA, Oleszko WR, William DC, et al. Hepatitis B vaccine: demonstration of efficacy in a controlled clinical trial in a high-risk population in the United States. N Engl J Med. 1980;303:833–841. [PubMed] [Google Scholar]

38. Huang LM, Chiang BL, Lee CY, Lee PI, Chi WK, Chang MH. Long-term response to hepatitis B vaccination and response to booster in children born to mothers with hepatitis B e antigen. Hepatology. 1999;29:954–959. [PubMed] [Google Scholar]

39. Wainwright RB, Bulkow LR, Parkinson AJ, Zanis C, McMahon BJ. Protection provided by hepatitis B vaccine in a Yupik Eskimo population-results of a 10-year study. J Infect Dis. 1997;175:674–677. [PubMed] [Google Scholar]

40. Mintai Z, Kezhou L, Lieming D, Smego RA., Jr Duration and efficacy of immune response to hepatitis B vaccine in high-risk Chinese adolescents. Clin Infect Dis. 1993;16:165–167. [PubMed] [Google Scholar]

41. Poovorawan Y, Chongsrisawat V, Theamboonlers A, Bock HL, Leyssen M, Jacquet JM. Persistence of antibodies and immune memory to hepatitis B vaccine 20 years after infant vaccination in Thailand. Vaccine. 2010;28:730–736. [PubMed] [Google Scholar]

42. Banatvala J, Van Damme P, Oehen S. Lifelong protection against hepatitis B: the role of vaccine immunogenicity in immune memory. Vaccine. 2000;19:877–885. [PubMed] [Google Scholar]

43. Centers for Disease Control. Hepatitis B virus: a comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination. Recommendations of the Immunization Practices Advisory Committee (ACIP) MMWR Recomm Rep. 1991;40:1–25. [PubMed] [Google Scholar]

44. West DJ, Calandra GB. Vaccine induced immunologic memory for hepatitis B surface antigen: implications for policy on booster vaccination. Vaccine. 1996;14:1019–1027. [PubMed] [Google Scholar]

45. Averhoff F, Mahoney F, Coleman P, Schatz G, Hurwitz E, Margolis H. Immunogenicity of hepatitis B Vaccines. Implications for persons at occupational risk of hepatitis B virus infection. Am J Prev Med. 1998;15:1–8. [PubMed] [Google Scholar]

46. Peces R, de la Torre M, Alcázar R, Urra JM. Prospective analysis of the factors influencing the antibody response to hepatitis B vaccine in hemodialysis patients. Am J Kidney Dis. 1997;29:239–245. [PubMed] [Google Scholar]

47. Hadler SC, Margolis HS. Hepatitis B immunization: vaccine types, efficacy, and indications for immunization. Curr Clin Top Infect Dis. 1992;12:282–308. [PubMed] [Google Scholar]

48. Poland GA. Hepatitis B immunization in health care workers. Dealing with vaccine nonresponse. Am J Prev Med. 1998;15:73–77. [PubMed] [Google Scholar]

49. Middleman AB, Anding R, Tung C. Effect of needle length when immunizing obese adolescents with hepatitis B vaccine. Pediatrics. 2010;125:e508–e512. [PubMed] [Google Scholar]

50. Sanyal G, Shi L. A review of multiple approaches towards an improved hepatitis B vaccine. Expert Opin Ther Pat. 2009;19:59–72. [PubMed] [Google Scholar]

51. Diez-Delgado J, Dal-Ré R, Llorente M, González A, López J. Hepatitis B component does not interfere with the immune response to diphtheria, tetanus and whole-cell Bordetella pertussis components of a quadrivalent (DTPw-HB) vaccine: a controlled trial in healthy infants. Vaccine. 1997;15:1418–1422. [PubMed] [Google Scholar]

52. Bruguera M, Bayas JM, Vilella A, Tural C, González A, Vidal J, et al. Immunogenicity and reactogenicity of a combined hepatitis A and B vaccine in young adults. Vaccine. 1996;14:1407–1411. [PubMed] [Google Scholar]

