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Hepatitis B is a serious viral infection of the liver caused by the hepatitis B virus (HBV).²⁴ HBV infections can be asymptomatic or mild or can cause acute hepatitis. The symptoms may include fever, stomach pains, nausea, vomiting, fatigue and jaundice (a yellowing of the skin and whites of the eyes).^7,24 The illness is often more severe in adults, with about 1% of cases being fatal. Following acute infection, 1–12% of those infected as adults and up to 90% of those infected as newborn infants remain persistently infected for many years.⁷ In the long-term, chronic HBV infection increases the risk of scarring of the liver and liver cancer.^7,24

Transmission
Transmission is from person-to-person by contact with infected body fluids. For example, the infection can be spread through sexual contact, transfusion of contaminated blood or blood products, use of contaminated needles or syringes for injections or skin-penetrating procedures including acupuncture, piercing and tattooing. Transmission may also occur from a mother to her unborn baby.²⁴

Geographical distribution²⁵
Worldwide, areas of high prevalence for chronic hepatitis B infection include:

• Africa
• Southeast Asia , including China , Korea , Indonesia , and the Philippines
• The Middle East , except Israel
• South and Western Pacific Islands
• The interior Amazon River basin
• Certain parts of the Caribbean (Haiti and the Dominican Republic )

See hepatitis B distribution map

Risk for travellers²⁴
Unvaccinated travellers are at risk if they have unprotected sex or use contaminated needles or syringes for injection, acupuncture, piercing or tattooing. An accident or medical emergency requiring blood transfusion may result in infection if the blood has not been screened for hepatitis B.

Precautions

• Vaccination. The standard schedule is three doses of vaccine, given at 0, 1 month, 6 months. Accelerated schedules are available in circumstances where more rapid protection is required. With these schedules, a booster dose should be given 12 months later to ensure long-term protection. A combined hepatitis A and B vaccine is available.⁷ (See your doctor.)
• Adopt safe sexual practices²⁴
• Avoid the use of any potentially contaminated instruments for injection or other skin-piercing activities, such as acupuncture, piercing or tattooing.^24,25

(Please read the Disclaimer before using the ABC Guide to Travel Health).

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