Question

Review the following website:

U.S. Department of Health and Human Services. (2017). Viral hepatitis action plan overview (Links to an external site.)Links to an external site.. Retrieved from http://www.hhs.gov/hepatitis/action-plan/u-s-viral-hepatitis-action-plan-overview/index.html

Initial Discussion Post:

Select one (1) of these National Viral Hepatitis Action Plan goals:

Prevent new viral infections

Reduce deaths and improve the health of people living with viral hepatitis

Reduce viral hepatitis health disparities

Coordinate, monitor, and report on implementation of viral hepatitis activities

Identify and describe three (3) interventions that the RN can implement to reach either goal.

Answer 1

Most of the hepatitis infections are caused by a type of hepatitis virus. Hepatitis A is a single stranded RNA non enveloped virus. This virus is a member of the picornavindae. Hepatitis E is another RNA virus. Hepatitis B virus is an enveloped DNA virus and a member of the hepadnaviridae. Lastly Hepatitis C virus is an RNA virus which is a member of the Flavivindae family

Hepatitis A and E are commonly transmitted through contaminated foods (vehicle) and the fecal-oral route. Hepatitis B is passed through blood contact and direct contact (such as sexual). It can also be spread vertically between mother and child. Hepatitis C is passed through blood contact and through vertical transmission.

Diagnosing Hepatitis A and E requires serology of IgM. Hepatitis B is diagnosed through serology as well; however ELISAs and radioimmunoassay are also used. Hepatitis C is also diagnosed using serology. Hepatitis A is prevented with the hepatitis A vaccine. The hepatitis B vaccine is also available and there is a mixed vaccine for both A and B.

There are no preventative measures for Hepatitis C or E other than avoiding blood contact and good food hygiene. Hepatitis A can be treated with a post-exposure vaccine or the use of immune globulins (which also treat for hepatitis E). Hepatitis B is treated with interferon and nucleoside analogs, but these are not curative. Hepatitis C is treated with pegylated Interferon, and in some cases ribavirin is also used.

Globally 257 million people are living with the hepatitis B (HBV) infection and approximately 325 million people living with chronic hepatitis and 71 million people were living with hepatitis C (HCV) infection in 2015 (World Health Organization, 2016)

The best way to prevent HAV and HBV infections is by effective use of the HAV &HBV vaccine. While the implementation of the universal HBV vaccine birth dose has been effective in reducing new HBV infections in the United States by over 80 percent, efforts to vaccinate adults at risk have not been as widespread (World Health Organization, 2016)

The nurse can engage with patients and communities to raise awareness about hepatitis. Increase community awareness of viral hepatitis and decrease stigma and discrimination. Educate communities and individuals about substance use disorders and available treatments, about risk factors for HBV, HCV, and HIV, and about other health dangers associated with substance use disorders, especially injection drug use. Ensure that people who inject drugs have access to viral hepatitis prevention services (World Health Organization, 2016).

Reducing health disparities:
A. Disease-specific initiatives should be launched;

B. Culturally appropriate community-driven programs may be done;

C. Collaboration with the community and government partners can be done to perform research on virus prevention;

D. Educational and developmental activities should be taught for the community; and

E. Help line programs can be implemented to increase diversity by the public health workforces.

Reference:

CDC. (2017, February 22). Viral Hepatitis Action Plan for 2017–2020. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/hepatitis/hhs-actionplan.htm.

World Health Organization. (2016, June). Global Health Sector Strategy on Viral Hepatitis 2016-2021. Retrieved from World Health Organization: http://apps.who.int/iris/bitstream/10665/246177/1/WHO-HIV-2016.06-eng.pdf?ua=1