Communicable diseases are diseases that are caused by a bacteria or virus which individuals transmit from one to the other through coming in contact with body fluids, insect bites, surfaces that are contaminated, blood products or even through the air. There are several examples of these communicable illnesses, most of which requires immediate reporting to the appropriate state agencies and the department of health in the region of the outbreak. Examples are measles, HIV, salmonella, influenza, Ebola, tuberculosis, chicken pox, hepatitis B and polio (Edemekong, 2018) . This paper will focus on one particular example of communicable diseases that is known as hepatitis B.
Hepatitis B is a contagious liver diseases caused by Hepatitis B virus also known as HBV. For most individuals, hepatitis B infection with time becomes chronic, implying that it lasts for over 6 months. Chronic hepatitis B eventually increases the risk of an individual developing liver cancer, failure of the liver as well as liver cirrhosis. Most adults infected with hepatitis B will completely recover even when their symptoms are severe. Infants and children probably develop chronic hepatitis B diseases (Kim, 2010) . Hepatitis B virus is transmitted from one individual to the other through bodily fluids, semen or blood. The most common ways that hepatitis B can be transmitted include; sexual intercourse with an individual who is infected. HBV can transmit if the infected individual’s saliva, vaginal secretions, semen, or blood enters another person’s body. Sharing of needles can as well result in the spread of hepatitis B virus. Sharing syringes and other drugs paraphernalia can also put one at a high risk of getting hepatitis B. pregnant mothers who are infected with the hepatitis B virus can easily pass the virus to their babies during giving birth. Nevertheless, the child can be vaccinated to prevent the infection in all aspects.
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Signs and symptoms for hepatitis B can range from mild symptoms to severe. In most cases, these signs and symptoms always appear from 1 to 4 months after and an individual has been infected. These signs together with symptoms of hepatitis B include; fever, abdominal pain, joint pain, dark urine, loss of appetite, nausea and vomiting, weakness as well as fatigue, yellowing of the body skin and the whites of the person’s eyes (Kim, 2010) . The period of incubation for hepatitis B infection is rather long, with the average period for symptoms to begin being approximately ninety days but can as well range from sixty to one hundred and fifty days. Symptoms of acute hepatitis B can last from weeks to approximately six months. However, not every individual infected with hepatitis B will require treatment; the treatment is specifically used in advanced stages of the disease. There exist several anti-viral agents that are more effective in curtailing hepatitis B infection from transmitting.
Chronic hepatitis B virus infection can result in multiple severe complications to an infected person like liver cirrhosis, which is the scarring of the liver which will eventually impair the ability of the liver to function properly. Also individuals with chronic hepatitis B virus infection are a greater risk of having liver cancer. Acute failure of the liver is another complication resulting from hepatitis B infection; this is a state where the critical functions of an individual’s liver shuts down completely (Edemekong, 2018) . In the case of liver failure, transplantation of the liver is necessary in order to sustain the patient’s life. Individuals with chronic hepatitis B can as well develop inflammation of the blood vessels or other kidney illnesses. Hepatitis B can either be acute or chronic, short-lived or acute hepatitis B will lasts for not more than 6 months. The immune system in most cases will eradicate the hepatitis B infection from the individual’s body and they can fully recover in a few weeks, but it can result in in chronic hepatitis infection. Chronic or long lasting hepatitis B infection normally lasts for 6 months and more. It stays because the immune system is not able to fight and remove the infection. It can last for a lifetime and result in severe complications like liver cirrhosis, liver failure as well as cancer.
A vaccine to prevent hepatitis B infection is usually given as 3 or 4 injections over a span of 6 months. The first dose of the vaccine is recommended to be given on the day of birth. It is recommended for adolescents and children who were never vaccinated after birth, individuals who reside with people who are infected by hepatitis B, people with more than one sexual partner. Others include; individuals with chronic liver illnesses, those with kidney diseases, individuals who share syringes or needles during injection of illegal substances and lastly, travelers who wish to visit the high endemic regions of the world (Kim, 2010) .
Short-lived hepatitis B usually does not need any treatment and most patients tend to clear the infection eventually. While the treatment of chronic hepatitis B infection is necessary in order to lower the risks of liver cirrhosis and cancer. The treatment of chronic infections lasts from 6 to 12 months, depending on the genotype as well as medication being used for the treatment (Lai, 2007) . The available treatment and medications usually prevents the HBV virus from replicating and hence reducing the potential damage to the liver. As of the year 2018, there were 8 certified medications approved for the treatment of the infection in the U.S. the certified medications include adefovir, telbivudine, entecavir, tenofovir disoproxil, lamivudine, tenofovir alafenamide, PEGylated interferon as well as alpha-2a interferon.
The prevalence of hepatitis B infection is high in the Western pacific region as well as the African continent with 6.2 per cent and 6.1 per cent respectively of adult individual population being infected. In the eastern Mediterranean, the Southeast Asia and Europe, an approximate of 3.3 per cent, 2.0 per cent as well as 1.6 per cent of the entire population is highly infected by hepatitis B infection (Gibson, 2017) . The prevalence of hepatitis B infection across the world ranges from <2 per cent in developed nations to <8 per cent in developing nations. Chronic hepatitis B virus has affected approximately eight hundred thousand to one and half million individuals in the United States of America. The prevalence of hepatitis B infection is higher in particular high-risk individuals such as those who inject illegal substances, those who practice unprotected sexual intercourse with the infected and individuals who are more exposed to infected bodily fluids or even blood.
