Hepatitis A takes hold in the community.

In 2016, large outbreaks of hepatitis A virus (HAV) infection began to occur among high-risk individuals, including those with a history of drug use and those experiencing homelessness. This article focusses on HAV infection among high-risk individuals in the community, including those experiencing homelessness.

Nursing case management, peer coaching, and hepatitis a and B vaccine completion among homeless men recently released on parole: randomized clinical trial.

BACKGROUND: Although hepatitis A virus (HAV) and hepatitis B virus (HBV) infections are vaccine-preventable diseases, few homeless parolees coming out of prisons and jails have received the hepatitis A and B vaccination series. OBJECTIVES: The study focused on completion of the HAV and HBV vaccine series among homeless men on parole. The efficacy of three levels of peer coaching (PC) and nurse-delivered interventions was compared at 12-month follow-up: (a) intensive peer coaching and nurse case management (PC-NCM); (b) intensive PC intervention condition, with minimal nurse involvement; and (c) usual care (UC) intervention condition, which included minimal PC and nurse involvement. Furthermore, we assessed predictors of vaccine completion among this targeted sample. METHODS: A randomized control trial was conducted with 600 recently paroled men to assess the impact of the three intervention conditions (PC-NCM vs. PC vs. UC) on reducing drug use and recidivism; of these, 345 seronegative, vaccine-eligible subjects were included in this analysis of completion of the Twinrix HAV/HBV vaccine. Logistic regression was added to assess predictors of completion of the HAV/HBV vaccine series and chi-square analysis to compare completion rates across the three levels of intervention. RESULTS: Vaccine completion rate for the intervention conditions were 75.4% (PC-NCM), 71.8% (PC), and 71.9% (UC; p = .78). Predictors of vaccine noncompletion included being Asian and Pacific Islander, experiencing high levels of hostility, positive social support, reporting a history of injection drug use, being released early from California prisons, and being admitted for psychiatric illness. Predictors of vaccine series completion included reporting having six or more friends, recent cocaine use, and staying in drug treatment for at least 90 days. DISCUSSION: Findings allow greater understanding of factors affecting vaccination completion in order to design more effective programs among the high-risk population of men recently released from prison and on parole.

Mobile outreach strategies for screening hepatitis and HIV in high-risk populations.

OBJECTIVES: To screen, counsel and offer hepatitis A and B vaccination for subjects at high risk for hepatitis C virus (HCV) and HIV, and determine any relationship between risk factors and HCV positivity. DESIGN AND SAMPLE: A descriptive correlational design. We correlated risk factors and HCV positivity and measured vaccination completion rates. Two hundred and two unduplicated subjects in 4 locations in Western Massachusetts: a walk in substance abuse clinic, a homeless shelter, a county jail, and a community corrections facility. MEASURES: Demographic data and a standard HCV risk- screening survey were used. RESULTS: Significantly higher rates of HCV were found in subjects who were currently using injection drugs (83.3% HCV positive, χ2(1) = 20.85, p<.001), who had a history of sharing needles for drug use (75% HCV positive χ(2) (1)=83.20, p<.001), or a history of receiving treatment for drug abuse/alcoholism (38.4% HCV positive χ2(1) = 12.14, p<.001). Vaccination completion ranged by setting between 18% and 38%. CONCLUSIONS: Targeted outreach to hard to reach groups is effective in providing access for those at high risk for HIV and HCV infection. A mobile outreach strategy can focus needed resources for a variety of groups in a community.

Update on the treatment and management of patients with hepatitis.

Hepatitis is an inflammation of the liver that can be mild to life-threatening, based on the causative agent. Hepatitis viruses A through G are described along with potential treatments and infusion therapies. Nonviral causes of hepatitis include autoimmune, toxic, drug-induced, and alcoholic. The role of the infusion nurse is critical in prevention, patient education regarding all aspects of the condition, and administering and monitoring appropriate therapy.

[Nursing of patients hospitalized for viral hepatitis]. / Cuidados de enfermería en pacientes hospitalizados por hepatitis viral.

Viral hepatitis is a serious health problem that deserves special attention. In the last ten years progress has been made in its diagnosis, treatment and prevention. An updated review is made of the main clinical and epidemiological characteristics of viral hepatitis and of the nursing care that children admitted for this disease receive at our Hospital.

Infection control. Nursing management of a patient with hepatitis A and B.

The Infection Control precautions for hepatitis B are those of "Blood and Body Fluid Precautions" and those of "Universal Precautions". Gloves, preferably latex, are worn when there is to be contact with blood and body fluid. Goggles/masks are worn when there is a danger of splashing or aerosol of blood-contaminated secretions. A plastic apron, or water repellant gown, may be indicated if there is a danger of splashing. Hand washing before and after contact with blood and body fluid, even if gloves are worn. Specimens are treated as biohazard. Refuse and linen are treated as infectious. It is important to establish if the patient is in the acute phase, a carrier, or not. Education of the patient about the disease, is very important, especially in the carrier. This poses a problem when there is a language barrier. This is a sensitive subject and must be handled tactfully, especially if the mode of transmission was sexual. Safe sex must be discussed. The partner, and the newborn baby must be assessed and immunised. The transmission of hepatitis A is mainly faeco-oral, and the infection control measures those called "Enteric Precautions", or blood and body fluid precautions. These include the wearing of latex gloves when handling faeces, urine, saliva, and blood. Handwashing is essential. The patient has his own bedpan, urinal, crockery and cutlery. Isolation is continued for the first two weeks of the illness, and one week after the onset of jaundice. The Infection Control management for hepatitis A is slightly different to that of hepatitis B, C, and Non-A Non-B.