The hepatitis B vaccine, which became available in the United States and elsewhere around the world in the early '80s, has proved to be a very good idea. A study published today in the Journal of the National Cancer Institute found cases of liver cancer have dropped significantly in children who received the vaccine.
Researchers in Taiwan collected information on almost 2,000 cases of liver cancer among people ages 6 to 29 at the time of diagnosis between the years of 1983 and 2004. Among people who vaccinated, there were 64 cases over almost 38 million person-years (the number of years times the number of people in the study) compared to 444 cancer cases in unvaccinated people in almost 80 million person-years.
Some people who received the vaccine developed liver cancer, the authors said. But records show they were born to hepatitis-infected mothers or did not get enough of the vaccine. The hepatitis B vaccine is a three-shot series. The first shot is usually given to newborns, followed by two booster shots in the months thereafter.
"This study provides evidence of effective long-term cancer prevention by vaccination and supports the conclusion that the HBV vaccine is a good cancer-preventive strategy," the authors wrote.
Global immunization rates vary, however. Almost 86% of U.S. children are vaccinated compared to only about 28% in Southeast Asia, according to the study.
-- Shari Roan
Photo: A child receiving a hepatitis B shot. Credit: Norm Dettlaff / LasCruces Sun-News / AP.
I just wanted to sare some exciting hepatitis B news from China. Recently, the Chinese government wrote a draft regulation that states that Chinese kindergartens and nurseries will shortly no longer be allowed to turn down children carrying hepatitis B who have normal liver function. This is a great step towards eliminating regulations that discriminate against hepatitis B infected individuals by not allowing them to go to school or seak employment.
Please read the article below and follow my blog for updates on these new regulations for China's children.
All the best,
Alena
China's kindergartens to take normally functioning hepatitis B children
BEIJING, July 31 (Xinhua) -- Chinese kindergartens and nurseries will shortly no longer be allowed to turn down children carrying hepatitis B who have normal liver function, says a draft government regulation.
The draft, which is open to public feedback till Aug. 15, is expected to replace the current regulation, a simplified version that took effect in December 1994 which did not include such a requirement, a source with the Ministry of Health said Friday.
The draft regulation, applying to all kindergartens and nurseries hosting children aged under six, also requires them to report to medical authorities and enforce strict sterilization measures if infected children are found.
Children will have to present health records issued by authorized medical institutions on entry into nursery institutions, and their guardians will be required to take them for treatment should they display infectious disease symptoms.
When they return to their preschools, children will be required to show medical recovery documents. Those who take three months or longer leave will have to present a new health check record if they want to return to the nursery or kindergarten.
The draft also requires medical staff in child care centers to have a fundamental knowledge of child care, sterilization, infectious disease control and dietary management.
Kindergartens will be required to recruit at least one professional medical staff member for every 150 children. Nurseries with less than 150 children are required to have at least part-time medical staff, the draft regulation says.
Preschool center staff will have to have an annual health examination and will not be allowed to continue work if they have an infectious disease. A return to work will be dependent on full recovery.
The regulation also bans people with a record of psychiatric disorder from working in kindergartens and nurseries.
In exactly two months, the first annual Team HBV Collegiate Conference will be in full swing! I can’t believe that everything is really beginning to come together for this incredible event.
Ying Ying has been working away with the China chapters to ensure that they secure Visas to travel to the US for a week. So far we have three approved!
I have received some outstanding abstract submissions from Chapter Presidents in both the US and China for student presentations at the conference. It will be difficult to choose from them for either oral or poster presentations because all of the work that our Team HBV students do is important and receives recognition. It is my hope that all of our Team HBV students and invited high school students from around the Bay Area can learn from each other and share their best ideas and strategies.
Last week we were brainstorming some ideas in the office about how to engage all of the Team HBV students from around the world during the conference since we are limiting the number of representatives from each chapter to three. We were hoping to employ some social media tactics like facebook, twitter and video blogging to enable students not at the conference to interact with those who were attending. Attendees could upload blogs and their thoughts on the conference. Chapter members could ask questions and follow the conference online. We’re working through some of the details on how this will all come together.
Still working on finalizing the program and inviting speakers…hope to get that all finalized with Ying Ying by the end of the week.
As the Global Health Coordinator for the Asian Liver Center at Stanford University, I find it refreshing to find positive and successful hepatitis B and liver cancer-related stories from around the world. Today I wanted to share a success story from Kuwait.
