Hepatitis B

Scientific Report

Queene, Jovan, Reihan, Aldo, Sabila

Biology-English 10
Mr. Michael Brannan
Ms. Adisty Damaranti

Sekolah Highscope Indonesia

Jl. Tahi Bonar Simatupang No.8, RT.1/RW.2, Cilandak Barat
Cilandak, Kota Jakarta Selatan, Daerah Khusus Ibukota Jakarta
12430

Academic Year 2016-2017

Term 1-2

Table of Contents
Hepatitis B
Table of Contents
ABSTRACT (Reihan, Queene)
a.
b.
c.
d.

Introduction
Purpose
Thesis Statement
Synopsis

DISEASE
a.
b.
c.
d.

Opening
Cause and Effects
The bodys defensive system
Effects of the Safety Program

a.
b.
c.
d.

Audience Opening
Data and Analysis
Use of Health Protection
Conclusion

a.
b.
c.
d.

Opening
Brief Overview
Detailed Explanation
Threats to Community

BACKGROUND

PLANNING

Reihan, Queene
ABSTRACT
Hepatitis B can cause liver and organ failure, along with cancer. Adults who has been
infected for a short while can recover quicker. There is also the long-term infection called
chronic hepatitis. The virus is spread through blood-to-blood contact, open sores, or bodily
fluids with an infected. If people have the Hepatitis B for more than 6 months, its called a
carrier, even if the people dont have symptoms. This means the people who have the diseases
can give the disease to someone else through.
(Hepatitis B. World Health Organization. http://www.who.int/mediacentre/factsheets/fs204/en/ Accessed 21
November 2016)
(Hepatitis B Information: Causes, Symptoms, Treatments, and More.
http://www.webmd.com/hepatitis/hepb-guide/hepatitis-b-topic-overview. Accessed 21 November 2016)

An estimated 240 million people are chronically infected with hepatitis B (defined as
hepatitis B surface antigen positive for at least 6 months). For example the Hepatitis B can
spread disease when martial arts club members, usually participating in bodily contact, have a
high risk of transmitting the disease onto one another. When we do some sports like martial
arts, the people who fight sometimes, get some wound after a match. From the cuts it can
transmit to other members. Some people who are infected never feel sick. Others who are
newly infected have, the symptoms include, achy muscles or joints, stomach pain, loss of
appetite, mild fever, loose stool (diarrhea), lack of energy, constipation, yellowing of skin or
whites of the eyes, being sick to your stomach, and brown urine.

In long-term effect of Hepatitis B it becomes a hepatitis B carrier, chronic hepatitis B

infection, cirrhosis (scarring of the liver), liver cancer, liver failure, and death. We can protect
yourself from Hepatitis B by get the hepatitis B vaccine, use a condom during sex, don't share
needles to take drugs, practice good personal hygiene, and don't use an infected person's
personal items.

Sabila
DISEASE
Hepatitis B is a liver infection caused by the Hepatitis B virus (HBV).
Hepatitis B is transmitted when blood, semen, or another body fluid from a person

infected with the Hepatitis B virus enters the body of someone who is not infected.
This can happen through sexual contact; sharing needles, syringes, or other druginjection equipment; or from mother to baby at birth. For some people, hepatitis B is
an acute, or short-term, illness but for others, it can become a long-term, chronic
infection. Risk for chronic infection is related to age at infection: approximately 90%
of infected infants become chronically infected, compared with 2%6% of adults.
Chronic Hepatitis B can lead to serious health issues, like cirrhosis or liver cancer.
The best way to prevent Hepatitis B is by getting vaccinated. Hepatitis B can cause
scarring of the organ, liver failure, and cancer.
Most adults who get it have it for a short time and then get better. This is
called acute hepatitis B. Sometimes the virus causes a long-term infection, called
chronic hepatitis B. Over time, it can damage your liver. Babies and young children
infected with the virus are more likely to get chronic hepatitis B.
You can have hepatitis B and not know it. You may not have symptoms. If you do,
they can make you feel like you have the flu. But as long as you have the virus, you
can spread it to others.
Vaccines that fight against hepatitis b have already been available for infants
since 1991 in the United States. Most vaccines are given in doses of three over a
course of months. The vaccine is more effective in children and 95 percent of those
vaccinated have protective levels of antibody. With age, antibody level drops, this first
occurs during 40 years of age, causing a 90% drop and around 75 percent in those
over 60 years. The protection afforded by vaccination is long lasting even after
antibody levels drop drastically. Vaccination at birth is recommended for all infants of
HBV infected or carrier mothers. A combination of hepatitis B immune globulin and

