PREVENTION OF HEPATITIS B
Hepatitis B is an acute systemic infection with major pathology in liver,caused by Hepatitis B virus.
since there is no specific treatment,measures must be taken to prevent it.

+Important measures

-All blood donors must be screened for Hepatitis B. 

-Carriers should not share razor or tooth brushes and barrier methods of contraception .

-Carriers must not donate blood.

-Health  personnel must use adequately sterilized instruments. 

Hepatitis B vaccine

Hepatitis B is available as monovalent formulation or fixed combination with other vaccines including DPT,Hib, Hepatitis A and inactivated polio vaccine.

Dose---ADULT    10-20 micrograms (depending upon formulation)

            CHILD under 10 years 5-10 micrograms

             AT 0 ,1 and 6 months.

             In deltoid muscle.

The duration of protection is for at least 15 years.

VACCINE MUST BE GIVEN TO --

All children and adolescents less than 18 years and not previously vaccinated,

Partners and household contacts of HBsAg positive persons,

Injecting drug users,

High risk sexual behaviour,

Persons who frequently require blood and blood products,

Recipients of solid organ transplantation,

Health care workers,

International travellers to HBV endemic countries.

Hepatitis B immunoglobulin

HBIG should be given as soon as possible after an accidental inoculation,IDEALLY WITHIN 6 HOURS AND PREFERABLY NOT LATER THAN 48 HOURS

DOSE  0.05-0.07ml/kg body weight

            Two doses should be given 30 days apart

PASSIVE-ACTIVE IMMUNIZATION

The simultaneous administration of HBIG and Hepatitis B vaccine is MORE EFFICACIOUS than HBIG alone.

                                         RHEUMATIC HEART DISEASE

RHD is the most readily preventable chronic disease.It results in continuing damage to heart, increasing disabilities and repeated hospitalization.It is consequence of RHEUMATIC FEVER.
RF is not a communicable disease but it results from a communicable disease which is sore throat caused by GROUP A BETA HAEMOLYTIC STREPTOCOCCI. 

RHD is a major cause of morbidity and mitral insufficiency.It must be prevented.

PRIMARY PREVENTION

-Practically it is not possible to avoid first attack of Rheumatic fever.

-In case of sore throat,it should be swabbed and cultured.If streptococci present then start PENICILLIN.

-If swab culture is not possible then it is justified to give

   a.-single IM 1.2 million U of Benzathine benzyl penicillin in adults

   b.-600000 uU in children

   c.-Oral penicillin for 10 days.

   d.- ERYTHROMYCIN is given in case of allergy to PENICILLIN.

SECONDARY PREVENTION

-It is more practical approach.

-It consists in identifying those who had taken penicillin at interval of 3 weeks.

-This must be continued for at least 5 years or until the child reaches 18.

-with carditis treatment should continue for 10 years after the last attack or up to 25 whichever is longer.

-more severe valvular disease or post valve surgery requires LIFE LONG TREATMENT.

NON MEDICAL MEASURES

-To break poverty---disease---poverty cycle improve living conditions such better housing.