53. King GE, Hadler SC. Simultaneous administration of childhood vaccines: an important public health policy that is safe and efficacious. Pediatr Infect Dis J. 1994;13:394–407. [PubMed] [Google Scholar]

54. Atkinson WL, Pickering LK, Schwartz B, Weniger BG, Iskander JK, Watson JC Centers for Disease Control and Prevention. General recommendations on immunization. Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP) MMWR Recomm Rep. 2002;51:1–35. [PubMed] [Google Scholar]

55. Lebre F, Borchard G, de Lima MC, Borges O. Progress towards a needle-free hepatitis B vaccine. Pharm Res. 2011;28:986–1012. [PubMed] [Google Scholar]

56. Chang MH, Chen CJ, Lai MS, Hsu HM, Wu TC, Kong MS, et al. Taiwan Childhood Hepatoma Study Group. Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. N Engl J Med. 1997;336:1855–1859. [PubMed] [Google Scholar]

57. Kim CY. Prevention of viral hepatitis, type B, by vaccination with purified hepatitis B surface antigen. J Korean Med Assoc. 1979;22:1013–1025. [Google Scholar]

58. Robert D, Sitrin D, Wampler E, Ellis RW. Survey of licensed hepatitis B vaccines and their production processes. In: Ellis RW, editor. Hepatitis B Vaccines in Clinical Practice. NewYork: Marcel Dekker; 1993. pp. 83–101. [Google Scholar]

59. Shaw FE, Jr, Guess HA, Roets JM, Mohr FE, Coleman PJ, Mandel EJ, et al. Effect of anatomic injection site, age and smoking on the immune response to hepatitis B vaccination. Vaccine. 1989;7:425–430. [PubMed] [Google Scholar]

60. Duval B, Deceuninck G. Seroprotection rates after late doses of hepatitis B vaccine. Pediatrics. 2002;109:350–351. [PubMed] [Google Scholar]

61. Mangione R, Stroffolini T, Tosti ME, Fragapani P, Mele A. Delayed third hepatitis B vaccine dose and immune response. Lancet. 1995;345:1111–1112. [PubMed] [Google Scholar]

62. Van Damme P, Cramm M, Safary A, Vandepapelière P, Meheus A. Heat stability of a recombinant DNA hepatitis B vaccine. Vaccine. 1992;10:366–367. [PubMed] [Google Scholar]

63. André FE. Summary of safety and efficacy data on a yeast-derived hepatitis B vaccine. Am J Med. 1989;87:14S–20S. [PubMed] [Google Scholar]

64. McMahon BJ, Helminiak C, Wainwright RB, Bulkow L, Trimble BA, Wainwright K. Frequency of adverse reactions to hepatitis B vaccine in 43,618 persons. Am J Med. 1992;92:254–256. [PubMed] [Google Scholar]

65. Centers for Disease Control and Prevention. Update: vaccine side effects, adverse reactions, contraindications, and precautions. Recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Recomm Rep. 1996;45:1–35. [PubMed] [Google Scholar]

66. Lear JT, English JS. Anaphylaxis after hepatitis B vaccination. Lancet. 1995;345:1249. [PubMed] [Google Scholar]

67. Kwon SY The Korean Society of Infectious Disease, editors. Infectious Disease. Seoul: Koonja Publishing; 2007. Catch-up vaccination in adult, vaccination for adult; pp. 54–65. [Google Scholar]

68. Levy M, Koren G. Hepatitis B vaccine in pregnancy: maternal and fetal safety. Am J Perinatol. 1991;8:227–232. [PubMed] [Google Scholar]

69. Bruguera M, Cremades M, Salinas R, Costa J, Grau M, Sans J. Impaired response to recombinant hepatitis B vaccine in HIV-infected persons. J Clin Gastroenterol. 1992;14:27–30. [PubMed] [Google Scholar]

