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Hepatitis B Diagnosis & Monitoring, Living with Hepatitis B

Raw Shellfish Warning for those with Hepatitis B

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Summer is here, and it’s time for a smorgasbord of your favorite, fresh seafood.  All good, but if you have hepatitis B, you’re going to want to take precautions to ensure you don’t get sick, or even die, from the seafood that you eat.

There are a couple of variations on what is considered shellfish, but basically it includes oysters, clams, mussels, shrimp, crab, and lobster.  Oysters and clams are the only shellfish eaten raw, so they present the greatest danger.  Raw oysters are the main culprit, although all raw or undercooked shellfish from warm coastal waters, especially during the summer months, are a risk.  It’s difficult to ensure the origin of your seafood, despite labeling requirements, and whether or not it was frozen, or partially unfrozen at some time.  As a result, it’s best to treat all seafood equally.  And of course it’s not the shellfish itself, but rather a microbe called Vibrio vulnificus.  In fact this hearty microbe may exist in warm, salt-water directly, and care should be taken to avoid exposure of open wounds to potentially contaminated water.

V. vulnificus is very virulent with a 50% mortality rate.  The microbe may enter the blood stream via an open wound, or the GI tract where it may cause sepsis.  This is especially perilous for people that are immunocompromised, or have liver damage due to chronic infections such as viral hepatitis – specifically hepatitis B.  Symptoms may include fever, chills, vomiting, diarrhea, and abdominal pain.  It is very serious, and may lead to septic shock and death.  Septic infections are carry a high mortality rate of 50% in individuals without liver disease.  Those that are immunocompromised or suffer from liver disease are 80 to 200 times more likely to develop septicemia from V. vulnificus than those without liver disease.  Those are pretty serious odds.

Please keep in mind that this is not to be confused with basic food poisoning from “bad seafood”.  There are no visible signs of the bacterium.  Contaminated shellfish smell and taste fine.  If you believe you may have been infected, you need to seek immediate medical attention.

If you must eat shellfish, please follow precautions.  Be sure shellfish are thoroughly cooked.  Cook all oysters, clams and mussels until the shells open and continue boiling for five additional minutes.  If steaming, cook for an additional nine minutes.  Boil shucked oysters for at least three minutes, or fry them in oil for at least ten minutes at 375 degrees F.  Wear protective gloves when handling and cleaning raw shellfish, and avoid exposure to open wounds.  (This warning actually includes exposure of open wounds to infected waters, so be careful when vacationing.)  Take care to keep raw seafood and all other foods separate.  Eat when cooked, and immediately store leftovers in the fridge.

I’ve never been a fan of raw shellfish, and with my HBV awareness, I instilled a sense of fear in my children regarding raw shellfish, or any raw seafood.  If it’s got a shell – especially oysters, clams and mussels, they don’t touch it, and they gag at the sight of raw seafood.  Okay, so maybe I carried that a bit too far, but at least I can check that one off my danger list. V. Vulnificus is dangerous! If you have HBV, it would be best to avoid shellfish.

Hepatitis B Diagnosis & Monitoring, Hepatitis B Prevention, Living with Hepatitis B

Show Your Support for World Hepatitis Day!

World Hepatitis Day is Thursday, July 28th!  Join the World Hepatitis Alliance.  The theme is “This is Hepatitis”, which is aimed at raising global awareness.  Globally, two billion people have been infected with hepatitis B, (one out of three), and 400 million live with a chronic, lifelong infection.  Although there are excellent treatments available, there is no cure for hepatitis B.  However, there is a safe and effective HBV vaccine.  If you are infected, be sure loved ones and household contacts are screened and vaccinated.  If you are not infected or not vaccinated, get vaccinated and help eliminate the spread of this virus, worldwide.