an accelerated course of Hepatitis B vaccine prevents Hepatitis B transmission around

the time of birth in most (99%) of all cases.
All those with a risk of exposure to body fluids such as blood should be vaccinated, if
not already. Testing to verify effective immunization is recommended and further
doses of vaccine are given to those whose immunization has worn off or is
inadequate.
Those at high risk of infection should be tested as there is effective treatment for those
who have the disease. Groups that screening is recommended for include those who
have not been vaccinated and one of the following: people from areas of the world
where hepatitis B occurs in more than 2%, those with HIV, intravenous drug users,
men who practice homosexual intercourse with other men, and those who live in close
proximity to someone with hepatitis B, such as a home or apartment block.
Acute hepatitis B infection does not usually require treatment and most adults clear
the infection spontaneously. Early antiviral treatment may be required in fewer than
1% of people, whose infection takes a very aggressive course (fulminant hepatitis) or
who are immune-compromised due to other viruses such as HIV/AIDS. On the other
hand, treatment of chronic infection may be necessary to reduce the risk of cirrhosis
and liver cancer. Chronically infected individuals with persistently elevated serum
alanine aminotransferase, a marker of liver damage, and HBV DNA levels are
candidates for therapy.
Although none of the available drugs can clear the infection, they can stop the virus
from replicating, thus minimizing liver damage. As of 2008, there are seven
medications licensed for treatment of hepatitis B infection in the United States. These
include the antiviral drugs lamivudine , adefovir, tenofovir, telbivudine and entecavir,
and the two immune system modulators interferon alpha-2a and PEGylated interferon

alpha-2a (Pegasys). The World Health Organization recommended a combination of

tenofovir and entecavir as first line agents. Those with current cirrhosis are in most
need of treatment.

Vaccines that fight against hepatitis b have already been available for infants since
1991 in the United States. Most vaccines are given in doses of three over a course of
months. The vaccine is more effective in children and 95 percent of those vaccinated
have adequate protective levels of antibody. With age, antibody level drops, this first
occurs during 40 years of age, causing a 90% drop and around 75 percent in those
over 60 years. The protection afforded by vaccination is long lasting even after
antibody levels drop drastically. Vaccination at birth is recommended for all infants of
HBV infected or carrier mothers. A combination of hepatitis B immune globulin and
an accelerated course of Hepatitis B vaccine prevents Hepatitis B transmission around
the

time

of

birth

in

most

(99%)

of

all

cases.

Anybody with even the slightest risk of exposure to body fluids such as blood should
be vaccinated, if not already. Testing to verify effective immunization is
recommended and further doses of vaccine are given to those whose immunization
have

worn

off

or

have

been

rendered

inadequate

by

age.

Those at high risk of infection should be tested as there is effective treatment for those
who have the disease. Groups that screening is recommended for include those who
have not been vaccinated and one of the following: people from areas of the world
where hepatitis B occurs in more than 2%, those with HIV, intravenous drug users,
men who practice homosexual intercourse with other men, and those who live in close
proximity to someone with hepatitis B, such as a home or apartment block.
Acute hepatitis B infection does not usually require treatment and most adults clear

the infection spontaneously. Early antiviral treatment may be required in fewer than
1% of people, whose infection takes a very aggressive course or who are immunecompromised due to other viruses such as HIV/AIDS which practically destroys their
immune system. On the other hand, treatment of chronic infection may be necessary
to

reduce

the

risk

of

cirrhosis

and

liver

cancer.