70. Terrault NA, Zhou S, Combs C, Hahn JA, Lake JR, Roberts JP, et al. Prophylaxis in liver transplant recipients using a fixed dosing schedule of hepatitis B immunoglobulin. Hepatology. 1996;24:1327–1333. [PubMed] [Google Scholar]

71. Seeff LB, Zimmerman HJ, Wright EC, Finkelstein JD, Garcia-Pont P, Greenlee HB, et al. A randomized, double blind controlled trial of the efficacy of immune serum globulin for the prevention of post-transfusion hepatitis. A Veterans Administration cooperative study. Gastroenterology. 1977;72:111–121. [PubMed] [Google Scholar]

72. Xu ZY, Liu CB, Francis DP, Purcell RH, Gun ZL, Duan SC, et al. Prevention of perinatal acquisition of hepatitis B virus carriage using vaccine: preliminary report of a randomized, double-blind placebo-controlled and comparative trial. Pediatrics. 1985;76:713–718. [PubMed] [Google Scholar]

73. Stevens CE, Toy PT, Tong MJ, Taylor PE, Vyas GN, Nair PV, et al. Perinatal hepatitis B virus transmission in the United States. Prevention by passive-active immunization. JAMA. 1985;253:1740–1745. [PubMed] [Google Scholar]

How not to get hepatitis and how to treat it

You can get hepatitis during a manicure or a visit to the dentist, but the presence of a virus in the blood does not mean that you will have cirrhosis of the liver. Bella Lurie, a member of the European Association for the Study of the Liver, head of the Hepatitis. RU”.

— What are viral hepatitis A, B, C, how do they differ and are they as scary as they say?
– Hepatitis is an inflammatory process in the liver, which can be caused by a variety of reasons, including alcohol, toxic substances, malnutrition. The most common causes of hepatitis are viruses A, B and C.

Bella Lurie

Candidate of Biological Sciences, graduated from Moscow State University. M. V. Lomonosov. Specialist in liver diseases (author of more than 100 scientific papers, including about 50 publications on the treatment of cirrhosis, as well as the correction of various metabolic disorders in . ..

Viral hepatitis A most often has external manifestations – jaundice, fever, nausea. Treatment in a hospital is aimed at reducing intoxication and relieving symptoms of the disease. In the vast majority of cases, it ends with recovery with the formation of natural immunity.

Viral hepatitis B and C are much more dangerous diseases. They also have an acute form, but very rarely with the characteristic symptoms of jaundice. Therefore, the disease goes unnoticed by a person, and the transition to a chronic form does not appear outwardly.

The danger of chronic viral hepatitis B and C lies in the fact that prolonged damage to the liver by these viruses in a large percentage of cases can result in cirrhosis or primary liver cancer – changes in the liver that are incompatible with life.

— How common is this disease in the world?
— Worldwide, more than 600 million people suffer from viral hepatitis B and C. The incidence rate is increasing every year. The scale of the spread of viral hepatitis in the world makes it possible to assess the situation as a worldwide epidemic. In developed countries, the situation with hepatitis B has been improved thanks to vaccination. However, despite this, the number of new cases of viral hepatitis B annually reaches 50 million people.

Today there are 7 million patients in Russia. And an epidemic is a situation when the disease covers more than 1% of the population (1 million 400 thousand people).

The epidemiological threshold has been exceeded five times, and this is only official data. Another egregious fact is that an unacceptable number of patients become infected with hepatitis in medical institutions.

— How can you get hepatitis?
– Hepatitis A is transmitted through the mouth with dirty hands, contaminated food, with water. Hepatitis B and C are transmitted through the blood. The hepatitis B virus is especially contagious, which is transmitted in a large percentage of cases sexually, in contrast to the hepatitis C virus, the sexual route of transmission of which is not relevant.

The hepatitis B virus is also transmitted from mother to child during pregnancy.

Everyone who has visited a dentist, had an operation, had tattoos, used intravenous drugs, used the services of a manicurist, etc., is at risk of contracting viral hepatitis. Thus, it can be considered that the vast majority of the population can be one large risk group.