Show your support by adding a World Hepatitis Day PicBadge to your facebook and twitter profile pictures.  This makes a great visual statement.  You can also add the widget to your website or blog.  Take a look at HBF’s website, and note the slider at the top with “World Hepatitis Day”.  Check out the details on how to add the World Hepatitis Day PicBadge to your profiles and website.  Select the “add to profile picture” button.  Follow the instructions and the badge will be added to your FB and/or twitter profile pics.  (FYI.. I use hootsuite to manage my tweets, and it wasn’t initially obvious that it picked it up, but it worked fine. )  Check out HBFs FB and twitter profile pics to get an idea of how it looks.  Once you make the modifications, the PicBadge program will post the badge to your wall and tweet an invite to others to join with their support.  You can also have picbadge send a request to FB friends so they may lend their support.

On a personal note, consider sharing your story on the World Hepatitis Alliance’s “Wall of Stories”  Please feel free to share your story in your native language.  The more personal the stories, the better!

Be sure to let us know what you or your organization is up to for World Hepatitis Day!  No contribution is too small in the fight against viral hepatitis!

Hepatitis B Diagnosis & Monitoring, Living with Hepatitis B

Mosquito Repellent and Hepatitis B

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Summer has arrived and so have your annoying neighborhood mosquitoes, who show up uninvited to every party.  Everyone’s first impulse is to spray on the DEET, an effective, insect repellent, to keep them away.

If you have hepatitis B, and are working hard to “love your liver”, you might be wondering what affect DEET will have on your liver.   Your liver is an amazing organ responsible for filtering just about everything we inhale, ingest or absorb through the skin.  DEET is an effective, but strong chemical, that when applied to the skin, or accidentally inhaled while spraying, or ingested due to poor hand washing, may be found in the blood stream up to 12 hours later.  It’s your liver’s job to ensure this toxin is filtered from your system.   An over-taxed liver can be problematic for anyone, but placing additional burdens on your liver when you have HBV can contribute to liver damage over time.

Here are a couple of things to consider.  Mosquitoes and other flying, or biting insects are vectors for numerous diseases that can make us very sick.   (Please keep in mind that mosquitoes are NOT vectors for hepatitis B.)  As a result we have to consider other options, or weigh the risks vs. the benefits of spraying on a dose of DEET.  If you do decide that DEET is the best protection against mosquitoes, consider limiting your exposure by applying it to your clothing, rather than directly to the skin.  When you’re back inside and out of mosquito territory, wash it off.  Don’t wear it to bed.

A natural alternative to chemically produced repellents is citronella, which has been registered for use in the U.S. since 1948.  It is made by steam distillation of certain grasses, and is considered a biopesticide, a naturally occurring substance that controls by non-toxic means.

Citronella can be purchased in various outdoor candles and natural, registered products such as Burt’s Bee’s Herbal Insect Repellent, or Avon Skin So Soft.  Citronella and other remedies can be purchased as essential oils and applied to the skin.  Please remember that natural does not equate to safe.  Make sure directions-for-use are legitimate and followed explicitly.  These oils are dangerous when ingested, and they are not packaged in child-resistant containers to avoid accidental swallowing.  Be sure to research all natural remedies or chemical products, and ensure the directions-for-use are legitimate, and that they are stored out of reach of children.  In researching this blog, I ran across various factoids and instructions-for-use with natural remedies that were contradicted in other articles.

Here are some additional tips that may require a little more forethought, and may not be as effective as a chemical repellent.  However, they can provide some relief and perhaps a balance.  Recommendations include:

  • Wear light colored clothing.  Mosquitoes are attracted to dark clothing.
  • Cover as much skin as possible with clothing… long sleeves, pants, socks, hats, etc.
  • Consider the fragrances you wear.  Floral or fruity fragrances, scented soaps, perfumes, hair products, scented sunscreen and even fragrance from fabric softeners and dryer sheets attract mosquitoes.  In my house, nothing smells clean and fresh.  Everything is unscented.
  • Avoid being out when mosquitoes are most active – dawn and dusk.
  • Use external fans.  Mosquitoes don’t fly well in a stiff breeze!
  • Avoid areas with standing water.
  • Eat garlic…lots of it.  My pharmacist is Indian, and also prescribes natural remedies.  She told me garlic is often consumed in massive quantities to discourage mosquitoes.
  • Bats are your friends…   I grew up with two medium-sized, but stagnant ponds on our property.  We had lots of bats and no mosquitoes.