Although none of the available drugs can clear the infection, they can stop the virus
from replicating, thus minimizing liver damage. As of 2008, there are seven
medications licensed for treatment of hepatitis B infection in the United States. These
include the antiviral drugs lamivudine , adefovir, tenofovir, telbivudine and entecavir,
and the two immune system modulators interferon alpha-2a and PEGylated interferon
alpha-2a (Pegasys). The World Health Organization recommended a combination of
tenofovir and entecavir as first line agents. Those with current cirrhosis are in most
need of treatment.

A.

WHAT IS HEPATITIS B

Hepatitis* B is a virus, or infection, that causes liver disease and inflammation of the liver.
Viruses can cause sickness. The flu is one of common sickness caused by a virus. People can
pass viruses to each other, whereas Inflammation is swelling that occurs when tissues of the
body become injured or infected. Inflammation can cause organs to not work properly.

There are 2 range of Hepatitis B which are acute and chronic. The difference between
acute and chronic are that acute is a short-term infection with the hepatitis B virus. Symptoms
usually last several weeks but they can last up to 6 months. The infection sometimes clears up
because your body is able to fight off the infection and get rid of the virus. Most healthy
adults and children older than 5 who have hepatitis B can get better without any treatment.

On the other hand chronic hepatitis B is a long-lasting infection. Chronic hepatitis B occurs
when the body cant get rid of the hepatitis B virus. Children, especially infants, are more
likely to get chronic hepatitis B. Chronic hepatitis B usually has no symptoms until a
persons liver damage appear.

So based on the data above, we know that chronic Hepatitis B is more dangerous than
acute. The people who get acute Hepatitis B tend to cure easily and people who already get
Hepatitis B cannot get this disease again and cannot spread the virus to others, so if you
caught a Hepatitis B virus once chances are you will not get infected again and spread it to
others, unlike a Dengue Fever.

This disease attacks a liver, as you know liver is an organ that has many important things
which makes a person cannot live without liver. The functions of liver are;

Removes harmful chemicals from your blood

fights infection
helps digest food
stores nutrients and vitamins
stores energy

As you can see above, if our liver doesnt work properly it affects everything in our body
1. HOW HEPATITIS B WORKS IN THE BODY
For this topic we start from what the symptoms are of this disease. There are
varieties of symptoms depending on how old you are. Most children under age 5
years and newly infected immunosuppressed adults are asymptomatic, whereas
30%50% of persons aged 5 years have initial signs and symptoms;

Fever

Dark urine

Fatigue
Loss of appetite
Nausea
Vomiting

Clay-colored bowel movements

Joint pain
Jaundice
Abdominal pain

C. HOW IS IT SPREAD TO OTHERS

Hepatitis B could spread to others when there are direct contact between the blood
from the person who has the disease and someone that gets infected. The contact of the blood
could easily be transmitted through breaks in the skin also from the mucous membranes
(nose, mouth, eyes, and other soft tissues).

Here are the examples when the virus

transmitted ;
1. Sexual contact with an infected person
2. Direct contact with infected or contaminated blood, even in tiny
3. amounts too small to see
4. Sharing personal items, such as toothbrushes, razors, syringes, or glucose
monitors that have even microscopic amounts of blood on them
5. Direct contact with open sores of an infected person
6. An infected mother passing it to her baby at birth
7. Hepatitis B is not spread through sneezing, coughing, hugging, or
breastfeeding. Although the virus can be found in saliva, it is not believed to
be spread through kissing or sharing utensils.

D. WHO GETS HEPATITIS B

There are several type of people that tend to be easier infected by the disease. One of
the most common cause people get infected Hepatitis B is because the genetics from their

family trees. Another common cause that peoples tend to get infected is by direct contact with
the infected person or through a blood transfusion.

