Ready for Some Public Health Fun? Pavitri Dwivedi, MPH Public Health Program Manager Hepatitis B Foundation December 22, 2014

Today’s Agenda Overview of Hepatitis B Public Health My journey from high school to now!

What is Hepatitis? Hepatitis – “inflammation” of the liver Viral Hepatitis – caused by a virus There are many different viruses that can cause hepatitis Hepatitis A, B, C, D, E Liver performs 500+ functions Stores vitamins Fights infections Regulate the body’s energy

HBV Virus The world’s most common, serious liver infection At least 100 times more virulent (ability to invade) than the HIV Virus Can survive on surface up to 2 weeks Found in liver, blood, and sexual fluids Results in both acute (short-term) and chronic (lifelong) infections Causes 80% of liver cancer worldwide

Transmission methods & myths Direct Contact with Someone’s Blood Close household contact: sharing razors, toothbrushes, earrings, nail clippers with infected person Blood transfusions prior to 1992 screening protocols Unsterile medical or dental equipment Sharing IV drug equipment Unclean needle sticks, piercings or tattoos Sexual Transmission From Infected Mother to Newborn Baby During the labor and delivery process Hepatitis B CANNOT be transmitted through hugging, coughing, sneezing, urine, tears, breast-milk, eating food prepared by an infected individual, or casual contact.

HBV IMPACT IN OUR WORLD! Worldwide: 2 billion infections (1/3 of all people) 400 million chronic infections 67% in Asia and Pacific Islands 1 million new infections annually 1 million deaths each year (10th leading cause of death) In the U.S.: 2 million Americans chronically infected 50,000-70,000 new infections annually 1,500 Perinatal infections annually

hepatitis B In Philadelphia Approximately 5,000 new infections in PA each year Prevalence breakdown: Chinese community: up to 23.5% Korean community: up to 4% Vietnamese community: up to 8% Cambodian/Indonesian/Laotian communities: up to 8% AAPIs in Philly: 61% need vaccine

Hbv infection symptoms Most individuals have NO symptoms! About 30% will have some symptoms, including: Feeling like you have the flu Very tired, fever, sore muscles, headache, nausea Loss of appetite and weight loss Yellowed skin and eyes (jaundice) Itchiness, rash Dark urine and/or clay-colored stools 70% of those infected will have no symptoms

Chronic infection One in 4 infected could develop severe consequences Chronic HBV infection greatly increases the risk/need of: Fibrosis, cirrhosis, liver failure Primary liver cancer (hepatocellular carcinoma, HCC) Liver Transplantation Premature Death

primary PREVENTION: VACCINATION! There is a safe and effective vaccine Three-doses of the vaccine Given over 6 months Offers safe and effective life-long immunity The first “Anti-Cancer” vaccine Routinely given to all babies and children in the U.S. Does not help someone who already has hepatitis B infection

Secondary prevention: testing! A single blood test will tell if you have hepatitis B Contact Hep B United Philadelphia to find out where you or a friend/family/classmate/neighbor can get a free or reduced cost hepatitis B blood test: Pavitri.Dwivedi@hepb.org

Drug treatments Not everybody needs drug treatments! 3 criteria have to be met Active virus Certain amount of liver damage (possibly) family history of liver cancer Continuous disease management is important for identifying whether a patient needs drug treatment Treatments are all expensive $10,000-$30,000 each year Drug assistance program can help!

Living with chronic hepatitis b It is important that infected individuals: Know their status HBV is a silent infection, so those at risk must be tested to see if they are infected! See a knowledgeable physician for medical care Learn about living with chronic HBV Healthy lifestyle to keep your liver healthy Prevent the spread to others (i.e. vaccinate close contacts)

Hepatitis b foundation The only national nonprofit organization dedicated to finding a cure and improving the quality of life for those affected by hepatitis B worldwide Biomedical Research Outreach & Education Public Health Research National Advocacy

HEP B UNITED PHILADELPHIA Goals: All high-risk people in Philadelphia are tested All non-infected high-risk people are vaccinated All people who have hepatitis B see a doctor and stay healthy Establish infrastructure so doctors will routinely test high-risk patients for hepatitis B

campaign COMPONENTS Education and Awareness (like right now!) Improve correct knowledge about hepatitis B Help people to talk about hepatitis B with family, friends and doctors Screening, Vaccination, and Linkage to Care Offer free hepatitis B testing at community events Help doctors to test and vaccinate their patients Help infected individuals find good healthcare Community Partnerships Everyone can help: community members, corporate partners, businessmen and women, community leaders

National efforts CDC National Demonstration Site May 2012-May 2013 Community Based Hepatitis B Care Over 1,000 unique, high risk foreign-born individuals screened Community vaccine clinics All 3 doses for free Provided at community sites instead of health centers In-language patient navigation National Capacity Building HBF leading the national Hep B United coalition Organize national capacity building webinars, panels, mentorship program, and mini-grants.

RESOURCES CDC’s Know Hepatitis B Campaign Hepatitis B Foundation http://www.cdc.gov/knowhepatitisb/ Knowledge for general population Promotional materials Hepatitis B Foundation http://hepb.org/ Technical Knowledge – medical, pharmaceutical Resources for the infected @HepBUnitedPhila, @cdchep, @HepBFoundation Facebook fan pages

Game Time! How do you define health? What are some of the fields you believe are in the healthcare field? Why are you interested in the healthcare field?

Public health “Public health refers to all organized measures (whether public or private) to prevent disease, promote health, and prolong life among the population as a whole. Its activities aim to provide conditions in which people can be healthy and focus on entire populations, not on individual patients or diseases.” – WHO

Public health umbrella Community health Health policy and management Environmental health Occupational health Toxicology Epidemiology Patterns, causes, effects of diseases Global health Biostatistics Lots of coding

My role as a manager Philadelphia National Coalition Coordinate screening & vaccine events Conduct linkage to care Maintain communication among coalition partners Establish relationships and partnerships Provide health education* Organize volunteers Social & traditional media National Coalition Information dissemination – webinars, panels, newsletter Know Hepatitis B campaign Policy initiatives

Now and then Newington High School University of Connecticut Molecular Cellular Biology- Major Medical Anthropology- Minor Boston University School of Public Health Global Health, Monitoring and Evaluation Emphasis Pharmaceutical Program

WORDS OF WISDOM DISCOVER TRAVEL STUDY ENGAGE Personal interests, hobbies, marketable skills TRAVEL Learn about the life beyond your backyard STUDY Stay in school and do well, grades matter! ENGAGE Internships, jobs, volunteering opportunities

Time is essence https://www.youtube.com/watch?v=a5SMyfbWYyE

Questions?