The Florida Hepatitis and Liver Failure Prevention and Control Program recognizes the major public health issues associated with hepatitis, and is sponsoring many activities to raise awareness about hepatitis A, hepatitis B, and hepatitis C.

• Throughout the year, Florida's Hepatitis Program provides many services to Florida's citizens, including
• Hepatitis A and hepatitis B vaccination for high risk adults
• Hepatitis B and hepatitis C testing for high risk adults
• Statewide hepatitis C hotline with free home test kits for high risk adults
• Public and professional education
• Hepatitis surveillance and research

HEPATITIS A is a significant public health issue for the state of Florida. In 2001, there were 892 confirmed cases of acute hepatitis A infection in the state of Florida. Hepatitis A is spread by fecal-oral contact. Of those infected, most have the common risk factors including having unprotected anal-oral sex, eating contaminated food, drinking contaminated water, and attending or working in a daycare facility.

Children usually display no symptoms for hepatitis A, while adults become very ill and display the common symptoms of hepatitis, including jaundice, fatigue, nausea, vomiting, abdominal pain, and loss of appetite. Hepatitis A causes only an acute infection that clears up within six months. Once the infection clears, persons will be immune to future infections.

To prevent the transmission and spread of hepatitis A you should:

• Wash hands properly after bowel movements and diaper changes
• Wash hands properly before preparing meals
• Avoid having unprotected anal-oral sex
• Avoid eating raw shellfish
• Get vaccinated

HEPATITIS B (formerly know as serum hepatitis) is a fairly common liver disease caused by a virus. Anyone can get hepatitis B, but those at greater risk include: drug abusers who share needles; certain health care workers who have contact with infected blood; homosexual males, particularly those with multiple partners; people in custodial care (in settings such as developmental centers); hemodialysis patients; certain household contacts of an infected person; and infants born to mothers who are hepatitis B carriers.

Hepatitis B carriers should follow standard hygienic practices to ensure that close contacts are not directly contaminated by blood or other body fluids. Carriers must not share razors, toothbrushes or any other object that may become contaminated with blood. In addition, susceptible household members, particularly sexual partners, should be immunized with hepatitis B vaccine. It is important for carriers to inform their dentist and health care providers.

Hepatitis B is found in blood, seminal fluids, vaginal secretions, and other body fluids. The virus can be spread by:

• Unprotected sexual contact with an infected person, especially among persons with multiple sex partners or men who have sex with men (MSM)
• Contact with contaminated needles, especially injection drug equipment. Other items such as tattoo and body piercing instruments, razors, and toothbrushes may be contaminated with infected blood
• An infected mother to her infant during delivery
• Household contact with an infected person
• Occupational exposure through accidental needle stick

The hepatitis B virus is not an airborne virus, and is never transmitted through casual contact such as coughing, sneezing, being in the same area as an infected person, or by consuming contaminated food or water.

HEPATITIS C virus (HCV) typically produces a symptomless liver infection that can lead, over decades, to severe liver disease, including cirrhosis and liver cancer. Most of those infected are unaware that they have the disease, and may serve as unknowing sources of transmission.

Based on national data, we estimate that 270,000 Floridians are infected with hepatitis C, although most do not know their status. Hepatitis C (and B) testing is available at no charge in 39 County Health Departments. Hepatitis C testing is also available at no charge by calling the hepatitis hotline at 1-866-FLA-HEPC (1-866-352-4372).

No vaccines are currently available to prevent HCV infection, and no medication has been approved for post-exposure prophylaxis. Prevention of HCV infection in the population currently depends on :

• screening of blood and tissue donors;
• risk-reduction counseling and services for high-risk groups like injecting drug users;
• screening (identification, testing, and counseling) of persons at high risk for HCV infection;
• improved population-based surveillance for acute and chronic HCV infection.

Screening programs should include persons who

• ever, even once, injected illegal drugs, including those who injected once or a few times many years ago and do not consider themselves drug users;
• received clotting factor concentrates produced before 1987;
• were ever on chronic (long-term) hemodialysis;
• have persistently abnormal ALT levels;
• received organ transplants before July 1992;
• received transfusions of blood or blood components before July 1992;
• were notified that they received blood from a donor who later tested positive for HCV infection;
• were born to HCV-positive women;
• are healthcare, emergency medical, or public safety workers who had needle stick, sharps, or mucosal exposures to HCV-positive blood.

Hepatitis C is found in blood, and can be spread by:

• Sharing injection drug equipment
• Blood transfusion or organ transplant before 1992
• Receiving clotting factor concentrates before 1987
• An infected mother to her infant during delivery
• Occupational exposure through needle stick
• Sexual contact (rarely)

There have been no studies that have shown an association with military service or exposure resulting from the following: medical, surgical, or dental procedures; tattooing; acupuncture; ear piercing; or foreign travel. If transmission from such exposure does occur, it is too infrequent to detect.

For more information about hepatitis or Florida's Hepatitis Program, please visit the Department of Health web site at www.doh.state.fl.us