Furthermore, Hepatitis B can also be caused by; a persons sexual activities, their medicine
intake, where they lived and if they ever use a drugs.
:

were born to a mother with hepatitis B

are in contact with blood, needles, or body fluids at work
live with someone who currently has an active hepatitis B infection
have had more than one sex partner in the last 6 months or have a history of

sexually transmitted disease

are on kidney dialysisthe process of filtering wastes and extra water from
the body by means other than the kidneys
are taking medicines that suppress the immune system, such as steroids or
chemotherapy medicines
have lived in or travel often to parts of the world where hepatitis B is common
are from Asian and Pacific Island nations
are infected with HIV or hepatitis C
have injected illegal drugs
work or live in a prison had a blood transfusion or organ transplant before the
mid-1980s

In conclusion, this disease is easy to be transferred between people through direct contacts of
blood. Currently there lots of people infected by Hepatitis B, however the level of awareness
is still quite low. People who were infected with this disease are highly recommended to seek
an expertised doctor immediately so can be treated accordingly. Nowadays, there are new
medications that are available that can delay or even reverse the effects of liver diseases.
-

https://www.cdc.gov/hepatitis/hbv/pdfs/hepbwhensomeoneclose.pdf
https://www.cdc.gov/hepatitis/hbv/hbvfaq.htm#b1
https://www.cdc.gov/hepatitis/hbv/hbvfaq.htm#b6
http://www.webmd.com/hepatitis/digestive-diseases-hepatitis-b#1

https://www.niddk.nih.gov/health-information/health-topics/liver-

disease/hepatitis-b/Pages/ez.aspx

Reihan
Once you've been infected by some other kind of illness, the Hepatitis B disease will
come back. This disease is a viral infection, it spreads rapidly depending on the number of
infected hosts, the more hosts the faster the infection spreads. Usually infections spread
across the population during the dormancy of the virus. Where it will not exhibit any of it's
symptoms on the host, because of that, the chance that two people will come in contact with
one another's bodily fluid is higher. One party will perceive the other healthy and
unknowingly allow themselves to be infected as well.
Adults are more susceptible to hepatitis B than children, as they participate in more
"activities" involving the swapping of bodily fluids, however most just develop an acute
strain of the virus, which could dissipate in 6 months, but there is a 10 percent chance that it
evolves into a chronic strain that follows the infected to their graves. Hepatitis generally
causes liver cirrhosis, which converts healthy liver tissue into scar tissue which blocks blood
flow in the liver and prevents it from functioning properly, children are likely to develop a
chronic strain either from inheritance from a carrier mother or father or the standard infection.
(World Health Organization. http://www.who.int/mediacentre/factsheets/fs204/en/. <21 November
2016>)
The best way to prevent hepatitis B is by getting the hepatitis B vaccine. The hepatitis B vaccine is safe and
effective and is usually given as 3-4 shots over a six month period.
(US Department of Health & Human Services. https://www.vaccines.gov/diseases/hepatitis_b/. <21
November 2016>)

Jovan
Hepatitis B infection is a worldwide healthcare problem, especially in developing
areas. The hepatitis B virus (HBV) is commonly transmitted via body fluids such as blood,
semen, and vaginal secretions. Many ways to prevent we get the Hepatitis B, but the best way
is we must do a vaccines for protect our body from the disease. Other ways we can dont use
a sharing stuff like when we do some martial arts exercise, because when when they fight and
they get some wound, and there was some blood because of cuts inside the gloves. If the
people who get wound have a Hepatitis B disease, if another member's use that boxing glove,
it can transmitted the Hepatitis B also.
If people already get the Hepatitis B we can do the treatment which is inpatient care,
patients with hepatitis B disease and fulminant hepatic failure should be hospitalized in the
intensive care unit (ICU) and be considered as liver transplant candidates in the event that
they do not recover. Any patient with acute HBV disease needs to be treated with first-line
oral therapy, such as tenofovir disoproxil fumarate (TDF) or entecavir (ETV). Also the other
treatment is dietary limitations, the patients with acute or chronic hepatitis without cirrhosis
have no dietary restrictions. The following dietary limitations are indicated, a low-sodium
diet (1.5 g/day), high-protein diet (white-meat protein, such as chicken, turkey, or fish), and
fluid restriction (1.5 L/day) in cases of hyponatremia.
( Hepatitis B Treatment & Management. http://emedicine.medscape.com/article/177632-treatment <21
November 2016>)

Queene
PLANNING
While there is no specific cure for hepatitis b, there are still possibilities of stopping it.
Ending the prevention of spreading along with slowing the advancement of it going on to the
next stage. With the use of our Safety Programs, the martial arts members would be secured
from any infectious diseases.
(How to Build Your Safety Program. WorkSafeMT. http://www.worksafemt.com/safety/build-safetyprogram/how-to-build-your-safety-program/. Accessed 20 November 2016.)