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— Are there any specific symptoms of this disease?
— Chronic viral hepatitis B and C are asymptomatic. Sometimes, with a sufficiently protracted course, non-specific symptoms may appear, that is, symptoms characteristic of many other diseases: weakness, loss of working capacity, insomnia, increased fatigue, joint pain.

— In such a dangerous epidemic situation, how do you know about infection with hepatitis viruses? How often should these tests be done?
— It is recommended to be tested for antibodies to the hepatitis C virus and, if they are detected, to be tested for the presence of the virus in the blood by PCR. Only the presence of the virus in the blood allows the diagnosis of chronic viral hepatitis C.

It is advisable to repeat this examination once a year.

To exclude viral hepatitis B, three tests are required: HBsAg, anti-HBcor and anti-HBs quantitative. These three analyzes allow either to diagnose chronic viral hepatitis B, or to identify viral hepatitis B transferred with recovery, or to establish the absence of any contact with the hepatitis B virus. In this case, you should be vaccinated and guaranteed to be protected from infection for 8-10 years.

— To characterize the hepatitis C virus, tests for the genotype of the virus and viral load are prescribed. What is the significance of these tests? What is the ratio of the amount of virus in International Units and in copies of the virus per milliliter of blood?
– The genotype of the virus is a type of hepatitis C virus. There are six such varieties. They react differently to antiviral drugs. Therefore, this is extremely important for prescribing therapy: for some genotypes, the duration of therapy is 11 months, for others – 6 months.

Viral load is the amount of virus in the blood. It can be low, medium and high. Units of measurement of viral load can be converted from one to another using a factor of 5. Viral load is very important for evaluating treatment prognosis, as well as for determining the effectiveness of antiviral therapy. It is estimated by counting the amount of virus before and after a certain stage of therapy and at the end of therapy. Therapy is considered effective if the amount of the virus has decreased by at least a hundred times in a month, and after three months the result of treatment should be the complete absence of the virus in the blood.

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— Why is the diagnosis of hepatitis so terrible? Does it lead to cirrhosis and death in all cases?
— The diagnosis of hepatitis is dangerous because of its consequences — the development of cirrhosis and liver cancer. From 20 to 60 percent of viral hepatitis pass into cirrhosis. The problem is that it is impossible to predict in advance how the disease will end in a particular patient, since we do not know what factors influence this process. It is because of this that when deciding who to treat, the European Association of Hepatology recommends: the earlier treatment is started, the better the prognosis for recovery.

It is extremely important to understand the state of the liver in terms of the degree of fibrosis and the threat of an early transition to an irreversible state (cirrhosis).

— How to identify how affected the human liver is? Is a biopsy used for this?
– To assess how much the liver is affected by the virus and how much fibrosis is expressed, there are many ways. Biopsy is one of them. However, this method is not safe and does not allow to objectively and accurately determine the degree of fibrosis. More modern non-invasive methods for determining fibrosis are increasingly used in clinical practice: direct determination of the elasticity of the liver tissue on the Fibroscan ultrasound device or by biochemical blood markers – FibroMax, FibroTest. These methods allow not only to determine the degree of fibrosis at the time of the start of therapy, but also to trace positive changes as a result of antiviral therapy, since fibrosis is reversible up to a certain stage.

— Is there an effective treatment for different types of hepatitis today? What therapy is prescribed for various hepatitis and various virus genotypes?
– For the treatment of viral hepatitis C for many years there has been a standard antiviral therapy for all genotypes of the virus C. This therapy gives good results and in a large percentage of cases allows you to get a cure, that is, complete removal of the virus from the body. However, this treatment should be recognized as imperfect: with a prolonged illness and severe liver damage, as well as often for reasons that are not clear to us, recovery cannot be achieved.

In addition, serious side effects of drugs impair the quality of life during treatment and require high qualifications and experience from the attending physician.

