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Hepatitis B and A

Information for occupational risk groups
for Hogeschool Arnhem Nijmegen – HAN

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What is Hepatitis B?

Hepatitis B is an inflammation of the liver caused by the highly contagious Hepatitis B virus.
Check the info in the next video

{mp4}film-uitleg-hepatitisB{/mp4}

How do you get infected with Hepatitis B virus?
The Hepatitis B virus can be found in blood, semen, pre-seminal fluid and vaginal fluid. Hepatitis B can be transmitted through unsafe sexual contact, blood contact or blood products. For example, you can become infected through needle, cutting, splashing or biting incidents. The virus can also be transmitted from mother to child at birth. A small amount of infected blood in a wound is enough to cause an infection.

What are the symptoms and possible consequences?
Although infection with the virus can go unnoticed, Hepatitis B can lead to acute or chronic infection. The symptoms of acute Hepatitis B are fatigue, flu-like symptoms, poor appetite, muscle and joint pain, nausea and abdominal discomfort. There may also be jaundice, dark urine and light-colored stool. Symptoms may last from a few weeks to up to 6 months. In 5 to 10% of the people who are infected, Hepatitis B does not heal by itself. A chronic infection will then develop. Most people have a few symptoms or are just a bit tired. In some cases chronic Hepatitis B can lead to scarring of the liver and/or liver cancer. People with chronic Hepatitis B can infect other people. Hepatitis B vaccination has been included in the National Vaccination Program in the Netherlands since 2011.

What is Hepatitis A:

Hepatitis A is an inflammation of the liver caused by the Hepatitis A virus.

How do you get infected with Hepatitis A virus?
The virus occurs in an infected person in their stool and blood. Infection can occur through fecal-contaminated materials eg: toys, doorknobs and hands and by eating and drinking contaminated food or water. The chance of contamination increases with poor hygienic conditions..

What are the symptoms?
Adults feel unwell, have a fever, flu-like symptoms, less appetite for food and experience fatigue, nausea and abdominal discomfort. There may also be jaundice, dark urine and light colored stools. Hepatitis A does not last longer than 6 weeks in most cases, but fatigue may last longer. Young children often have no symptoms. The Hepatitis A vaccination is not included in the National Vaccination Program.

In some work areas you are at risk of infection with Hepatitis A in addition to Hepatitis B. A Hepatitis A vaccination is also recommended if you are going on vacation or internship to a Hepatitis A area such as Turkey, Egypt, Croatia and beyond (e.g. Thailand). A Hepatitis A vaccination protects you for at least 40 years. You can now protect yourself against Hepatitis A at a reduced price when we vaccinate at your school.
The cost is € 90 and you must pay this yourself. Some health insurances reimburse this vaccination in whole or in part in additional packages. You can claim these costs from your own health insurance company. If you want to make use of this offer make sure you have a debit card with you or pay €90 in cash the first time you are vaccinated. We will then arrange for you to receive an invoice by email for your health insurance.

Is there an occupational risk?

In some occupations there is a higher risk of infection and vaccination is recommended for Hepatitis B and in some cases for Hepatitis A. For some occupations it may even be mandatory to vaccinate preventively against Hepatitis B. The employer or educational institution is responsible for introducing preventive measures and a vaccination policy for the workplace.
According to the Arbo conditions decree, the employer is obliged to offer Hepatitis B vaccination to every employee if they can be exposed to the Hepatitis B virus (after risk inventory and evaluation). No separate occupational health and safety policy has been formulated for Hepatitis A.

The following (para)medical professions where there is exposure to blood are at increased risk of Hepatitis B, among others::

• Doctors, nurses and paramedics who regularly are in contact with human blood or patient material contaminated with blood, and their employees;

• Workers in diagnostic and research laboratories;

• Midwives and maternity nurses;

• Dentists, dental hygienists, dental assistants and those indirectly involved in dental patient care;

• Students or trainees in the above professions;

• Employees who take care of laboratory animals in laboratories where the Hepatitis B virus is handled;

• Workers who perform cleaning or waste disposal activities in hospitals or who transport potentially infected patient material;

• Workers who transport unfixed, potentially contaminated pathology material;

• Home and community caregivers.