As always, it’s all about common sense and balance.  If you’re having a picnic at the Dismal Swamp, or traveling to countries where the risk of disease carrying mosquitoes is very high, then you might want to think about bringing along the can of DEET, and using it responsibly.  Perhaps an outing here or there may also warrant the use.  Otherwise, make an attempt to combat mosquitoes naturally, or make a concerted effort to avoid them at their worst.  Yet another way to incorporate “loving your liver” into your daily life!

 

 

 

 

 

 

Hepatitis B Prevention, Living with Hepatitis B

Hepatitis B and Your Neighborhood Pool

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Photo by Sheila http://ht.ly/6eRlt

Memorial Day marks the unofficial beginning of the summer, and with it, the opening of the community pool.  Every summer, questions regarding hepatitis B and the public pool are asked.  Typically it is those that are infected, or have children that are infected with HBV, that have concerns.  Hepatitis B is 100 times more infectious than HIV.  Does that mean you should be worried about contracting or spreading a blood borne pathogen like hepatitis B at the community pool?  Personally I don’t believe so, but there are a couple of things to consider.

If you’re concerned about a blood spill in the pool water than do not worry.  As long as you are frequenting a well-maintained pool that follows guidelines for consistently monitoring chlorine and pH levels in the pool, you’ll be fine.

Use common sense when at the pool.  Check that the water is clear, and the sides aren’t slimy. If the odor of your pool is too strong, something may be off.  Speak with management if you have concerns.  Pool staff are responsible for keeping water safe.  There are strict guidelines that must be followed.  Still have doubts?  Purchase your own pool test strips to confirm disinfecting quality of the pool.

Blood spills on the deck are a plausible transmission route for blood borne pathogens like HBV, but this hazard can be readily averted with proper cleanup.  Chlorine is a very effective agent against hepatitis B and other pathogens.  When made fresh and used in the correct concentrations, (nine parts water to one part chlorine) it kills pathogens like HBV.  As a team manager of a neighborhood swim team, I found the lifeguard slow to clean up a blood spill on deck.  The protocols are in place, but everyone needs to be vigilant to ensure they are followed.  If you have HBV and are bleeding on deck, don’t be afraid to insist that the blood spill be properly disinfected.  There’s no need to disclose your status.  These are standard precautions that should be followed for all blood and other body fluid spills.

The big culprit at the pool is swimmers with diarrhea.  Diarrhea causing germs may survive even in a well-maintained pool.    Chlorine resistant Cryptosporidium, also known as “Crypto”, is one such microbe.  One inadvertent gulp of contaminated pool water and it’s possible you, too, will contract diarrhea.  The good news is HBV is not spread via contaminated water, or the oral-fecal route.  Know the ABC’s of viral hepatitis!  Keep little ones out of the pool if they have diarrhea, make frequent swim-diaper changes, and don’t count on the plastic swim pants to keep everything in.  Oh, and don’t let the kids drink the pool water.  Parents, good luck with that one!

There are legitimate dangers lurking at the pool – a recent recall on pool drain covers jeopardize the safety of children, the risk of drowning and injury always exists, and of course there’s the risk of diarrhea causing illnesses.  Fortunately the odds of transmitting or contracting HBV are infinitesimal in a well maintained pool.  As always, remember that HBV has a safe and effective vaccine. Be sure those you know and love are vaccinated.

Beat the heat at your neighborhood pool this summer.  And finally, if your public pool looks like this… well, common sense would tell you there’s a lot more to worry about than hepatitis B!

 

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B A Hero Flash Mob Event!

