Hepatitis B Resource Package

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					                                                   Grade Seven

                                                   Hepatitis B

                             School Immunization Program


                                        Resource Package
                              Adapted from:

                              Hepatitis B Teacher Package (1996)    -   Ministry of Health
                              Hepatitis B Teacher Package (1996)    -   Peel Regional Health Unit
                                                                    -   Peel Board of Education
                              Hepatitis B Teaching Package (1994)   -   Toronto Public Health Unit - Etobicoke Office




    205 Queen St. E.       125 Delhi St.          51 Zina St.        140 Wellington St.      500 Whites Rd.          211 First Ave.
Fergus, ON N1M 1T2     Guelph, ON N1E 4J5 Orangeville, ON L9W 1E5 Mt. Forest, ON N0G 2L0 Palmerston, ON N0G 2P0 Shelburne, ON L0N 1S0
 Tel. (519) 843-2460   Tel: (519) 821-2370   Tel: (519) 941-0760   Tel: (519) 323-2330     Tel: (519) 343-2240   Tel: (519) 925-2000
 Fax: (519) 843-2321   Fax: (519) 836-7215  Fax: (519) 941-1600    Fax: (519) 323-3794     Fax: (519) 343-2487   Fax: (519) 925-6743
 HPD VP (FS) 50 - 08/01 cb
                             Grade Seven
                              Hepatitis B
                Immunization Program Resource Package



       Included in the package are:

       •   What to Expect at Your School Hep B Immunization Clinic
       •   Anaphylactic Reactions to Vaccines
       •   Hepatitis B Lesson Plan
       •   Background information for the teacher
       •   Commonly asked questions
       •   Hepatitis B quiz
       • Hepatitis B activities (definitions, criss-cross puzzle, cryptogram,
           hepatitis B rap, word search, double puzzle, puzzle answers)




                      Grade Seven School Immunization Program Resource Package
HPD VP (FS) 50 – 08/01 cb         Wellington-Dufferin-Guelph Health Unit         1
                                 What to Expect at your
                            School Hep B Immunization Clinics



       Please ensure that you have delivered the Hepatitis B Immunization
       Program Envelope to the office with the following:

                       1) A copy of your class list
                       2) All completed and blank consents
                       3) Program Evaluation Checklist

       On the Hepatitis B immunization clinic day, students will be called to
       the clinic room in small groups or as a class.

       •   The vaccine will not be given under certain circumstances:

               ⇒ If the student is ill with anything more serious than a minor
                   viral infection e.g. common cold

               ⇒ If the student is allergic to components of the vaccine or has
                   had serious reactions to previous vaccines

               ⇒ If the student is pregnant (should check with family doctor
                   as to whether the vaccine should be given now or deferred)

       •   Students who are absent or have been transferred into or out of
           your class will be tracked by Health Unit staff in order to complete
           their immunization.

                                      Remember:
                              You Can Make A Difference!
                                Encourage Participation!


                      Grade Seven School Immunization Program Resource Package
HPD VP (FS) 50 – 08/01 cb         Wellington-Dufferin-Guelph Health Unit          2
                     Anaphylactic Reactions To Vaccines

       Anaphylaxis is a very rare allergic complication that can occur after
       receiving a vaccination. Immunization clinic nurses ask questions
       regarding possible allergy to any component of the vaccine.
       Although rare, anaphylactic reactions can still occur.

       Students should remain under supervision close to the clinic area for
       fifteen minutes in case of an anaphylactic reaction.




                  If a student displays ANY of the following symptoms,
                        please contact a clinic nurse immediately.



                  Possible Signs And Symptoms Of Anaphylaxis

                   •    flushed face, hives and itching
                   •    swelling - eyes, lips, face, tongue
                   •    difficulty breathing or swallowing
                   •    coughing, choking, wheezing
                   •    vomiting, stomach upset
                   •    a “funny” or tingling feeling in the throat or mouth
                   •    dizziness, unsteadiness
                   •    loss of consciousness




                       Grade Seven School Immunization Program Resource Package
HPD VP (FS) 50 – 08/01 cb          Wellington-Dufferin-Guelph Health Unit         3
                             Hepatitis B Lesson Plan


                                          Lesson Goals

       1) To increase awareness of Hepatitis B and the importance
          of the Hepatitis vaccine.
       2) To increase awareness of healthy lifestyle choices.
       3) To decrease the incidence of Hepatitis B.



