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Hepatitis 101

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Hep 101
Laying Down A Framework
Today We Will
• Define hepatitis, viral hepatitis &
the liver
• Learn about the 5 different types
of viral hepatitis
• Learn more about hepatitis C:
–The scope of the disease
–Signs/symptoms
–Risk factors and prevention
What Is Hepatitis?
• Hepatitis means inflammation of the liver
– Hepat (liver) + itis (inflammation)= Hepatitis
• Viral hepatitis means there is a specific
virus that is causing your liver to inflame
(swell or become larger than normal)
The Liver
• Is located in the upper right
quadrant of the abdomen
•Cleans the blood
•Regulates hormones
•Helps with blood clotting
•Produces bile
•Produces important proteins
•Maintains blood sugar levels
•And much, much, more
• The liver is essential
for life !
Inflammation
Walls of
scar
tissue
begin to
form
Healthy liver cells
become trapped
by a wall of scar
tissue
Viral Hepatitis
5 types:
A: fecal-oral transmission
B: sexual fluids & blood to blood
C: blood to blood
Vaccine
D: travels with B
Preventable
E: fecal–oral transmission
Adapted from Corneil, 2003
Hepatitis C Infection
• World - 170 million people
• Canada - 240,000 to 300,000
(0.8% to 1% of pop.)
• BC - 40,000 (1%)
• Vancouver - 11,350 (2%)
• DTES VIDUS Study - 1,437
•90% hep C posititve
WHO 2000, BC Hepatitis Service 2003, VIDUS 2003
Hepatitis C
• Affects each person differently
• No vaccine available
• Many people have the virus and
do not even know it
• Approximately 1 out of 100
Canadians infected
Overall cure rate with new treatment is 55%
*BC Hepatitis Service 2003
*
Natural History of Hep C
Only 20% will
show symptoms
Initially !
Healthy
Liver
Acute
Infection
20%
Clear the
Virus
Chronic
Infection
80% Virus
Continues
to Damage
Liver
Adapted from Lauer and Walker, NEJM 2001
Natural History Con’t
Chronic
Hepatitis
Cirrhosis
20-30%
Liver
Cancer
1-4%/year
Most symptoms begin to show only when liver is more severely damaged
Factors Affecting
Progression
• 30yrs or longer if:
• Young at time of infection
• Healthy liver at time of infection
• Female
• 20yrs or less if:
• Drinking alcohol
• Co-infection (HIV, Hep B)
• Damaged liver before infection
Adapted from Bigham, BC Hepatitis Services 2002
Signs and Symptoms
• Individuals may have one or more
of the following symptoms, while
others experience no symptoms:
–Tiredness
–Nausea
–Muscle or joint pain
–Trouble sleeping
–Loss of appetite
–Weight loss
–Abdominal pain
–Itchiness
–Depression
–Dark urine (pee)
Signs and Symptoms
• A few may have specific liver
related symptoms initially:
– Pale stool (poo)
– Jaundice (yellowing of the skin or
eyes)
Risk Factors
IDU/snorting
(51%)
No RF identified
(23%)
Incarceration (3%)
Transfusion/dialysis
blood contact (4%)
Hospitalization
dental work
(6%)
Tattooing
piercing
(6%)
HCV-infected household
member/sexual partner
(7%)
Source: Health Canada Enhanced Surveillance, Oct 98-Oct 99, Calgary, Edmonton, Winnipeg, Ottawa
Hepatitis C
Dispelling Myths
• Hepatitis C is not spread by:
–Casual contact
– Hugging/kissing
– Sharing eating utensils and drinking
glasses
– Sneezing/coughing
– Shaking hands
– Sitting on a toilet seat
Prevention
• Never share drug equipment
– Straws, bills, needles, syringes, water,
filter, cooker, pipes etc…
• Never share tooth brushes/razors
or any personal hygiene articles
that have blood on them (even tiny
amounts).
• Practice safer sex
Prevention
• Always make sure new & sterilized
equipment is being used for tattooing
& piercing
– Make sure ink for tattooing is not being
shared
• Do not touch dirty needles without
proper equipment or following proper
procedures
Dirty Needle Precautions
1. Handle only if you have proper equipment
• Sturdy pair of gloves, tongs or pliers and a puncture
proof container (heavy plastic or metal)
2. Place needle in puncture proof container
• Do not touch needle with bare hands and do not try to
recap needle if cap present
3. Can dispose container in garbage but better
if it is taken to health clinic or needle
exchange
4. At school, notify custodian, teacher, nurse
or police liaison officer
Needle Prick
1. Do not “milk” prick site
2. Wash the area with soap and water
3. Go to nearest emergency department
for assessment and treatment
Questions?
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