Participants Perform a B A Hero Chant
What a pleasure and inspiration is was to participate in Hep B Free Philadelphia’s “B A Hero Flash Mob” event at City Hall, this week, in Philadelphia. It was great to experience the energy of the event through the many students and participants.

The group gathered at 11:30 to listen to brief messages from former Philadelphia Health commissioner Dr. Walter Tsou; current Philadelphia Health Commissioner Dr. Donald Schwarz; along with Professor Raymond Lum, Drexel University School of Public Health; Chari Cohen, MPH, Associate Director of Public Health of the Hepatitis B Foundation, and Dr. Timothy Block, Volunteer President, Hepatitis B Foundation, and Professor, Drexel University College of Medicine, who addressed the group.  This was a great forum to raise awareness of Hepatitis B, and urge the public to be screened and vaccinated.

As the clock-ticked down to the final minutes, the sun beamed and particpants waited in anticipation to reveal their “secret” to the world.

Richard Liu, MPH, rallied the crowd….

“Everyone has a secret.
Someone you know has Hepatitis B.
You can fight hepatitis B and liver cancer.
Reveal your secret.
B A Hero!”

The bull-horn blew at noon, and the crowd stripped off their jackets and cover-ups, revealing their blue T-shirts emblazoned with a superman-like emblem with a big, red “B” in the shield, all the while chanting:

 “B A Hero!  Get Screened!  Get Vaccinated!”

B A Hero!

The crowd was charged with energy.  The chanting continued.  Some ran about with their B A Hero T-shirts, and red capes. 

One group of elderly adults quietly displayed their support, wearing their T-shirts.  Guest speakers were interviewed.  One group of students performed an educational, “Hep B Rap”.   

The message was clear.  Hepatitis B is a serious problem, and the public needs to be screened for hepatitis B.  There are effective drugs for those identified, and may be in need of treatment.  There is a safe and effective vaccine.  We need to ensure vaccination against hepatitis B for young and old, and especially those in high risk groups.

It was great to have media coverage at the event.  We were thankful to have KYW News Radio, CBS, Fox and ABC in attendance to help spread the word to a broader, listening group.  This was a wonderful event for Hep B Free Philly, the Hepatitis B Foundation, Hepatitis Awareness Month and the community.

Now it’s time to do your part.  Be an educator, and help raise hepatitis B awareness.  Be sure everyone you know has been screened and vaccinated for HBV. 

B A Hero today!

Hepatitis B Advocacy, Hepatitis B Treatment

Happy 20th Anniversary to the Hepatitis B Foundation!

Hepatitis B Foundation 20th Anniversary Gala

 

Join the Hepatitis B Foundation with this short, fun, YouTube video with great snapshots and music as the Hepatitis B Foundation  celebrates its 20th Anniversary.  The Hepatitis B Foundation is the only national non-profit organization solely dedicated to the global problem of Hepatitis B. 

If you want to know more about HBF, check out our mission and story.  We’ve had some great accomplishments over the last year, so take a moment and review our  2010 annual report, and see what contributions HBF has made to hepatitis B research, outreach, and advocacy.

Hepatitis B Advocacy

Call to Action! Urge Your Members of Congress to Attend Viral Hepatitis Congressional Briefing!

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On Thursday, May 12th, Congressman Mike Honda and Senator John Kerry will hold a Congressional briefing entitled “Combating the Hidden Epidemic: U.S. Department of Health and Human Services Action Plan for the Prevention and Treatment of Viral Hepatitis.” This briefing will inform Members of Congress and their staff about the long-awaited report from HHS that will detail the federal government’s strategy for combating hepatitis B and C in the United States.

The release of this report and the briefing offer a tremendous opportunity to change the course of the viral hepatitis epidemic in the U.S. and demonstrate Congressional leadership in moving forward a comprehensive prevention and treatment strategy.

We need as many Members of Congress and their staff to attend this briefing to show their commitment to implement and fund the HHS plan. You can help make this happen by making three important phone calls right now!