According to (Gibson, 2017) , a research study conducted in 2010 indicated a rising burden of mortality attributed to hepatitis B infections and other liver complications. Previous studies had failed to allocate deaths from liver cirrhosis as well as cancer to their actual cause which is hepatitis B, contributing to its underestimation of the effect of hepatitis B on health of human beings. In the study conducted the sum of deaths as a result of hepatitis B infection was 796,000, with 17 per cent which is 121,000 attributed to acute HBV, forty three per cent which is 322,500 were from liver cirrhosis.it was approximated to be the fifteenth cause of death globally. The social determinants of health associated with hepatitis B infection testing, care and treatment in the United States of America include; cultural factors, access to medical care, health insurance coverage , language barriers, country of origin, social as well as ecological factors all affect hepatitis B infection testing and care differently. Both low SES and the decreased access to healthcare are known factors that contribute immensely to the vulnerability that result in disparities in hepatitis B health outcomes.
The epidemiology triangle consists of three main parts; the host, environment and agent. The hepatitis B infection epidemiology triangle typically has three vertices: 1). agent or the virus that causes the hepatitis B infection; 2). the host, is the organism that is hosting the HBV virus and 3). The environment which are the outside factors that enables the transmission of the hepatitis B infection by transferring the hepatitis B virus from a single host to the other (Gibson, 2017) . Hepatitis B infection occurs when the disease agent leaves the host through an available exit and is conveyed by a particular mode of transmission to enter the other susceptible new host via another point of entry. Transmission of hepatitis B infection is only direct that is host to host through contact or droplets from one individual to another and not through suspended air particles.
Individuals diagnosed with either acute or chronic hepatitis B infection need long-term monitoring as well as care. These patients are always taken care of by community health care nurses who plays a significant role in their recovery and treatment. The community health care nurses are critical in optimizing their hepatitis B disease management skills to facilitate the diagnosis, testing as well as monitoring of the individuals with hepatitis B infection (Lai, 2007) . They are also critical in developing and supporting lifestyle changes to improve the patient’s results. Other roles of community health care nurses include; promoting the health as well as wellbeing in the community, increase hepatitis B infection diagnosis by encouraging people to know their health status, contact tracing by motivating members of the family, household members and sexual partners to come together for hepatitis B testing. It is also the role of community health nurse to test for hepatitis B virus immunity after the last dose, encourage and facilitate the hepatitis B vaccination for people which is currently free. They are also supposed to provide support as well as care for patients with chronic hepatitis B infection in their local communities. Demographic data is important to the health of a community because it allows the community healthcare nurse as well as health facilities to be informed of the number of infected patients, the rate of prevalence and the social determinants factors that may enhance the spread of hepatitis B infection.
World health organization is an international agency that has been committed in eradicating and preventing the spread as well as the prevalence of hepatitis B disease in the world. In the year 2015, world health organization launched an initiative termed Guidelines for prevention care as well as treatment of persons living with chronic hepatitis B. these guidelines recommended the prioritizing of treatment for individuals with chronic liver illnesses who are at a higher risk of mortality, promoting the application of simple diagnostic tests to evaluate the phases of liver illnesses as well as the eligibility for HBV treatment and lastly it recommended the use of nucleolus analogues with great cushion against drug resistance (Kim, 2010) . In the following year, the world health organization adopted the Global Health sector on Hepatitis B from 2016 to 2020. This highlighted the crucial role of universal health coverage. Its goals and objectives was to eliminate the spread of hepatitis B infection as a public health issue with the global objective of minimizing hepatitis B disease by ninety per cent as well as lowering the total number of deaths as a result of hepatitis B infection by sixty five per cent by the year 2030. It also organizes the world Hepatitis Day on 28 th of July each and every year to promote awareness as well as understanding of hepatitis B.
Hepatitis B infection has global implications, with over three hundred million individuals being carriers of the hepatitis B virus around the world. It is the cause of close to 80 per cent of all the cases of liver cancer and the only most significant cause of mortality around the globe (Lai, 2007) . In states where hepatitis B virus individual carriers can reach to approximately 70 per cent, the hepatitis B infection rates accounts to 3 per cent of the rate of mortality, this has by far exceeded the mortality rate levels associated with polio. High endemic regions of hepatitis B disease are south East Asia, western pacific region, central Asian states, sub-Saharan Africa as well as the amazon region.
References
Edemekong, P. (2018). Epidemiology of prevention of Communicable Diseases. Journal of Health and science , 34-45.
Gibson, M. (2017). Epidemiology and Demographics . Journal on Hepatitis B .
Kim, w. (2010). Natural History of Hepatitis B virus infcetion. Mayo Clinic Proceedings , (pp. 967-975).
Lai, C. L. (2007). The natural history and treatment of chronic hepatitis B. Annals of Internal Medicine , 58-61.