Hepatitis B in Kuwait: Immunizations Making an Impact
The Public Health Matters blog welcomes requests from its readers. Recently, a reader asked us to address the issue of Hepatitis B in Kuwait. Dr. Frank Mahoney, a CDC medical epidemiologist who has worked extensively in the Middle East, wrote this response:
The global burden of disease due to cirrhosis (hardening) of the liver and hepatocellular carcinoma (HCC—liver cancer) is high (~ 2% of all deaths) and expected to increase over the next 20 years. Liver cancer is already the 4th leading cause of cancer deaths worldwide. Studies of patients with cirrhosis and HCC in the Eastern Mediterranean Region indicate more than 75% is caused by hepatitis B virus (Hep B) or hepatitis C virus (Hep C) infection. The World Health Organization (WHO) estimates approximately 4.3 million persons are infected each year with Hep B and 800,000 persons with HCV in the Eastern Mediterranean Region. Numerous studies suggest that most Hep B and Hep C infections in the Eastern Mediterranean Region are acquired due to unsafe injections and medical procedures. The cost to treat patients with chronic Hep B or Hep C infection far outweighs the cost of implementing prevention programs (like immunizations and infection control). A wide-ranging strategy is urgently needed to prevent spread of these blood-borne pathogens throughout the Eastern Mediterranean Region and other parts of the world.
Kuwait is a small country within the Eastern Mediterranean Region, located between Iraq and Saudi Arabia and bordered on one side by the Persian Gulf. In 1990, Kuwait was one of the first countries in the Eastern Mediterranean Region to introduce Hep B vaccine in their national immunization program. Before vaccine introduction, ~ 25% of adults had evidence of Hep B infection, including 2.5% with chronic (lifelong) infection. Hep B vaccination began with infant immunizations and included the delivery of a dose at birth to prevent Hep B transmission from mother to child. Kuwait reports high numbers of children receiving the Hep B vaccine. While no formal studies have been conducted to document the impact of introducing Hep B vaccine in Kuwait, it is likely that the program has significantly protected children born since 1990, resulting in a reduced prevalence of chronic Hep B infection and associated morbidity and mortality (chronic liver disease and HCC). Kuwait also offers Hep B vaccination to health care workers with occupational exposure to blood.
WHO estimates about 1.8% of the Kuwait population have evidence of Hep C infection. The epidemiology of Hep C infection in Kuwait is not well-studied.
Dr. Samuel So, Director of the Asian Liver Center, is currently in Washington DC at the National Summit on Viral Hepatitis, where politicians, medical experts and community advocates will gather for 2-Day Conference to develop an action plan to combat hepatitis B and C in the United States.
Here is some additional information on the National Summit on Viral Hepatitis:
WHAT: Chronic viral hepatitis is a leading cause of liver cancer and cirrhosis that costs the nation's health system hundreds of millions of dollars each year, yet attracts little public attention. As many as 2 million people in the United States are living with chronic hepatitis B and an estimated 3.2 million are chronically infected with hepatitis C. However, most do not even know they are infected and miss out on getting early medical care, putting them at increased risk for developing serious liver disease.
To address this public health challenge, government, medical and community experts will meet September 10-11 in Washington, D.C. to plan an improved national response to viral hepatitis. The conference "The Dawn of a New Era: Transforming our Domestic Response to Hepatitis B & C" will feature keynote addresses, panel discussions and scientific poster sessions focused on enhancing the prevention and detection of viral hepatitis and improving care for people who are already living with the disease.
Journalists are encouraged to participate in all aspects of the summit, and will enjoy unprecedented access to leading experts on viral hepatitis. A press room will be available.
WHO: Speakers include:
John W. Ward, MD, Director, U.S. Centers for Disease Control and Prevention (CDC) Division of Viral Hepatitis
Congressman Bill Cassidy, MD (R-LA), Gastroenterologist and Associate Professor of Medicine, Louisiana State University Health Sciences Center
Anna S.F. Lok, MD, Director of Clinical Hepatology, University of Michigan
Eugene R. Schiff, MD, Director, Center for Liver Diseases, University of Miami School of Medicine
Ronald O. Valdiserri, MD, MPH, U.S. Department of Veterans Affairs
Jeff Caballero, Executive Director, Association of Asian Pacific Community Health Organizations
Sponsors and supporters of the summit meeting include the Centers for Disease Control and Prevention (CDC), the National Institute of Allergy and Infectious Diseases, the American Gastroenterological Association's AGA Institute, the U.S. Department of Veterans Affairs, Gilead Sciences, Bristol-Myers Squibb and Vertex Pharmaceuticals.
