12 Even though most body fluids have low concentrations of infectious HBV particles, contact should be avoided with all other potentially infectious body fluids (e.g., saliva in dental procedures). 8 Although blood is the most efficient vehicle of infection, infectious HBV has been found in other body fluids, including bile, nasopharyngeal secretions, saliva, and sweat. HBV is a bloodborne pathogen and can be transmitted through infected blood from a percutaneous injury (such as a needlestick or cut with a sharp object) or through contact with mucous membranes, non-intact skin with HBV-positive blood, or other bodily fluids. each year (primarily from liver failure). 9 Overall, less than five percent of HBV-infected older children and adults develop chronic infection, 10 which is estimated to cause over 1,800 deaths in the U.S. are estimated to have chronic HBV infection, 8 with Asian-American adults (foreign- or U.S.-born) having the highest estimated risk of chronic HBV infection. and abroad: between 847,000 to 2.2 million people in the U.S. 6 Chronic HBV infection remains a public health challenge both in the U.S. 1, 6 In 2019, 13,859 new cases of chronic hepatitis B were reported in the U.S. 8 After the development of effective HBV vaccines, the incidence of acute HBV infection declined and has stabilized. Symptoms of the acute illness caused by HBV infection include nausea, malaise, abdominal pain, and jaundice untreated, it can then develop into a chronic condition, predisposing individuals to cirrhosis (scarring) of the liver, liver cancer, liver failure, and death. 7 HBV can remain infectious on environmental surfaces for at least seven days and can also be transmitted in the absence of visible blood. HBV is transmitted via blood or sexual contact, and the virus is transmissible through percutaneous or mucosal exposure to infectious blood or body fluids. HBV infection is an occupational risk to individuals who have exposure to blood, blood products or other bodily fluids. 1Įpidemiology and Risk to Dental Personnel In 2006, ACIP expanded these recommendations to include routine vaccination of children aged older than one year in all 50 states. 1 In 1996, CDC’s Advisory Committee on Immunization Practices (ACIP) recommended administration of HAV vaccine to persons at increased risk for the disease, including international travelers, men who have sex with men (MSM), persons who use drugs and persons who inject drugs (PWID), and children living in communities with high rates of disease. Since 1995, vaccines to prevent HAV infection have been available in the U.S. 6 In recent years, the Centers of Disease Control and Prevention (CDC) has been monitoring an emerging outbreak of HAV infection in the United States, with 36 states reporting just over 42,000 cases since 2016. In 2019, a total of 18,846 acute cases of HAV were reported to CDC from 50 states and the District of Columbia, with an estimated 37,700 acute HAV infections occurring that same year. 1, 3 Unlike HBV and HCV, HAV does not cause chronic infection cases of HAV infection are generally self-resolving within 4-7 weeks with mild to moderate symptoms (e.g., fever, fatigue, malaise, loss of appetite), but symptomatic relapse may occur in up to 20 percent of cases, particularly among individuals of older age groups. primarily through close personal contact with an infected person or exposure to contaminated food or water.
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