Written by Roxanne Royce from Colorado Travel Health www.coloradotravelhealth.com.
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Incidence in India

April '10- In Gujarat India there were 92 deaths reported, most between 15 and 45 years old. In the Sabarkantha district cases rose to 43 with 5 deaths reported. From Modesa town and nearby villages 6 new cases of hepatitis have been registered to date.

Infectious Agent

Hepatitis B (HBV) is a virus.

Mode of Transmission

It is transmitted through blood and body fluids. Potential for infection can occur with the following: sex with a HBV-infected person; sharing of needles with IV drug injections; transfusions with blood or blood products; tattooing or other procedures involving needle puncture; exposure to various wound exudates; and working in health-care.

Occurance

The prevalence of chronic HBV infection in India is 2-7%.

Risk for Travelers

The risk is for HBV infection for travelers to India can be intermediate depending on one's purpose of travel and activities engaged in while traveling. A car accident necessitating specific medical interventions can also increase one's risk for infection. Dental treatment; injection drug use; dental treatment; tatooing or other invasive cosmetic or health procedures; and even sharing things such as a razor, earrings and toothbrushes can transmit the virus.

Clinical Presentation

After an incubation period of 60-150 days (typically 90), malaise, lack of appetite and jaundice (yellowing of the skin and eyes) develops. Joint pain, arthritis and rashes sometimes also manifest. (Some people including children less than 5 and immunosuppressed adults will exhibit no symptoms). 95% or more of adults, however, will clear the virus. The remaining < 5% can result in chronic liver disease, cirrhosis and liver cancer.

Treatment

Chronic HBV can be treated with antiviral medications.

Vaccine

Hepatitis B vaccine is recommended for all travelers to India since the risk there is considered to be intermediate.

References

CDC. Hepatitis B. [Cited 2010 April 30]. Available from: http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/hepatitis-b.aspx