National Collegiate Athletic Association

The NCAA News - News and Features

April 20, 1998

SPORTS SCIENCES NEWSLETTER

Hepatitis B virus can be controlled with vaccine

The image of Magic Johnson in his first comeback game after disclosing he was infected with HIV is frozen in our mind: hard contact with an opponent opened a small cut on his leg. The game was stopped while a latex-gloved athletic trainer bandaged the wound, as television cameras zoomed in.

HIV is as frightening now as it was then, because it is contagious in certain settings and there is no known cure. The threat of contamination spurred important changes in procedures of athletic trainers, sports medicine professionals and others for dealing with any open wounds, at virtually all levels of professional and amateur sports.

But what of hepatitis B? In some settings this virus can be up to 100 times more contagious than HIV, and can cause liver damage, including cancer, and death. Unlike HIV, which is relatively short-lived in an open environment, the hepatitis B virus has been found to survive on contaminated surfaces for at least one week, posing an unseen hazard. Moreover, there is no proven treatment for hepatitis B.

There is, however, one extremely important distinction between hepatitis B and HIV -- there are safe and highly effective vaccines for hepatitis B that can prevent the disease.

It is important for athletic trainers and sports medicine personnel to be informed about the hepatitis B virus, how it is transmitted and the appropriate safeguards, not only for their personal well-being, but for the well-being of their coaches, players, equipment personnel and sanitation staff.

Since 1994 the NCAA Sports Medicine Handbook has recommended hepatitis B immunization for all student-athletes as part of guideline 1B. Readers may refer to guideline 2H in the same publications for more complete information blood-borne pathogens, including hepatitis B.

The facts about hepatitis B

  • Hepatitis B is a viral disease that attacks the liver.

  • After smoking, hepatitis B is the world's leading known cause of cancer.

  • The virus is on the rise in the U.S., infecting some 240,000 Americans annually.

  • More than 200 million people worldwide are chronic carriers of hepatitis B.

  • More than 40 percent of cases occur in adolescents or young adults (ages 15 to 29).

  • The virus is spread through blood and other body fluids, and can survive for at least one week on surfaces contaminated with these fluids.

  • Hepatitis B can be spread in a variety of ways, including:

  • Contact of cuts or scrapes with contaminated blood or body fluids;

  • Sexual contact with an infected partner (some individuals who are infected do not show symptoms);

  • Contact with a contaminated needle during intravenous drug use, tattooing, ear or body piercing;

  • Repeated sharing of razor and/or toothbrush with an infected person;

  • Perinatal transmission.

  • Hepatitis B can cause mild flu-like symptoms, fatigue, nausea, vomiting, abdominal pain or jaundice.

  • Hepatitis B is a disease that kills more than 6,000 Americans every year. It can result in chronic liver dysfunction and cancer, and may lead to the need for liver transplantation.

    Vaccination recommendations

    In 1982, the U.S. Centers For Disease Control and Prevention (CDC) recommended vaccinations for individuals in the highest risk groups -- individuals most likely to engage in activities, such as those above, where the virus was most likely to be spread.

    In 1991 the CDC recommended inoculation programs for all infants and adolescents at high risk of acquiring the virus. In 1995, this recommendation was expanded to include all adolescents not previously immunized. Joining the Advisory Committee on Immunization Practices (ACIP) of the CDC in support of vaccination to prevent hepatitis B are the American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP), American Medical Association (AMA), Society for Adolescent Medicine (SAM) and the American College Health Association (ACHA).

    For athletes, prevention is the solution

    SmithKline Beecham markets Engerix-Br [hepatitis B vaccine (recombinant)], a genetically engineered (not from live virus) vaccine to prevent hepatitis B. Engerix-B is made from natural yeast using recombinant DNA technology. The vaccine is generally well tolerated.

    Most commonly seen adverse reactions include injection-site soreness or swelling, fatigue, fever and erythema. This vaccine is virtually 100 percent effective in stimulating immunity to the hepatitis B virus.

    If your school does not provide information on hepatitis B or make the vaccine readily available, consider contacting the appropriate individuals to suggest such a program. Pursuant to NCAA Bylaw 16.4.1-(j), an NCAA school may finance the cost of immunizations for hepatitis B for any of its student-athletes. The NCAA has considered such arrangements as a permissible benefit incidental to participation in athletics. Many school or state programs throughout the country provide funding for hepatitis B vaccinations.

    If you would like further information about hepatitis B or Engerix-B vaccine, contact the SmithKline Beecham's product information division, 800/366-8900, ext. 5231, or visit SmithKline Beecham on the World Wide Web at http://www.sb.com. Additional information also is available through the Hepatitis Foundation International, 30 Sunrise Terrace, Cedar Grove, NJ 07009-1423; 800/891-0707; http://www.hepfi.org.