How you can make a difference:

Call the Capitol Switchboard toll-free at 1-888-876-6242 and ask to be connected to your U.S. Representative. When you are connected, ask for the staff person who handles health care issues. Whether you speak directly to the staff person or leave a message, tell him/her:

“My name is _____________ and I live in (city/state). I am calling to urge Representative _____________ to attend a Congressional briefing on fighting the viral hepatitis epidemic in the United States. This important briefing will outline the new HHS “Action Plan for the Prevention and Treatment of Viral Hepatitis.” The briefing will be held on Thursday, May 12th, from 9:30 – 11:00 am in 210 Cannon House Office Building. Please contact Meina Banh in Congressman Mike Honda’s office for more information and to register. In the next 10 years, about 150,000 people in the United States are projected to die from liver cancer and liver disease associated with chronic hepatitis B and C. I strongly urge your office to participate in this briefing and show your commitment to fighting these preventable diseases.”

Next, call both of your two U.S. Senators (using the Capitol Switchboard number) and deliver the same message to their health care staff.

You can also ask the staff person for his/her email address and forward the attached “Dear Colleague” letter with more information about the briefing.

Thank you for taking the time to make a difference!

This Action Alert was created by the Hepatitis Appropriations Partnership, the National Task Force on Hepatitis B: Focus on AAPIs, and the National Viral Hepatitis Roundtable.

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Join The Hepatitis B Foundation for Our 20th Anniversary Crystal Ball!

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The Hepatitis B Foundation is celebrating 20 years as the global authority dedicated to eradicating Hepatitis B. 

Please join us for an evening of fine dining and entertainment!

Date: Friday May 13th, 2011
Time:  Cocktails 7:00 pm
Dinner:  8:00 pm
Place:  PineCrest Country Club in Landsdale, PA
Dress:  Business or Cocktail Attire
Tickets:  $175 per person or $300 per couple

This is the Hepatitis B Foundation’s signature fund raising event, so we hope you will join us in an elegant evening of celebration, fine dining, and dancing to the sounds of Courtney Colletti Music!

Both a silent and live auction will add to the festivities.

If you are unable to attend the evening, but would like an opportunity to participate in a raffle to benefit the Hepatitis B Foundation, and WIN a six days/nights vacation to exotic Costa Rica, you may purchase a ticket.  The winning ticket will be drawn May 13th, but the winner need NOT be present to claim the prize!  Click here for more information!

For additional details and tickets, please call Ms. Peggy Farley at
215-589-6328 or email Peggy.Farley@hepb.org

We hope to see you there!

Hepatitis B Diagnosis & Monitoring, Living with Hepatitis B

Hepatitis B and Chocolate

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Planning on digging into your favorite dark-chocolate stash, or biting the ears off of a dark-chocolate bunny this weekend?  Dark chocolate is popping up everywhere.  Even some old favorites have a new, dark chocolate wrapper, replacing the now-passé milk chocolate.  Recently, studies have extolled the benefits of dark chocolate, and how it potentially prevents heart disease, reduces the risk of brain damage after a stroke, lowers the risk of heart failure, lowers blood pressure, reduces heart disease, has anti-cancer benefits, slows dementia, raises libido, and last but not least, is mood enhancing.  What about those suffering hepatitis B associated liver disease?

Last year there was a study out of Spain that investigated the benefits of dark chocolate to patients with liver disease – specifically patients with cirrhosis.  Cirrhosis causes portal pressure to rise, potentially resulting in damage to blood vessels in the liver.  Eating causes an additional rise in pressure, which becomes more dangerous as liver disease progresses.  Half of the study participants were given white chocolate, and the other dark chocolate.  The dark chocolate group saw a larger decrease in the blood pressure of the liver, and increased blood flow.  Keep in mind that this was a small study with only 21 participants.