The Safety Program is divided into two sections, the welfare of the members and the
environment. Regular check-ups will range from 3-6 months, since after the victim have been
exposed the symptoms will appear in 90 days/3 months. However, it may also appear within
the span of 6 weeks to 6 months.
(Hepatitis B FAQs for the Public. Centers for Disease Control and Prevention.
http://www.cdc.gov/hepatitis/hbv/bfaq.htm. Accessed 20 November 2016)

The members would have to go through a series of blood testing procedures. After all,
the disease is spread from blood-to-blood contact. The examination not only determines if
they have been infected, but also protects them from receiving other illnesses. It also shows
doctors the condition of your organs, blood clots, and any possibilities for a heart disease.
(What Are Blood Tests?. U.S National Library of Medicine. https://www.nhlbi.nih.gov/health/healthtopics/topics/bdt. Accessed 20 November 2016)

Protecting the environment is as important as the individuals who use it. The

surrounding areas have one the biggest effects on the club. Although it is spread through the
use of blood, the unclean environment can trigger the advancement of the disease. From
sharp objects to regular use of equipment failure. The activities and lifestyles of the Martial
Arts fighters can either avoid or secure the disease into their blood systems.
(How to Build Your Safety Program. WorkSafeMT. http://www.worksafemt.com/safety/build-safetyprogram/how-to-build-your-safety-program/. Accessed 20 November 2016.)

The lifestyles of the infectee can either speed up the process or avoid it. If they barely
come to practice, and have an incredibly low immune system with no vaccination of the
disease. They would have a higher chance of becoming a full-time victim and a carrier. If
they were to do the opposite, such as attending to practices regularly, has a healthy diet, and a
manageable sleeping schedule. The infected can still recover, although it wont stop the virus
from advancing, it will at least slow it down. With the use of the Safety Program, the
members will be protected from carriers of the disease. Having regular check up to see if any
of them are in danger. Not only does it protect them from hepatitis b, from other known
illnesses as well.
(Hepatitis B. Canadian Liver Foundation. http://www.liver.ca/liverdisease/types/viral_hepatitis/Hepatitis_B.aspx. Accessed 20 November 2016)

At 5:30PM the team is required to take off their shoes and socks to begin their warm
ups and regular activities. The reason for such actions is for the coach to be able to pinpoint
where the position of the foot is directed to. Wrong gestures in the foot can cause fatal
injuries, unbalanced footing, or kicking it in the improper form can cause cramps.

The Martial Arts club arent the only ones using the gym, as they finish later than

the younger students. Leaves them with leftovers from the Elementary Taekwondo Club and
Middle School Fencing Activities. Used mattresses, floors, snack wrappers lying about,
misplaced belongings can bring out the spread of hepatitis b. An infected, who may or may
not know they are diagnosed, interacts with the listed objects. The previous students couldve
misplaced their arts and crafts materials, that includes cutters and other sharp objects. Along
with pins and nails that could pop-up from the old wooden floors, and snack wrappers that
can stimulate scratches. Any cuts and similar wounds that can ooze out blood if it were to
worsen, will help the spread of the disease. The original equipments of the team such as the
sam sak, boxing gloves, and punching bags may be old and in need for replacing.

It can cause them to cut themselves with their activities such as, jogging and punching
with bare limbs. When the cut has made, it contact with infected and theres still a chance to
stop it with the use of Safety Programs. The special program will educate and train the
members it selves to protect the environment, which is Environment Program. The members
would have more knowledge about the environment.

