Hepatitis B


Hepatitis B is the third most common infection in travelers. It is a disease which affects the liver. World wide, endemic with little seasonal variation. In areas of Africa and Asia widespread infection may occur in infancy and childhood, in North America infection is most common in young adults.

In developed countries exposure to HBV may be common in certain high risk group such as injecting drug users, heterosexuals with multiple partners, medical staffs (e.g. doctors, surgeons, dentists, pathologist, nurses, Medical assistant and hemodialysis centre).

Causative agent: Hepatitis B virus (HBV), belonging to the Hepadnaviridae

Transmission: Transmitted from person to person by contact with infected body fluids (saliva, semen and vaginal fluids), transfusion of contaminated blood or blood products, Sexual contact, or use of contaminated needles or syringes for injections. Potential risk of transmission through other skin-penetrating procedures including acupuncture, piercing and tattooing, and perinatal transmission may occur from mother to baby.

Incubation period: 45 – 180 days, average 60 – 90 days

Sign & Symptoms

Many HBV are asymptomatic or cause mild symptoms, which are often unrecognized in adults. In symptomatic cases they will get a gradual onset with anorexia, abdominal discomfort, nausea, vomiting, arthralgia and rash, followed by development of jaundice in some cases.


Liver cirrhosis and/or liver cancer.


Symptomatic treatment

Advise rest, drink plenty of fluids and take regular antipyretic (e.g. Paracetamol) to relieve symptom of fever.

Prevention & Precautions

Vaccination is available for those at risk and should be discussed with a health care provider.

Type of vaccine: Inactivated

Number of doses: three (3), given i.m. in anterolateral aspect of the thigh ( 2 years of age). Some products, only two doses for adolescents

Contraindications: Adverse reaction to previous dose

Adverse reactions: Local soreness and redness

Before departure: Second dose at least 2 weeks before departure

Recommended for: All travelers to areas with moderate to high risk of infection

Special precautions: Particularly important for travelers from low incidence areas to hyperendemic regions and for those at high risk.

Precautions: Adopt safe sexual practices and avoid the use of any potentially contaminated instruments for injection or other skin piercing activity.

Last Reviewed : 26 April 2012
Writer : Dr. Norhayati Rusli
Reviewer : Dr. Muhaini Othman