The good news is that dark chocolate, specifically the cocoa component, is rich in antioxidants called flavonoids, and other beneficial components such as  phenylethylamine, theobromine,  anandamide, magnesium, copper, and vitamins E and B.  That’s certainly a mouth-full, but it is these key components that provide all the benefits of chocolate.

Here’s the bad news.  Many of us enjoy milk chocolate, or even the dreaded white chocolate, which has little or no benefit due to the processing of the cocoa, and the resulting loss of flavonoids.   In fact, the lighter the chocolate, the fewer the benefits.  In a perfect world we would be eating unsweetened, cocoa powder right out of the tin, or a chocolate bar with upwards of 85% cocoa.  That can be a pretty biting chocolate.  The chocolate many of us enjoy has a larger quantity of white sugar , which is not beneficial to the liver, or any other organ, nor is the additional butterfat, which is added to lighter chocolate.  However, if you can adjust your tastes a little and learn to adapt to less sugar and butterfat, dark chocolate is great addition to your diet.

Aren’t most of us looking for an excuse to add chocolate to our diets?  Ultimately, all things in moderation is the key.  A small amount (roughly 6.7 grams) of dark chocolate added to your daily diet is certainly not going to hurt you, and may in fact reduce abdominal pressure and portal pressure in the liver.  Perhaps the greatest redeeming quality of chocolate is it’s mood enhancing qualities.  If it feels good, and eaten in moderation, then why not reap the benefits of dark chocolate and enjoy your improved mood.

Hepatitis B Advocacy

Hepatitis Health Action Alert: The Hepatitis Community Responds to Health Care Reform

ACTION ALERT!

Prevention funding in Health Care Reform is under attack.

Tell your representative to vote NO on H.R. 1217

On April 5th, the assault on the Affordable Care Act continued when the House Energy and Commerce Committee voted along partisan lines in favor of H.R. 1217, which would repeal the Prevention and Public Health Fund. This fund, part of the health care reform law, provides money each year for vital prevention and public health services. The fund will grow each year until it eventually provides $2 billion/year.

This fund offers a great opportunity to get some of the money targeted to viral hepatitis prevention, screening, and testing programs. We cannot advocate for that money if the entire fund is repealed. We also must protect this fund as part of defeating the ongoing strategy by those who oppose the Affordable Care Act to attack the law by repealing and de-funding its important pieces.

The full House of Representatives is expected to vote on H.R. 1217 as early as this week. Please take a few minutes to call your Representative and tell him/her to vote NO.

Here’s what YOU can DO:

Please call your U.S. House Representative immediately. We are hearing directly from Congressional staff that phone calls are the most effective form of communication.

Call the Capitol Switchboard toll-free at 1-888-876-6242 and ask to be connected to your Representative. When you reach your Representative’s office, tell whoever answers the phone that you are a constituent, and that you would like to speak to the staff person who handles health care issues. Whether you speak to the staff person live or leave a voice mail, tell him/her:

“My name is _______________ and I live in (city/state). I am calling to urge Representative ____________ to vote no on H.R. 1217. This bill would repeal the Prevention and Public Health Fund, which is an important part of the Affordable Care Act. This Fund is a great opportunity to provide badly needed funding for viral hepatitis prevention, testing, and screening programs and must be preserved.”

Thank you for taking the time to make a difference! Please spread the word.

Get involved with Hepatitis Health Action!

·         Sign up for the Hepatitis Health Action email list by visiting http://groups.google.com/group/HepHealth or, email Christina at cchun@projectinform.org and we will make sure you are added.

·         Join Hepatitis Health Action’s Facebook group:  http://tinyurl.com/hephealthfacebook where you can participate in discussions with other advocates and share your ideas and strategies.

·         Follow Hepatitis Health Action’s blog for news and commentary: http://hephealthaction.wordpress.com

Hepatitis Health Action is a new campaign led by viral hepatitis advocates working to make sure that health care reform addresses hepatitis B and C.

Baruch S. Blumberg Institute