                                            Objectives

       1) Students will understand that Hepatitis B is a serious viral
          infection that affects the liver and can be prevented by
          immunization.
       2) Students will be able to identify three ways the Hepatitis B
          virus can be spread.
       3) Students will know four ways to reduce the risk of Hepatitis B
          infection.



                                               Outline



       1) Conduct a short lesson on Hepatitis B disease, ways it is spread, benefits of
           immunization and receiving the Hepatitis B vaccine. (15-20 min)
       2) Discuss questions and concerns re: Hepatitis B disease and
           immunization.(10-15 min)
       3) Distribute Hepatitis B puzzles and activities and/or conduct the Hepatitis
           B Quiz. (15-25 min)
       4) Distribute consents and remind students to return them by the deadline.




                      Grade Seven School Immunization Program Resource Package
HPD VP (FS) 50 – 08/01 cb         Wellington-Dufferin-Guelph Health Unit                  4
                 Background Information About Hepatitis B

       What is Hepatitis B?

       Hepatitis B is a viral infection of the liver. Up to 50% of people who
       get Hepatitis B never feel sick. Others develop flu-like symptoms,
       such as fatigue and nausea. Some become very ill with fever,
       abdominal pain, dark coloured urine, clay-coloured stools and
       jaundice (yellowish colour of the skin and eyes). Up to 1% of
       persons with acute Hepatitis B infection may die of the initial illness.
       If you are infected with Hepatitis B (whether you are ill or not) you can
       pass the virus to others. Because it is caused by a virus, Hepatitis B
       cannot be treated with antibiotics and there is no cure.


       Why is Hepatitis B such a concern?

       • Hepatitis B is the world’s most common blood-borne viral
         infection.
       • More than 200 million people worldwide have chronic Hepatitis B
         infection.
       • The younger a person is when infected with Hepatitis B, the
         greater the risk of becoming a chronic carrier. Approximately
         10% of people who get Hepatitis B infections will become lifelong
         carriers of the disease even though they no longer have
         symptoms.
       • Hepatitis B can kill. Up to 1% of people with Hepatitis B die from
         the initial infection.
       • Hepatitis B carriers have a higher risk of developing liver cancer.

       Approximately 300 cases of Hepatitis B are reported each year in
       Ontario. Many more cases are unreported because people can have
       the disease and not know it.

       Up to 50% of people who have the disease do not look or feel sick.
       They can pass the disease to others even if they do not feel sick.
       Chronic carriers can also pass the disease on for years without
       knowing it.

                      Grade Seven School Immunization Program Resource Package
HPD VP (FS) 50 – 08/01 cb         Wellington-Dufferin-Guelph Health Unit           5
       How is Hepatitis B spread?

       Hepatitis B is spread through contact with blood and body fluids (e.g.
       semen, vaginal fluids) of an infected person. Blood or body fluids
       containing the virus must enter a break in the skin or be absorbed
       through mucous membranes (e.g. eyes, mouth). The virus can live
       outside the body in blood droplets for 7 days.

       You could contract Hep B through contact with an infected person’s
       blood. This can happen by:
       • Sharing a needle that someone else has used for drugs, ear
          piercing, body piercing or tattoos.
       • Accidentally pricking yourself with a used needle.
       • Sharing toothbrushes, razors, or other personal items
       • Cleaning cuts or open sores of an infected person when you
          have an open cut in your skin.
       • Hepatitis B is also spread through semen and vaginal fluids
          during unprotected sexual intercourse. The risk of exposure to
          the virus is higher when someone has multiple sexual partners.
          Using condoms at all times will reduce the risk of infection.
       • An infected mother can pass Hepatitis B to her infant at birth.



        Hepatitis B can be spread through a bite when infected blood or
        saliva enters the other person’s blood stream through the wound.
        Sneezing, coughing, hugging, kissing, or using the same dishes as
        an infected person, does not spread the virus.




                      Grade Seven School Immunization Program Resource Package
HPD VP (FS) 50 – 08/01 cb         Wellington-Dufferin-Guelph Health Unit         6
        Why Immunize Against Hepatitis B In Grade Seven?

