ACP/CDC new recommendations on hepatitis B screening and vaccination

ACP/CDC new recommendations on hepatitis B screening and vaccination

The American College of Physicians (ACP) and the Centers for Disease Control and Prevention (CDC) have jointly issued new recommendations for care of patients with hepatitis B including screening and vaccination with an aim to reduce chronic hepatitis B infections by screening at-risk adults, increasing hepatitis B vaccination rates, and linking infected persons to care.

Published November 21, 2017 in the Annals of Internal Medicine, the best practice statements are as follows:

·         Hepatitis B vaccination is the most effective measure to prevent Hepatitis B infection and its complications. All unvaccinated adults, including pregnant women, at risk for infection due to sexual, percutaneous, or mucosal exposure should be vaccinated against HBV. Other high risk groups including health care and public safety workers at risk for blood exposure; adults with chronic liver disease, end-stage renal disease (including hemodialysis patients), or HIV infection; travelers to HBV-endemic regions; and adults seeking protection from HBV infection should also be advised vaccination.

·         Clinicians should screen (hepatitis B surface antigen, antibody to hepatitis B core antigen, and antibody to hepatitis B surface antigen) for HBV in high-risk persons, including persons born in countries with 2% or higher HBV prevalence, men who have sex with men, persons who inject drugs, HIV-positive persons, household and sexual contacts of HBV-infected persons, persons requiring immunosuppressive therapy, persons with end-stage renal disease (including hemodialysis patients), blood and tissue donors, persons infected with hepatitis C virus, persons with elevated alanine aminotransferase levels (≥19 IU/L for women and
≥30 IU/L for men), incarcerated persons, pregnant women, and infants born to HBV-infected mothers.

·         All HBsAg-positive patients should be referred for or provided posttest counseling and hepatitis B–directed care

(Source: Annals of Internal Medicine, November 20, 2017)

Measles needs a vaccination strategy like polio

Measles needs a vaccination strategy like polio It is a deadly disease and still a cause of major child mortality in the country New Delhi, 15 August 2017: Statistics indicate that about 1,34,200 children, mostly under the age of five years, died due to measles around the world in the year 2015. In India, it killed 49,200 children. As per the IMA, measles is a deadly disease and one of the main causes behind child mortality in the country. Eliminating measles will help achieve Sustainable Development Goal’s target 3.2, which aims to end preventable deaths of children under 5 years by 2030. Measles is a highly infectious illness caused by the rubeola virus. As many as 21 strains of the virus have been identified to date. The virus takes about 1 to 3 weeks to establish itself. While there is no specific treatment for this, getting vaccination at the right time can be affective. Pregnant women are advised taking the vaccine. Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “The rubeolavirus lives in the mucus of the nose and throat of an infected child or adult. The disease is contagious for 4 days before the rash appears. It then continues to be contagious for about 4 to 5 days after.A person can get infected through physical contact with an infected person, being near an infected people when they cough or sneeze, touching a surface that has infected droplets of mucus. When the virus enters the body, it multiplies in the back of the throat, lungs, and the lymphatic system. The infection then replicates in the urinary tract, eyes, blood vessels, and central nervous system.” The symptoms of measles include runny nose, dry hacking cough, swollen eyelids, and inflamed and watery eyes, sensitivity to light, sneezing, a reddish-brown rash, Koplik's spots, and generalized body aches. Adding further, Dr Aggarwal, said, “A highly contagious disease, measles spreads like wildfire in communities where children are unvaccinated. Since the virus reduces immunity, children who have had measles - especially those who are undernourished - may die of pneumonia, diarrhea and encephalitis later on. India should build on its polio eradication campaign experience to ensure more children get vaccinated against measles. Awareness needs to be created about the need and safety of measles vaccination.” Some tips to ease the symptoms of measles include the following. • Get adequate rest and avoid heavy activities. • Drink plenty of water, fruit juice, and herbal tea to replace fluids lost by fever and sweating. • Seek respiratory relief and use a humidifier to relieve cough and sore throat. • Rest your eyes by keeping the lights low, and avoid reading and watching the television.