Nevertheless, this is a real chance to protect your liver and your life. Even in the absence of a complete virological response, antiviral therapy has a positive effect on the state of the liver, stops the formation of fibrosis, and often contributes to its reverse development.

There is no standard for the treatment of viral hepatitis B. In each case, decisions are made that depend on how dangerous the virus is, how active it is, how much the liver is already affected. A special examination of the virus and the liver allows the doctor to determine the tactics: sometimes antiviral drugs are not prescribed at all, sometimes large doses are prescribed, but most often, if necessary, modern drugs are used in the form of tablets – nucleoside analogues, which stop the active reproduction of the virus and help not only stop the destructive process, but also the reverse development of fibrosis. The disadvantage of this treatment is the duration of the course, often requiring more than five years.

— Is therapy prescribed in all cases? Are there any contraindications for treatment?
— Therapy is prescribed only in cases where there are grounds for this and there are no contraindications. The basis for the appointment of therapy against viral hepatitis C is the young age of the patient, changes in the liver according to ultrasound and biochemical data, as well as the degree of fibrosis 2–3. Contraindications for treatment are some chronic diseases, including the thyroid gland, changes in the blood, autoimmune processes.

Fibrosis

Compaction of connective tissue with the appearance of cicatricial changes in various organs, resulting, as a rule, as a result of chronic inflammation.

– How do you rate the new hepatitis C drugs – protease and polymerase inhibitors of the hepatitis C virus?
– These drugs significantly increase the effectiveness of treatment and are especially important for patients who either did not respond to standard therapy, or relapsed after successful therapy – the return of the virus. These drugs sometimes become a life-saving chance if the situation is close to decompensated cirrhosis, and standard drugs are not effective. However, their very high cost and serious side effects have so far limited their use.

— Is a special diet necessary for patients, giving up bad habits? Is it possible to play sports with such a diagnosis? How often do you need to see a doctor?
– A special diet is recommended to preserve the liver, but it is not very hard. A reasonable restriction of fatty, fried and spicy is enough. An important limitation in viral hepatitis is the exclusion of alcohol.

Even small doses of alcohol activate the virus and, consequently, its destructive effect on the liver. In addition, it makes senseless antiviral therapy, which is aimed at suppressing the activity of the virus.

— Can a woman with hepatitis give birth to a healthy child?
– Maybe. With viral hepatitis C, the virus can rarely pass through the placenta, so in the vast majority of cases, a woman with viral hepatitis C has healthy children. With viral hepatitis B, the probability of infection of a child is about 40 percent. However, the right measures at birth—immunoglobulin administration and hepatitis B vaccination within hours after birth—protect the baby from viral hepatitis B.

— How to protect friends and relatives from infection in case of hepatitis?
– Since viral hepatitis does not have a domestic transmission route, friends and acquaintances of a patient with viral hepatitis B or C do not risk anything when communicating with him. For viral hepatitis B, sexual transmission is relevant, so partners should be tested and vaccinated. There is no vaccination against hepatitis C, and you should be very careful with the patient’s blood – it is contagious.

symptoms, treatment, prevention, transmission

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Natalia Konstantinovna

Experience 23 years

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In December 2019, the world faced a new threat – in China, the first cases of a respiratory infection were recorded, which was characterized by an acute course of the disease with a transition to SARS. Soon, Chinese experts identified the pathogen. It turned out to be a virus from the coronavirus family, officially named 2019-nCoV.

What is it

The coronavirus was first isolated from a sick person in 1965. It got its name because of the structural features: it has spike-like processes that look like a crown. Since then, scientists have already described 40 of its species, united in two families. These agents have always existed alongside humans and are found in cats, dogs, pigs, cows, other mammals, and birds.