        Many new cases of Hep B occur in early adulthood. Immunizing
        Grade 7 students will ensure they’re protected well before they
        might be exposed to the virus.

        • This type of disease prevention reduces long-term medical care
          and is therefore cost effective in the long run.
        • Immunization in schools ensures universal access for all students.
        • The Hepatitis B education component, provided in the classroom
          promotes informed decision-making.

        The Hepatitis B vaccine promotes antibody protection to over 95%
        of those who receive it. A small percentage may not respond for a
        variety of reasons. It is important for students to be aware that a
        combination of wise personal habits and being immunized gives the
        best protection against contracting the Hepatitis B virus.


        About the Vaccination

        The vaccine used to protect against Hep B is one of the safest
        vaccines available today. There is no danger of receiving other
        blood-borne diseases, because no human substance is used. A
        registered nurse will give the students a series of 2 injections during
        the school year.

        Hepatitis B vaccine usually causes no major side effects. Some
        students may have minor reactions, such as:

        • redness, warmth or swelling at the injection site.
        • tiredness or slight fever lasting 1-2 days.

       More serious reactions occurring within 15 days of the injection
       should be reported to the family doctor or local health department.
       These include a fever over 39.0 0C, difficulty breathing, swelling of
       the mouth or face, and hives or rashes.



                      Grade Seven School Immunization Program Resource Package
HPD VP (FS) 50 – 08/01 cb         Wellington-Dufferin-Guelph Health Unit          7
                      Commonly Asked Questions by Students

       General

       1.     How big is the needle?

              The needle is the same size as other needles you get at the doctor’s for
              immunization. It is very small.

       2.     Will it hurt?

              The needle feels like a tiny pinch. It is very quick and most people find it is
              over before they know it.

       3.     Where do they give the needle?

              The needle is given in the upper arm. It is given in the deltoid muscle.
              It is not given in the buttock.

       4.     Do I have to get the needle?

              The needle is not required in order to attend school. You have the right to
              decide if you want the protection this immunization provides. However, this is
              the only time you will be able to access this immunization free of charge.
              Should you decide to get it at a later time, it may cost over $100.

       5.     Why are there two needles?

              It takes time for your body to build up immunity to the Hepatitis B virus. Each
              needle gives a small dose of vaccine that allows your body to produce more
              fighter cells (antibodies) against the Hepatitis B virus.

      6.     Why can’t I get it from my doctor?

             In order to get the immunization from your doctor, you would have to buy the
             vaccine at a cost of more than $100. It is easy to reach students through the
             schools and every student has equal opportunity to receive the immunization.
             Also, the information provided about Hepatitis B, in the classroom, helps
             students make informed decisions.




                      Grade Seven School Immunization Program Resource Package
HPD VP (FS) 50 – 08/01 cb         Wellington-Dufferin-Guelph Health Unit                        8
      7.     Why grade 7 students?

             Grade seven was chosen in Ontario for several reasons. Students in this
             grade have the ability to be involved in the decision-making process. Also, the
             program reaches students before the majority engage in behaviours that
             increase their risk of exposure.

      8.     Will the vaccine cure other types of Hepatitis?

             Hepatitis B is the only disease prevented by this immunization. It will not
             provide protection against any other form of Hepatitis (A, C, etc.). This
             immunization will help prevent infection of Hepatitis B but will not cure any
             form of Hepatitis.

      9.     If I have Hepatitis B and don’t know it, what will happen if I get the
             needle?

             If you have active Hepatitis B or are a carrier, getting the vaccine will not harm
             you. If you are already immune to Hepatitis B, (i.e. You had the disease and
             did or did not know it) getting the vaccine will also not harm you in any way.

      10.    Do they use a new needle for everyone?

             Every person gets a new, sterile needle every time he/she is immunized. All
             needles are disposable, single-use needle.




                      Grade Seven School Immunization Program Resource Package
HPD VP (FS) 50 – 08/01 cb         Wellington-Dufferin-Guelph Health Unit                          9
       Disease Specific Questions

       1.     What are the signs and symptoms of Hepatitis B disease?

              Blood tests will show if the Hepatitis B virus is in the body. Up to 50% of
              people infected with Hepatitis B have no symptoms at all or think they have
              the flu when they are infected with Hepatitis B.