The following work-related risk groups, among others, are at increased risk for Hepatitis A:

• Sewer workers;

• Business travellers;

• Daycare workers, caretakers, supervisors;

• Cleaners;

• Endoscopists

The nature of the work determines whether a job falls under a risk-forming job. Consult with your doctor or vaccination center which vaccinations are advised in your case.

Why is it wise to vaccinate?

Did you know that the Hepatitis B virus is 100 times more contagious than HIV on blood contact? Infection through blood contact with Hepatitis B is an occupational risk for (future) employees in (para)medical care and health care providers. In some occupations there can be an increased risk of Hepatitis A, such as people working in childcare, cleaners and endoscopists.
Are you going or planning to go abroad for an internship during your (para)medical studies? Then it may be advisable to check whether additional vaccinations are recommended.

What can you do about it?
Taking hygienic measures, avoiding risky behavior and vaccination can help prevent Hepatitis A and B infection. In addition to using needle disposal containers, the use of personal protective equipment (gloves, goggles, mouth mask, etc.) are important. If there is a possible chance of being at risk for the infectious disease Hepatitis A or B during work or internship, you can choose to vaccinate against it. There are vaccines available against both infectious diseases. This can be at the expense of your employer or may be (partially) reimbursed by your (supplementary) health insurance. Vaccination is possible through your family doctor, employer, GGD or other vaccination center

Frequently Asked Questions

{slider Why should I be vaccinated against hepatitis B?} The vaccinations are not mandatory but we strongly recommend that you get vaccinated against Hepatitis B. In your training and at your future workplace, you have an increased risk of contracting Hepatitis B. That is why we also advise you to do a blood test after the vaccination series to see whether you have made enough antibodies to be protected. {slider I can’t make it to school on vaccination day, now what?} All students are urged to come to school for the vaccination. If you cannot come to school on the scheduled vaccination day, please inquire by email or phone with vaccinatiecentrum.nl about alternative options. If you choose not to be vaccinated, please send an email. Mail address: info@vaccinatiecentrum.nl Tel no: +31 85 9020303 {slider I have already been vaccinated against hepatitis B, do I still need to visit?} We advise all students to come to the first vaccination day. You may need a booster vaccination or a titer test (blood sampling). Fill out the health statement and bring the vaccination certificate with you to your appointment, we will assess what the next steps are. {slider I have already had an antibody determination for hepatitis B, do I need to visit?} Have you already had the Hepatitis B vaccinations and antibody test? Then send us an email with your name, date of birth, a copy of your vaccination certificate (or the dates on which you were vaccinated) and the result of your antibody test so that we can make your file complete.
In some cases we recommend a Hepatitis B booster vaccination. {slider Is there anywhere else I can get my blood drawn?} If you let us take your blood for the antibody determination or if you let us do this at a SALTRO blood collecting station, the costs will be covered. If you have blood taken elsewhere, for example at the GP, you will have to pay the costs yourself. {slider My vaccination passport says I am protected for life, do I need to visit?} We advise all students to come to the first vaccination day. You may need a booster vaccination or a titer test (blood sampling). Fill out the health statement and bring the vaccination certificate with you to your appointment, we will assess what the next steps are. {slider How many vaccinations do I need?} Hepatitis B is a series of 3 vaccinations, given in months 0-1-6 after which the blood is checked for antibodies in month 7. Sometimes the schedule can be slightly different. {slider Do I have to pay for vaccinations?} The Hepatitis B vaccination is paid for by your program; you must pay for the Hepatitis A vaccination yourself. {sliderDo I have to pay for the antibody determination?} The antibody test will only be covered if you have blood taken by us or by the SALTRO. If you have blood taken elsewhere, for example from the GP, you will have to pay the costs yourself. {slider Does my parent/guardian have to sign the health statement?} No, this is not necessary if you are 16 years or older. {slider I am very afraid of the vaccinations, can I bring someone with me?} We work with highly experienced nurses who can put your mind at ease. It is not necessary to bring someone with you. However, it is important that you indicate this and you can do this on the health statement. {/sliders}