Coronaviruses discovered before the 2000s caused SARS in humans. For the most part, the disease proceeded without serious complications, so its pathogens were not given as much attention as, for example, influenza viruses. However, the situation changed dramatically in 2002-2003, when an outbreak of SARS occurred in China. The patients were diagnosed with severe acute respiratory syndrome, which developed rapidly and had a severe course. It turned out that he was provoked by a coronavirus, later named SARS-CoV. China informed the WHO about the new threat too late, so the pathogen managed to get out of the country. Cases were reported in 33 countries, 775 people died, and the overall death rate was 9.6%. In 2012, the coronavirus again reminded of itself, but already in the Middle East. Patients also developed severe pneumonia, but this time the cause was MERS-CoV. Studies have shown that in all these cases, the pathogen has overcome the species barrier, that is, animals have become the source of human infection. So, the Middle East virus was transmitted from camels, which in turn became infected from bats. And the source of SARS infection was animal civets living in Asia and Africa. Virologists have combined these agents into a separate subgroup called betacoronaviruses.

Studies have shown that 80% of people have specific antibodies to strains of coronaviruses that cause SARS. This confirms that the latter are very common in the environment and have long lived next to humans.

Ways of their transmission:

• airborne;
• air-dust;
• fecal-oral;
• contact.

Coronavirus vaccination

JSC “Medicina” (Clinic of Academician Roitberg) provides vaccination against coronavirus infection (COVID-19). You can undergo the procedure in a comfortable environment. The service is available to all citizens of the Russian Federation.

Learn more

The share of infection with strains of coronavirus is estimated at 12% of the total number of all cases of acute respiratory viral infections, and after the illness, short-term immunity is formed, that is, after a short period of time, a person can get sick again. In addition to respiratory diseases and pneumonia, pathogens can cause gastroenteritis, but this happens much less frequently. In aerosol, they remain active for 8-10 hours, in water – up to 9days. They withstand freezing down to -70 ° C, but lose their disease-causing properties after 15 minutes of exposure to UV rays and several minutes of contact with organic compounds that dissolve fats and detergents. At a temperature of +56 ° C, viruses die in 10 minutes.

How the outbreak started

An outbreak of a new coronavirus 2019-nCoV began in the Chinese city of Wuhan. In December 2019, doctors isolated it for the first time from a patient with pneumonia who worked at a local fish market. All the first cases of the disease were diagnosed in people associated with the fish market, which gave reason to assume that the virus has again learned to bypass species barriers. The new pathogen caused diseases of the respiratory system. Many patients developed acute respiratory syndrome with a severe course (destruction of the pulmonary alveoli), which led to death.

Unlike the situation in 2002, the Chinese authorities promptly reacted to the emergence of the problem and informed the world about the new threat in time. Local authorities introduced strict quarantine in Wuhan and adjacent cities, canceled all mass events, including the celebration of the New Year according to the lunar calendar, stopped transport links, and carried out disinfection measures everywhere. Especially for such patients, two hospitals were built in the shortest possible time. January 30 WHO recognized the 2019 virus outbreak-nCoV international emergency.

Despite the fact that cases of coronavirus were identified in other countries, a large-scale spread of the pathogen was avoided. The infection was localized in China and nearby states. The leading virologists of the world quickly joined the work to combat the new threat, so its genome was deciphered quite quickly, markers for diagnostics were developed, and work began on the creation of a vaccine.

What is known about the pathogen

Studies have shown that the new coronavirus 2019-nCoV is 80% similar to the SARS virus. They use the same receptors to enter the human body. Initially it was believed that snakes – the southern Chinese multi-striped krait and the Chinese cobra, as well as the local population of bats, were the source of distribution, but later scientists blamed only the latter.

The incubation period for 2019-nCoV is 3 to 14 days. It is asymptomatic, but the carrier is a danger to others: 3.3-5.47 people can become infected from one patient (an indicator above 1 is already considered epidemic, for influenza it is 2-3). Transmission of SARS-CoV and MERS-CoV from person to person was not as intense, infection occurred mainly from animals or through very close contact with infected people. In the case of 2019-nCoV, the overall mortality rate was not very high, but the number of seriously ill patients requiring hospitalization and expensive treatment is quite large.