              Some people do have symptoms. If someone has been exposed to blood or
              body fluids of another person and has symptoms such as tiredness, nausea,
              fever, abdominal pain, jaundice, rash, dark urine and pale stool, he/she may
              have Hepatitis B. Only a blood test will tell for certain.

       2.     What does Hepatitis B do to you?

              Hepatitis B affects the liver. Most people who get Hepatitis B recover and
              develop antibodies. However, even if you don’t have symptoms, you can
              become a chronic carrier of the virus for the rest of your life. This means the
              virus lives in your body and can be passed to others. Some carriers develop
              liver diseases such as cirrhosis (scarring) or cancer, years later.

       3.     How does the unborn baby get Hepatitis B?

              During the birth process, the baby is exposed to many of the mother’s
              body fluids including blood, vaginal fluids and mucus. If the baby’s
              mother is a carrier of Hepatitis B, a special needle called immune globulin is
              given together with the first shot of Hepatitis B vaccine to the baby within 12
              hours of birth. The second shot of vaccine is given when the baby is one
              month old and the third one is given at six months of age. The Hepatitis B
              vaccine protects most babies who get all three shots.

       4.     Can’t I just get penicillin if I get Hepatitis B?

              Hepatitis B is caused by a virus. Antibiotics, such as penicillin, only help the
              body fight diseases caused by bacteria. There are no drugs that will cure
              Hepatitis B.




                      Grade Seven School Immunization Program Resource Package
HPD VP (FS) 50 – 08/01 cb         Wellington-Dufferin-Guelph Health Unit                         10
       Name___________________________
       Class________

                                      Hepatitis B Quiz

       Fill In The Blanks:


       1. Hepatitis B is a viral disease that affects the __________________.

       2. The choice is yours. If you get the Hepatitis B needle, you’ll be
           ____________ if you come in contact with the Hepatitis B virus.


       3. If you have had a serious reaction to any vaccine in the past, tell the
           __________________________ before you get the first needle.


       4. For full protection against Hepatitis B, you need __________Hepatitis B
           immunization needles over the school year.


       5. List three ways that Hepatitis B virus can spread from person to person.
          1) ________________________________________
          2) ________________________________________
          3) ________________________________________


       Write True (T) Or False (F) In The Blanks:

       Some of the ways to reduce the risk of Hepatitis B infection are:

       _________ Avoid picking up or sharing needles.

       _________ Be immunized with Hepatitis B vaccine.

       _________ Do not share toothbrushes or razors.

       _________ Avoid tattoos and body piercing unless you’re sure that sterile
                 equipment is being used.



                      Grade Seven School Immunization Program Resource Package
HPD VP (FS) 50 – 08/01 cb         Wellington-Dufferin-Guelph Health Unit             11
                        Hepatitis B Quiz Answer Sheet

       Fill In The Blanks:


       1. Hepatitis B is a viral disease that effects the liver.

       2. The choice is yours. If you get the Hepatitis B immunization or Hepatitis B
           vaccine, you’ll be protected if you come in contact with the Hepatitis B
           virus.


       3. If you have had a serious reaction to any vaccine in the past, tell the nurse
           before you get the first needle.


       4. For full protection against Hepatitis B, you need two Hepatitis B
           immunization needles over the school year.


       5. List three ways that Hepatitis B virus can spread from person to person.
          1) sharing needles used for drugs, body piercing or tattoos
          2) sharing tooth brushes, razors or other personal items
          3) exposure to blood or body fluids of an infected person

       Note: Please refer to written information about Hepatitis B for other
       possible answers.

       Write True (T) Or False (F) In The Blanks:
       Some of the ways to reduce the risk of Hepatitis B infection are:

       TRUE            Avoid picking up or sharing needles.

       TRUE            Be immunized with Hepatitis B vaccine.

       TRUE            Do not share toothbrushes or razors.

       TRUE           Avoid tattoos and body piercing unless you’re sure that sterile
                      equipment is being used.




                      Grade Seven School Immunization Program Resource Package
HPD VP (FS) 50 – 08/01 cb         Wellington-Dufferin-Guelph Health Unit                  12

				
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