Aldo
For the Environmental Safety Program, the member should brushing and mopping the
whole floor to get rid of any foreign objects. They also need to check and repairing all the
martial arts equipment such as mattress, samsak, gloves, etc. Theres some equipment that
need to be checked like water fountain, if there are any leakage that could electrocute or
cause the members to fall. Create a rule about cleaning up the martial arts equipment, and
others so the people that use the gym wont litter the gym, and spilled food and drinks should
be cleaned immediately.

We could provide the club with the safety programs, it help them to achieve their

desired goals disease free. Without safety program we wont know whether the member are
safe or not, the most important part is we wont know if theyve already been infected, and
they doesnt know if they were infected. Some infectious disease could occur if the disease
spreads from blood to blood contact.

Reihan
We offer a safety programs for the martial arts members, we recommend a 3 month
check-up for each individual. The purpose of the safety programs ensures the members are
virus-free. Many people get the Hepatitis B from the other martial arts member. Martial arts
club members, usually participating in bodily contact, have a high risk of transmitting the
disease onto one another. When we do some sports like martial arts, the people who fight
sometimes, get some wound after a match. From the cuts it can transmitted to other members.
We want to give more information to all people, especially teenagers around 14-18 years old
to know the Hepatitis B can transmitted from the wound when they do martial arts exercise.
Also all the members should bring they own martial arts equipment to prevent the transmitted
of the disease. The disease can transmitted by the martial arts equipment which that
equipments use for sharing. For example in boxing glove, when they fight and they get some
wound, and there was some blood because of cuts inside the gloves. If the people who get
wound have a Hepatitis B disease, if another member's use that boxing glove, it can
transmitted the Hepatitis B to the next person who use that boxing glove. Hepatitis B is a
silent threat. People with chronic infections may feel fine for a long time, even as the virus is
causing damage to the liver. Recent evidence shows that during the immune tolerant phase,
when most researchers had assumed the virus was quiet, the liver may be sustaining injury.
By the time symptoms appear, liver damage may be advanced.

(H.B.T. http://www.nytimes.com/ref/health/healthguide/esn-hepatitis-B-know.html
<21 November 2016>)
The purpose of the safety programs ensures the members are virus-free. Theyll be
checked on their weight, height, body temperature, and blood tests to determine their health.
If one member were to be infected, they would be hospitalized as soon as possible. This
should stop the spread of the infection from going any further.

Aldo, Queene
BACKGROUND
Martial arts is an activities that involve fighting techniques, physical exercises, and
methods of mental discipline. Martial arts was found in the ancient culture of Asia, and used
today around the world for self defense, health, exercise, and more. There are lots of types

martial arts, such as Karate, Kung Fu, Aikido, Judo, T'ai chi chuan, Jiu Jitsu, and other more.
Many of them have more similarities than differences.

Martial arts teach self defense, and it can improve confidence. If we use Martial Arts
as an exercise, it can improve your balance, strength, stamina, flexibility, and posture. Some
martial arts such as qigong and t'ai chi are used for disease prevention and healing purposes.

MMA Community needs health protection because they are require pre-fight blood
work testing for HIB, Hepatitis B, and C. In some states it doesnt require this testing at the
amateur, to pass the pre-fight blood work testing they need a health protection. level let's take
Hepatitis B disease, Hepatitis B is a serious virus that can cause scarring of the liver, liver
failure, liver cancer, and death. It is also transmitted by blood. The person who are infected
usually develops an immunity. It can transmit the disease to others through blood and other
bodily fluids.

Some MMA, like karate is helping to lower your cholesterol in a couple ways, The
first way is to losing your weight it will make your cholesterol level lower by stimulating
enzymes that move the LDL from your blood to your liver.

Sources
-

http://www.nhs.uk/conditions/Hepatitis-B/Pages/Introduction.aspx
http://www.webmd.com/hepatitis/hepb-guide/hepatitis-b-topic-overview#1
http://www.scifighting.com/2014/10/09/35048/basic-pre-fight-blood-work-

101-hiv-hepatitis-b-c/