Terry's case: A Youth at Risk

Hepatitis B Infection

1. INCUBATION PERIOD
   

   • The incubation period lasts from 6 weeks to 6 months with an average of 3 months.

2. ASYMPTOMATIC PATIENT

   • About half of adult acute cases are asymptomatic.

3. EFFECTIVENESS OF TRANSMISSION

   • The patient is contagious many weeks before symptoms are apparent and remains in that state as long as HBeAg is present; the highest degree of contagiousness occurs in the presence of HBeAg. The HBsAg disappears 3 to 4 months after the appearance of jaundice or the initial diagnosis.

   • The risk of contracting hepatitis B after an accidental stabbing with a contaminated needle is between 5% and 30%. The risk of transmission from an infected individual to their regular sexual partner is estimated to be around 30%. Transmission from a man to a woman is more effective than from a woman to a man.

4. COMPLICATIONS

   • 5% to 20% of acute cases need to be hospitalized.
     

   • Fulminant hepatitis can occur in less than 1% of cases.
     

   • A chronic carrier (i.e. presence of HBsAg for more than 6 months) status may persist in 5% to 10% of individuals who present with an acute case of hepatitis B (6% to 10% of the adult population, 90% of children less than 1 year old and 25% to 50% of children under 5 years of age).
     

   • About 25% of chronic carriers of HBsAg will suffer from cirrhosis or cancer of the liver

     Newborn
     90% of children born to mothers with positive HBsAg and positive HBeAg become infected; this proportion decreases to 15% to 30% when the mother's HBeAg is negative. Transmission happens mainly at the time of delivery.

5. PARTNERS TO BE NOTIFIED

   • Sexual and needle sharing partners from at least 6 months before the appearance of symptoms or
   • Sexual and needle sharing partners from at least 6 months before the time of diagnosis in asymptomatic patients.

Adapted from: Maladies transmissibles sexuellement. Guide pratique, Direction de la santé publique, Régies régionales de la Santé et des Services sociaux - Montréal-Centre et Laval, 1995. p 26

Principles and General Management for Partner Notification