Human symptoms of coronavirus

The disease begins as a common cold, which complicates its early diagnosis. The patient develops cough, headache, general weakness. Then the temperature rises sharply, the cough intensifies, shortness of breath appears. On the 8-9th day, and some earlier, an acute respiratory syndrome develops, leading to lung damage. Possibly a bacterial infection. A serious condition developed in almost 25% of patients, but in some the process was mild, almost asymptomatic. A small number of coronavirus patients also showed signs of an upper respiratory tract infection: runny nose, sneezing, sore throat.

What are the symptoms of the disease caused by the new coronavirus?

• Feeling tired.
• Labored breathing.
• High temperature.
• Cough and/or sore throat.

Symptoms are in many ways similar to many respiratory diseases, often mimic the common cold, and may resemble the flu.

If you have similar symptoms, consider the following:

• Have you visited high-risk areas (China and surrounding areas) in the last two weeks?
• Have you been in contact with anyone who has visited high-risk areas (China and surrounding areas) in the last two weeks?

The Covid Hospital in Khimki (a branch of JSC Medicina (Academician Roitberg Clinic)) accepts patients with coronavirus infection (COVID-19) for hospitalization and treatment.

All details can be found by phone +7(495) 775-73-60

Treatment and diagnostics

The exact diagnosis is determined by the PCR test. There is no specific cure for the new Chinese coronavirus, but doctors are testing the effectiveness of the newest broad-spectrum antivirals, as they have shown good results in animal experiments with MERS-CoV infection.

Patients are given supportive care. For the treatment of pneumonia in respiratory failure, it is recommended to use the method of extracorporeal oxygenation, which allows you to maintain the vital activity of the body. It is not new, it was first used back in 1952 year. With the help of a special membrane oxygenator, blood is taken from the patient’s vein, which is purified, saturated with oxygen and returned back. Chinese doctors said that such treatment has been very effective, but it is expensive and not widely available due to the limited number of devices. In the case of a bacterial infection, antibiotics are additionally used.

Scientists from Hong Kong announced the creation of a prototype vaccine against 2019-nCoV, but its widespread use is still far away. The drug needs to be tested and checked for side effects. Vaccines against SARS-CoV and MERS-CoV are also not yet available. In the first case, development has stopped due to the suppression of the outbreak by preventive measures alone, and in the second, research is underway, but they are slowed down by a lack of funding.

JSC “Medicina” (clinic of Academician Roitberg) conducts screening testing for those wishing to be tested for infection with the SARS-CoV-2 coronavirus (the causative agent of the disease COVID-19)

Who can get sick

The disease caused by the Chinese coronavirus can occur in anyone, because our immune system is not yet familiar with it and cannot quickly identify it as a foreign object. However, the disease is not severe for everyone, this feature is still being studied, and there are probably less virulent strains of 2019-nCoV. However, the following individuals are at risk:

• people of retirement age;
• children;
• diabetics;
• patients with chronic diseases and weakened immunity.

Preventive measures

Since the virus is localized in China, it is not recommended to visit the Celestial Empire, or at least the province of Hubei, in which the city of Wuhan is located, until the situation improves. You should lead a healthy lifestyle, exercise and eat well. You should not take popular antiviral drugs prophylactically because they do not work, but you can buy pharmacy saline solutions for washing your nose and throat and do this several times a day. The mucous membranes of the nasopharynx are the first immune barrier for all viruses and bacteria on the way of their penetration into the human body. Normally, these shells are cleaned on their own, neutralizing all the pathogenic microflora that has settled on their surface. But due to a lack of fluid or other problems, the mechanism may malfunction, therefore, after visiting public places, washing the nasopharynx is very advisable.

To prevent infection, you can wear a medical mask, but conventional products are ineffective. Full protection is provided by masks with a HEPA filter with a class of at least N95. It is also useful to protect the mucous membrane of the eye, at least with ordinary glasses.

