Symptoms of Hepatitis B
Not everyone with hepatitis B infection has symptoms. If symptoms develop, they usually appear 90 days (three months) after exposure, but they can appear any time between six weeks and six months after exposure. Symptoms of acute hepatitis B, if they appear, can include:
Symptoms are more likely to occur in adults than in children. They usually last a few weeks, but some people can be ill as long as six months. You can spread hepatitis B without having symptoms.
Most individuals with chronic hepatitis B remain symptom free for as long as 20 or 30 years. About 15% to 25% of people with chronic hepatitis B develop serious liver conditions, such as cirrhosis or liver cancer. Even as the liver becomes diseased, some people still do not have symptoms, although certain blood tests for liver function might begin to show abnormalities.
Hepatitis B is diagnosed with a blood test. The presence of hepatitis B antibodies can tell a health care professional if you have been exposed to hepatitis B, if you have a chronic infection, or if you have previously received the hepatitis B vaccine.
How It Spreads
The hepatitis B virus is spread when blood, semen, or other body fluids from an infected person enters the body of someone who is not infected.
Activities that can expose someone to hepatitis B include:
Having sex with someone who has hepatitis B
Sharing needles, syringes or drug preparation equipment
Contact with blood or skin wounds and sores of an infected person
Sharing household items (razors, toothbrushes, nail clippers, and tweezers)
Being born to a hepatitis B positive mother
Exposure to infected blood in any situation can be a risk for transmission
The hepatitis B virus can survive outside the body at least seven days. During that time, the virus can still cause infection if it enters the body of a person who is not infected.
Hepatitis B is not spread through breastfeeding, sharing eating utensils, hugging, kissing, holding hands, coughing, or sneezing. Unlike some forms of hepatitis, hepatitis B is also not spread by contaminated food or water.
The best way to prevent hepatitis B is by getting vaccinated. The hepatitis B vaccine is safe and effective and is usually given as 2-4 shots over a 6-month period. All children should get their first dose of hepatitis B vaccine at birth and complete the vaccine series by 6 to 18 months of age.
Beginning in 2022, the Advisory Committee on Immunization Practices (ACIP) recommends anyone between the ages of 19-59 be vaccinated against hepatitis B in addition to groups already advised to receive hepatitis B vaccination:
All infants, starting with the first dose of hepatitis B vaccine at birth
All children and adolescents younger than 19 years of age who have not been vaccinated
People whose sex partners have hepatitis B
Sexually active persons who are not in a long-term, mutually monogamous relationship
Persons seeking evaluation or treatment for a sexually transmitted disease
Men who have sexual contact with other men
People who share needles, syringes, or other drug-injection equipment
People who have close household contact with someone infected with the hepatitis B virus
Health care and public safety workers at risk for exposure to blood or blood-contaminated body fluids on the job
People with end-stage renal disease, including predialysis, hemodialysis, peritoneal dialysis, and home dialysis patients
Residents and staff of facilities for developmentally disabled persons
Travelers to regions with moderate or high rates of hepatitis B
People with chronic liver disease
People with HIV infection
Anyone who wishes to be protected from hepatitis B virus infection regardless of age
For those with acute hepatitis B, doctors usually recommend rest, adequate nutrition, fluids, and close medical monitoring. Some people may need to be hospitalized.
People living with chronic hepatitis B should be evaluated for liver problems and monitored on a regular basis. They should avoid alcohol and check with a health professional before taking any prescription pills, supplements, or over-the-counter medications, as these can potentially damage the liver.
Vaccination to protect against hepatitis A is also recommended. Getting more than one type of hepatitis at once can increase the chance of liver damage and liver cancer.
Hepatitis B and Pregnancy
If a pregnant woman has hepatitis B, she can pass the infection to her baby during birth. For this reason, all pregnant women should be tested for hepatitis B infection during their prenatal care.
Almost all cases of hepatitis B can be prevented if a baby born to an infected woman receives the necessary shots at the recommended times. The infant should receive a shot called hepatitis B immune globulin (HBIG) and the first dose of hepatitis B vaccine within 12 hours of birth. Two or three additional shots of vaccine are needed over the next one to six months to help prevent hepatitis B. The timing and total number of shots will be influenced by several factors, including the type of vaccine and the baby's age and birth weight. In addition, experts recommend that the baby get an antibody test one to two months after completion of the vaccine series at age 9-12 months to make sure he or she is protected from the disease.
The Vermont Department of Health’s Perinatal Hepatitis B Prevention Program works to identify the hepatitis B status of pregnant women, communicate with those at high risk for transmitting hepatitis B infection to their infants, and ensure access to hepatitis B immune globulin and hepatitis B vaccine. Hepatitis B vaccine is available free of charge to hospitals participating in the Vaccines for Children Program from the Vermont Department of Health Immunization Program.
The hepatitis B vaccine is recommended for all infants, not just infants born to infected women. The CDC recommends that infants get their first shot before leaving the hospital.
For more information on the Health Department’s Perinatal Hepatitis B Prevention Program, vaccine recommendations, and access to free vaccines through the Vaccines for Children Program, visit the Vermont Department of Health Immunization Program web pages.
See the Vermont Immunization Registry Hepatitis B Birth Dose Data Brief
Acute Hepatitis B Activity in Vermont
The table and map below shows the number of acute hepatitis B cases in Vermont by county since January 1, 2019. This information is pending updates due to the COVID-19 pandemic.