Prevention and Control of Communicable Diseases
Hepatitis B
Reportable to local or state health department
This fact sheet is for provider information only.
If you have questions, please call the health department.
It is rare for children to be infected with hepatitis B with the exception of those children infected by their mothers during pregnancy or childbirth. These children may have a lifelong infection (chronic infection). Children who have chronic hepatitis B infection may be attending child care or school; however, spread of hepatitis B in these settings is very rare.
Cause
Hepatitis B virus.
Symptoms
Loss of appetite, tiredness, stomach pain, nausea, vomiting, dark (tea or cola-colored) urine, light-colored feces, and sometime rash or joint pain. Jaundice (yellowing of eyes or skin) may be present in adults but it is uncommon in young children. Symptoms vary greatly from none at all to severe illness. Adults have symptoms more often than children.
Spread
Virus is present in the blood and other body fluids that may contain blood. It can be spread person-to-person when blood from an infected person enters an open cut or splashes into the eye or mouth of another person, by sharing any equipment to inject drugs or puncture the skin, such as tattooing or body piercing, or through sexual contact. Although virus can be found in saliva, the amount of virus in the saliva is so low that spread is very unlikely. It can also be spread from a mother to her baby during pregnancy or childbirth.
Incubation
It takes from 45 to 160 days, with an average of 90 days, from the time a person is exposed to hepatitis B virus until disease occurs.
Contagious Period
May be infectious for many weeks before onset of symptoms and remain infectious for 4 to 6 months. Some people may have chronic hepatitis B infection and may be infectious for life.
Exclusion
None, unless the child has unusually aggressive behavior (e.g., biting) that cannot be controlled, oozing sores that cannot be covered, or bleeding problems. The child’s health professional and the child care program director or school principal should assess on a case-by-case basis to determine whether exclusion from some activities is necessary. Children with hepatitis B infection should not be excluded from school, child care, or other group care settings solely based on their hepatitis B infection.
Diagnosis
Hepatitis B can be diagnosed through blood tests.
Treatment
Recommend parents/guardians call their healthcare provider.
Prevention/Control
- All children should receive the three dose hepatitis B vaccine series as part of their routine immunizations.
- Child care providers/school staff should discuss the need for hepatitis B vaccine with their healthcare provider.
- Hepatitis B vaccine is recommended for unvaccinated adolescents and adults who are at risk for exposure to blood borne pathogens in their work or personal life.
- Persons exposed to blood or bloody body fluids from an infected person should contact their healthcare provider or the local or state health department immediately regarding the possible need for hepatitis B immune globulin (HBIG) and hepatitis B vaccine.
- Cleaning and disinfecting of blood and body fluid spills: (See Cleaning, Sanitizing, and Disinfection)
- Surfaces and objects contaminated with blood or bloody body fluids must be cleaned with soap or detergent and water and then disinfected immediately. Hepatitis B virus, as well as other infectious bacteria, may be found in the blood and other bloody body fluids of any person, even when there are no symptoms to suggest infection is present.
- Wear disposable medical gloves when handling blood (nosebleeds, cuts) or items, surfaces, or clothing soiled by blood or bloody body fluids, or when there are open sores, cuts, or abrasions on the hands.
- Regular and thorough handwashing is the best way to prevent the spread of communicable diseases. Wash hands immediately after contact with any body fluids, even if gloves have been worn. Wash hands thoroughly with soap and warm running water.
- DO NOT allow sharing of toothbrushes, nail clippers, or razors.
- Encourage students and staff to do self-care when age appropriate.
For more information, call the Missouri Department of Health and Senior Services (MDHSS) at Bureau of HIV, STD, and Hepatitis at 573-751-6439.