Immune serum globulin should be administered intramuscularly within a few days
of exposure. Disposable needles, syringes, and thermometers should be used for the
hepatitis patient. The hepatitis virus is excreted in feces 2 to 3 weeks before and up to
1 week after the appearance of jaundice and the virus remains in the blood during the
same period. Because of this, the feces and blood of patients with acute hepatitis must
be considered infectious. While strict attention to personal hygiene and sanitation is
necessary, rigid isolation of the patient is not necessary. Susceptible contacts are
generally infected before the clinical symptoms become apparent in the transmitter. If
disposable needles and syringes are not available, needles and other equipment must
be boiled to destroy the virus because soaking in alcohol is useless. Proper safeguards
should be used to prevent the use of blood and its components from infected or carrier
donors. Food handlers should be screened carefully and sanitary practices must be
used during the preparation and serving of food. Wear gloves when handling bedpans
and fecal-contaminated linens. Use the patient care hand wash after possible
exposure and teach the patient to wash with lots of soap and running water, especially
Section III. TYPE B HEPATITIS
a. Distribution. As with type A, the serum hepatitis or type B is distributed
b. Frequency. Serum hepatitis is seen mostly in young adults and in older
people who have been administered blood or blood products.
c. Mode of Transmission. This disease can be transmitted by oral-oral mode,
for example from mother to child via breast-feeding. The most common means of
transmission is parenterally, from the administration of blood or blood products. It may
be caused by any type of injection, by renal dialysis, by drug addiction, or by intimate
contact with carriers. Male homosexuals and prostitutes are very susceptible since
fecal-oral spread is possible. Other susceptible persons are general surgeons, clinical
laboratory workers, oral surgeons, nurses, and respiratory therapists.
4-12. SYMPTOMS AND PATHOLOGY
The pathology for serum hepatitis is the same as for infectious hepatitis. The
factors which influence the course and severity of type B are also the same as for type
A. The symptoms for serum hepatitis resemble those for infectious hepatitis clinically,
but the onset of symptoms in more insidious. The symptoms have high variability.
There is a high likelihood that some of the symptoms will not be as pronounced or will
be missing. Fever and respiratory symptoms are rare and there may be no jaundice.
There may be rashes and pain in the joints.