Dallas County Health & Human Services
Communicable Diseases
2377 N. Stemmons Freeway . Dallas, Texas 75207-2710 . 214.819.2000 Main Switchboard

Viral Hepatitis

Viral hepatitis is an infectious disease that affects the liver. There are several types of viruses that cause this illness. The type of virus that causes the illness determines how the disease is transmitted from one person to another. Hepatitis means inflammation of the liver. Symptoms of hepatitis are similar no matter what type of virus causes it. Symptoms can include extreme fatigue, loss of appetite, nausea, vomiting and abdominal discomfort, followed within a few days by jaundice. The severity of symptoms varies from none to severe illness. Children have milder symptoms than adults. The most common types of viral hepatitis in the United States are listed below:

Type A hepatitis is transmitted from one person to another through the fecal-oral route. This means that the germ is found in the bowel movement of the patient and must get into another person's mouth to cause illness. Hand-washing is the most important way to protect yourself and others from getting this disease. Hepatitis A has a sudden onset of symptoms approximately 4 weeks after exposure. This illness is contagious from about 2 weeks before to about 1 week after onset of symptoms. There is no carrier state for hepatitis A. The Communicable Disease Division can provide immune globulin (IG) to household and intimate contacts of laboratory confirmed cases of hepatitis A. An appointment is required for this service. Day Care intervention with immune globulin (IG) is available in certain situations. There is a vaccine available to protect people from this illness but vaccine works best if given before an exposure has occurred. Hepatitis A vaccine is covered in the VFC program and is available through Immunization and Foreign Travel for a fee.

Type B hepatitis (acute) is most commonly transmitted from one person to another through sexual contact, needle sticks and blood exposure to non intact skin and mucous membranes. It can also be transmitted through exposure to sharp instruments contaminated with infected blood, such as tattooing, body piercing and acupuncture needles, sharing of razors, nail files, or toothbrushes with an infected person, following human bites or through blood received before 1975. An acute case of hepatitis B can be contagious for approximately 6 months. There is a gradual onset of symptoms with this illness. This division provides a screening test for intimate contacts of laboratory confirmed cases of acute hepatitis B. If it is determined that the contact has not had hepatitis B already, vaccine is provided. Approximately 90% of adults diagnosed with acute hepatitis B recover and remain immune to hepatitis B for life. About 1-10% of adults who get hepatitis B become chronic carriers. Infants and young children have a greater risk of becoming a chronic carrier.

Type B hepatitis (chronic carrier) is transmitted form one person to another in the same way acute hepatitis B is transmitted. A chronic carrier is someone who had acute hepatitis B and for some reason did not completely rid the body of the virus. Anyone still contagious after 6 months is usually considered a chronic carrier. Approximately 10% of adults diagnosed with acute hepatitis B become chronic carriers. Because this person will be contagious for an extended period of time, this division provides vaccine to household as well as intimate contacts of laboratory confirmed cases. A blood test is done to insure that the contact has not already had hepatitis B. Type C hepatitis is usually transmitted from one person to another though blood to blood contact. There is no vaccine to protect against this illness and immune globulin is not considered a protective measure. Approximately 85% of people diagnosed with hepatitis C become chronic carriers. Type D hepatitis is transmitted through blood to blood and intimate contact. A person can get hepatitis D only if they are already infected with hepatitis B.

Invasive Bacterial Diseases

The following diseases are caused by bacterial infections that invade a normally sterile site in the body. These sterile sites include spinal fluid, blood, synovial fluid (joint fluid), lungs, cells and others. Following are diseases included in this group of illnesses:

Vaccine Preventable Disease Program provides surveillance for:

Laboratory screening is available for confirmation of diagnosis for measles, mumps, and rubella. Vaccine is available but works best if given before exposure. Specific antibiotics are available for household and close contacts to prevent the spread of pertussis.

Enteric Disease Program deals with diarrhea diseases. Most diseases in this category are transmitted through the fecal-oral route or through contaminated food or drink. This means that the germ is found in the bowel movement of the patient and must get into another person's mouth to cause illness. Hand-washing is the most important way to protect yourself and others from getting a disease in this category. Proper cooking and storage of food is also important. Diseases in this category include:

Animal Bites And Rabies Vaccine Program

Human rabies is reportable. Because there is no cure for rabies, prevention through immunization is very important and the only "treatment" for exposure to rabies. This program provides rabies vaccine to doctors whose patients need post-exposure rabies vaccine. A prescription is required. The patient pays the Texas Department of Health for this vaccine through insurance or monthly payments (dependent on income). The patient needs to call (214) 819-2004 for information and to make an appointment to pick up post-exposure rabies vaccine to transport to the prescribing physician. The patient needs to bring a prescription for the post exposure vaccine, a small ice chest with ice and an insurance card or proof of income to the appointment. This program also provides pre-exposure vaccination to individuals who are at high risk for possible

exposure to rabies, such as animal control officers. There is a fee for this service and an appointment is required.

Lead Program

This program takes reports of adults (15 years and older) with blood lead levels of 25 :g/dL and greater and reports of children (birth through age 14 years) with blood lead levels of 10 :g/dl and greater. Home visits are provided to Dallas County residents, who live outside the city of Dallas, to evaluate the cause

of elevated blood lead levels in children with blood lead levels of 14 :g/dl and greater. The Dallas City Health Department provides this service to residents of the city of Dallas.

Zoonotic Disease And Vector Borne Illnesses

This program addresses diseases that are communicable from animals and insects to man. Diseases in this category include:

Public Safety Worker Exposures

The Communicable Disease Prevention and Control Act, Health and Safety Code, 81.050, provides a mechanism by which an emergency medical service employee, paramedic, fire fighter, correctional officer, or law enforcement officer, (this group to be known as Public Safety Worker or PSW) who receives a bona fide exposure to a reportable disease in the course of employment or volunteer service may request the department or the department's designee to order testing of the person who may have exposed the worker. All licensed medical facilities must notify the local health authority when a PSW has been exposed to a communicable disease. PSW personnel are required to present a sworn affidavit to the health authority to request testing of a person who may have exposed him/her to a reportable disease in the course of his/her

duties.

Occupational Exposures and Accidents include work related conditions and accidents. These conditions are reported to specific Texas Department of Health Departments for follow-up. Conditions include: Acute Pesticide Poisoning Drowning and Near Drowning Asbestosis Silicosis.

For information, consultation or an appointment call (214) 819- 2004. Appointment Required For Office Visits.