People travelling abroad, particularly to developing countries, were warned yesterday of the risks of contracting hepatitis B, not only from casual sex but from acupuncture, street barbers, tattooing and body-piercing.
A hepatitis study day in Dublin was told that hepatitis B virus (HBV) was also one of the major global threats to blood safety, and visitors abroad who had accidents were at risk from blood transfusions. The HBV was much more infectious than hepatitis C and a hundred times more so than HIV.
However, speakers at the conference in the Royal College of Physicians pointed out that HBV was the second most common vaccine-preventable disease among unprotected people travelling and called for vaccine programmes to be implemented.
Opening the study day Dr Brian O'Herlihy, Director of Public Health with the Eastern Health Board, said Ireland was among those countries with low prevalence, but he warned against complacency. A vaccine had been available since the 1980s and the World Health Organisation recommended the implementation of universal immunisation programmes irrespective of prevalence.
A warning also came from Dr Alan Kitchen of the National Blood Service, London. He said the virus was transmitted by blood transfusion and was endemic in many parts of the world.
Unfortunately, many such countries had relatively underdeveloped health-care systems. They had poor blood transfusion facilities and standards. Areas with greater risk included South-East Asia, India, Africa and Indonesia.
Dr Kitchen said some non-medical actions such as acupuncture, tattooing and body-piercing were also dangerous. Drug use was another risk factor due to contamination of needles.
He advocated vaccination, which should be monitored, with booster doses given where necessary.
A consultant physician and gastroenterologist at St Luke's General Hospital, Kilkenny, Dr Garry Courtney, said we should learn from the experience with hepatitis C. While no vaccine was available against that disease, there was a vaccine against hepatitis B.
Dr Jane Zuckerman, head of the Academic Unit of Travel Medicine and Vaccine and Clinical Trials Centre, London, also called for vaccination to be encouraged. All travellers were at risk. She added that more than a third of the world's population had been infected with the virus, with an estimated 350 million chronic carriers worldwide. Approximately 25 per cent of chronic carriers would develop chronic hepatitis, cirrhosis and primary liver cancer.
Dr Elizabeth McCloy, of the Viral Hepatitis Prevention Board, Manchester, said HBV infection was preventable. The most important strategies for prevention included universal immunisation, the education of high-risk groups and health-care providers, universal precautions and screening of blood and blood products.