WHEN: September 10-11, 2009 (Opening Keynote Address begins at 8 A.M. on Thursday, September 10)
WHERE: Washington Marriott Wardman Park Hotel 2660 Woodley Road NW (between 27th St. and Connecticut Ave) Washington, DC 20008
KEY FACTS ABOUT HEPATITIS B AND C:
The hepatitis B virus is up to 100 times more infectious than HIV and causes up to 80 percent of liver cancer cases worldwide, making it second only to tobacco as a cancer-causing agent in humans.
Chronic infection with the hepatitis C virus is the most common reason for liver transplantation among adults in the United States.
More than $1 billion is spent each year on hospitalizations related to hepatitis B, and hepatitis C is responsible for more than $600 million annually in medical costs and lost productivity.
Public awareness about viral hepatitis is low; too few physicians conduct routine screening and many patients are not benefiting from improved treatment options.
SOURCE: The Dawn of a New Era: Transforming our Domestic Response to Hepatitis B & C Lauren Graham, +1-201-463-1057, lgraham@corkerygroup.com
We all look forward to hearing about the progress being made nationally on hepatitis B policy and action.
Young and happy couples fetching marriage licenses at City Hall are also poised to receive this piece of not-so-fun advice: Don’t forget to receive your Hepatitis B vaccinations!
On Wednesday Mayor Gavin Newsom directed The City and County Clerk to offer additional preventative information about the dangerous disease to couples applying for marriage licenses, including where they can be tested or receive vaccinations.
The Newsom directive says Hepatitis B largely affects The City’s Asian and Pacific Islander population and can cause acute illness and chronic infection including cirrhosis, liver failure and liver cancer. It is easily transmitted from mother-to-child at birth, through unprotected sex or by contaminated blood on toothbrushes, razors or needles, the mayor said.
“An estimated 1 in 10 people of (Asian or Pacific Islander) descent in the Bay Area has an undiagnosed HBV infection compared to 1 in 1000 in the general population,” the mayor said in his executive directive.
Alena's Blog: One of my collegues recently told me that all new marriage liscences issued at San Francisco City Hall will come with a Know HBV brochure! Yes, the very same one that the Asian Liver Center created!
It is now September and the summer has come to a close. My summer interns have finished their projects (but will still be happily involved with the ALC in one form or another). And we continue to make progress in the fight against hepatitis B and liver cancer.
This morning I found this alarming article on blood tainted with hepatitis B in norther India (see below):
Police arrest 6 for supplying blood tainted with hepatitis B, C to hospitals in northern India
By Biswajeet Banerjee (CP) – 5 hours ago
LUCKNOW, INDIA — Police charged six people, including a doctor, for spreading infectious diseases after they allegedly supplied blood contaminated with hepatitis B and C to blood banks in northern India, police said Tuesday.
Police raided blood banks in Lucknow, the capital of Uttar Pradesh state, last month and seized about 60 pouches of blood ready for delivery to hospitals and private clinics, said Vinay Chandra, a senior police official. Each pouch contained a unit, or 3/4 of a pint (350 millilitres), of blood.
The seized samples had a low hemoglobin count and were unfit for human use, superintendent of Police Paresh Pandey said, adding he initially suspected animal blood had been mixed with human blood, but later discovered it was diluted with saline water.
Some of the blood samples tested positive for the hepatitis B and C viruses. Others had been diluted to make three units of blood from a single unit, Chandra said.
The men running the blood supply racket bought blood from professional donors who were paid as little as 25 rupees (50 U.S. cents) a unit. Diluted blood was sold to blood banks for 1,000 to 1,500 rupees (US$20-$30) a unit, Pandey said.
The suspected leader of the scam was a doctor who works at a state-run hospital, while three others were medical technicians employed at pathological laboratories in Lucknow, Chandra said. No details were available about the other two suspects.
Chandra said the men were arrested Sunday on charges of forgery and fraud, spreading infectious diseases, and for violating the Drug and Cosmetics Act. If found guilty, they could be sentenced to life terms in prison.
The fraud became known last month after a woman tested positive for hepatitis B after surgery at a Lucknow clinic. The virus was traced to a blood transfusion during the operation.
Lack of stringent legislation and oversight allows blood banks in India to supply untested blood to hospitals. Last week, media reports said at least four children in Rajasthan state were given blood donated by a man who later tested positive for HIV.
It saddens me to think that may innocent people became infected with hepatitis B through unsafe blood. This situation clearly points to the necessity for a comprehansive initiative to eliminate hepatitis B transmission, and one that unites all people against hepatitis B and liver cancer.