It is worth abandoning culinary exotics, and eating only well-boiled eggs, meat and fish. Wash fruits and vegetables thoroughly and keep your hands clean.

If you have symptoms of a cold, you should immediately consult a doctor. During coughing, the mouth is covered not with hands, but with a napkin, which must be disposed of immediately. If drops of sputum or saliva get on your hands, they should be washed immediately with soap, because they can become a source of spread of coronavirus.

Wear a mask – protect yourself from coronavirus

• Gently cover your nose and mouth with the mask and secure it to reduce the gap between your face and mask.
• Wash hands thoroughly with soap and water after touching a used mask.
• Change the mask to a new one every 2 hours.
• Do not reuse disposable masks. They should be discarded after each use.
• Wearing a mask is required when in contact with people who have symptoms of an acute respiratory viral illness, or if you have similar symptoms.

The mask cannot be reused!

The use of a mask will be most effective only in combination with meticulous hand hygiene.

Conspiracy theorists

At the end of January 2020, well-known blogger Tyler Durden published an article Did China Steal Coronavirus From Canada And Weaponize It, which states that the 2019-nCoV coronavirus is the product of the developments of Chinese virologists working on secret projects to create biological weapons. The author reports that in March 20191999, especially virulent viruses were stolen from the Canadian NML laboratory, which subsequently ended up in China. This laboratory, which had the 4th level of biosafety, among other things, was engaged in the study of dangerous coronaviruses. Later, Dr. Xiangguo Qiu and her husband Dr. Keding Cheng, whom the author refers to as Chinese agents working for the government’s secret biological warfare program, were fired from it. Wuhan, China is home to one of the research institutes participating in this program, the Wuhan Institute of Virology of the Chinese Academy of Sciences. This facility is located just 20 miles from the fish market that became the epicenter of the spread of the 2019 coronavirus.-nCoV. The blogger claims that these viruses are included in the Chinese biological weapons program, therefore they are actively studied in several laboratories, the funding of which is increasing year by year. The outbreak of the novel coronavirus in Wuhan may have been linked to the creation of these weapons.

It is difficult to say how reliable such information is. It is true that such a laboratory does exist in Wuhan. It was created after the outbreak of SARS-CoV specifically to study pathogens that cause SARS. Such objects, as a rule, have a high degree of biological protection; therefore, it is difficult to allow a banal leakage of hazardous biomaterial into the external environment. Similar theories took place at the beginning of the 20th century during the Spanish flu epidemic. Then there were persistent rumors that a new influenza virus was launched by the German company Bayer in order to increase the sale of its drugs.

Be that as it may, many virologists and epidemiologists say: the world needs to prepare for the emergence of new viruses that will provoke massive cases of severe acute respiratory syndrome.

FAQ

How is coronavirus transmitted?

• Airborne (virus release when coughing, sneezing, talking).
• By airborne dust.
• By contact – by contact with any contaminated surface, such as a doorknob. People also become infected when they touch their mouth, nose, or eyes with contaminated hands.

Can the new coronavirus be cured?

Yes, of course. However, there is no specific antiviral drug for the new coronavirus. As there is no specific treatment for most other respiratory viruses that cause colds.

Viral pneumonia, the main and most dangerous complication of coronavirus infection, cannot be treated with antibiotics. If pneumonia develops, treatment is aimed at maintaining lung function.

How to protect yourself from infection with coronavirus?

Keep your hands clean by washing them frequently with soap and water or using a disinfectant.

Avoid touching your mouth, nose, or eyes with unwashed hands (usually, we unconsciously do this about 15 times an hour).

Carry hand sanitizer with you so you can clean your hands in any setting.

Always wash your hands before eating.

• Minimize touching public surfaces and objects as much as possible.
• Carry disposable tissues and always cover your nose and mouth when you cough or sneeze, and be sure to dispose of them after use.
• Do not eat food (nuts, chips, biscuits, and other snacks) from shared containers or utensils if other people have dipped their fingers into them.