cal errors put infants at risk for chronic hepatitis B virus ：卡尔错误把婴儿在慢性乙型肝炎病毒的风险

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1、MedicalerrorsputinfantsatriskforchronichepatitisBvirusinfection–sixcasereportsDebraBlog,MD,MPH,ElizabethHerlihy,RN,BSN,MS,ConsequencesofHBVInfectioninInfantsandYoungChildren~90%ofinfantsand30%ofchildren<5yrswhoacquireHBVinfectionbecomechronicallyinfectedWithoutimmu

2、noprophylaxis,~40%ofinfantsofHepatitisBSurfaceAntigen(HBsAg)positivemothersdevelopchronicHBVinfection~25%ofthosewithchronicinfectiondieprematurelyoflivercancerorcirrhosisChronicLiverDiseaseCausedbyHBVInfectionModesofHBVTransmissioninEarlyChildhoodVerticaltransmissi

3、onfrommothertoinfantHorizontaltransmissionfrominfectedhouseholdcontacttochildBothmodesoftransmissioncanbepreventedbyvaccinationofnewbornsVaccineEfficacyinPreventingVerticalHBVTransmissionImmunoprophylaxisincludes:HepatitisBvaccine&HepatitisBImmuneGlobulin(HBIG)withi

4、n12hoursofbirthThisis85%-95%effectiveinpreventingverticalHBVtransmission;hepatitisBvaccinealoneatbirthpreventstransmissionin70-95%ofinfants!VaccineEfficacyinPreventingHorizontalHBVTransmissionBeforeimplementationofperinatalhepatitisBpreventionprograms,studiesshow:61%

5、-66%ofchildrenwithchronicHBVinfectionwereborntoHBsAg-negativemothersChildrenlikelywereinfectedbyhouseholdcontacts**BirthdoseofhepatitisBvaccinewillpreventtheseearlychildhoodinfections!!FurtherBenefitsofHepatitisBBirthDoseEnsuresthatinfantsborntomotherswithunknownHBs

6、AgstatusatdeliveryreceivetimelyprophylaxisAnopportunitytoimmunizeduringoneofthefewdependablemedicalencounters(atdeliveryinahospital)Placestheimportanceofimmunizationasanearlyandvisiblepriorityforparents–studiesshowgreaterchancethathepatitisBseriesandoverallimmunizati

7、onserieswillbecompletedontimeHepatitisBistheonlyvaccinethatisreliablyimmunogenicinthenewbornperiod!NYSPerinatalHepatitisBPublicHealthLawIt’sthelawinNYS!In1989,NewYorkStatepassedaPublicHealthLaw2500-emandatingmaternalHBsAgtesting,reportingofresults,andtreatmentofinfa

8、ntsborntoHBsAg-positivewomenHospitalrecordreview:ThecornerstoneofqualityassuranceforperinatalhepatitisBpreventioninNYSDeliveryhospi