About five million Americans are estimated to live with chronic viral hepatitis. Up to 1.4 million hepatitis B and about 3 million are infected with hepatitis C. Compared with the month of May Hepatitis Awareness, I am reminded of my experience of screening six months ago.
I went to the table, plastic Christmas tree with flashing white lights and tinsel sporadically. Decorations Winter has always seemed a little 'out of place for me in sunny Southern California. I waitedA few minutes in the lobby desk, and eventually I became a woman who spoke English directly. I asked her where was the screening event.
"It 'to test for hepatitis B."
"Yes, I know. And 'here?"
"They want to test for hepatitis B?"
"Yes This is the Herald Community Center?"
She nodded, and with a sigh of resignation, he said that I needed to go and the next building. "Hepatitis B!" he called after me, in a last desperate attempt to explainSituation.
I work for the intervention of Hepatitis Project Los Angeles (LA HIP), a project of the Asia-Pacific Liver Center (APLC) St. Vincent Medical Center, so really, I do not need an explanation. I was in San Gabriel, Calif., a suburb of Los Angeles, mainly China to attend a free screening of the events of the APLC. I think that the woman did not think I need to be protected, because they are Asian. The hepatitis B virus (HBV) disproportionately affects Asian and Pacific Islands(API) in the U.S. - about one in ten HBV and do not know. There is a particular problem for immigrants in many countries for the treatment of hepatitis B or are vaccinated against. Mothers with chronic HBV infection unknowingly pass on to their children, whose immune systems are not strong enough to fight it. The disease often has no symptoms until middle age, when severe liver damage has already in early May, the infection can be controlledDrugs, and those who test negative can be vaccinated to prevent contracting in the future. Senior Nurse Practitioner APLC, Mimi Chang, MSN, NP, encourages all Asian and Pacific Islands who have not renounced developed antibodies against hepatitis B, either through vaccination or previous exposure to the disease immunized.
Asian and Pacific Islander ethnic groups are not the only ones affected, any immigrants or children of immigrants from a country with more than 2% prevalence ofHBV should be screened, according to the Centers for Disease Control (CDC). In addition to all countries except Japan APIs, this includes the countries of Africa, the Middle East, the former Soviet Union and Europe, among others. The full list is at the end of this article. It 'also important to screen and vaccinate children accepted date of each of these countries, even if the organization adopted in foreign assets of all tests and vaccinations up to date.
TheVirus is transmitted by contact with blood, family members and sexual partners of patients with chronic HBV infection should be checked and vaccinated, as well as pregnant women, health professionals, gays, intravenous drug users, and that in a country with a high prevalence of hepatitis B. I did not know of viral hepatitis in 1992, before leaving for work in Russia. Fortunately, I have no problem, but I wish my doctor had advised me to get vaccinated. Unfortunatelybecause primary care physicians in the United States lack the basic knowledge about the disease, tests and vaccinations are not as often as they should for patients at risk is recommended.
I'm a few hours can be exposed to the virus, and how a healthy adult, if I would contract the disease will probably clear by itself, but I wanted the screening process is that a part of our project. I went to the construction of understanding others and I went to the registration desk. All wereChinese language. I took a survey form and asked a woman where you set the projection. They did not understand. I asked if he knew where Mimi and Jason, two employees were members of the APLC. I have referred to another woman at the end of the table. I asked the woman, and she stared at me in silence for a few minutes, shook his head sideways. "Hepatitis B screening!" They prevailed on me. I think I believed in the wrong place to be.
A third woman was the second womanand chatted with her, according to the Chinese. Reaches people around me from behind to grab questionnaires, squinted at me how it went. The new wife asked me what I wanted and I asked again, Mimi, Jason, or one of the APLC staff of the facility to screen. His face brightened. "Yes, yes!" he said excitedly. "You're going to see the lady over there."
I followed the direction of his outstretched arm of a tall blonde woman I had never seen before - the only other white woman in the room. Discouraged, Iapproached. It was discovered that she was the representative of Gilead, the pharmaceutical company sponsoring the event. Although Mimi and Jason did not know or had never heard of the LA-HIP project, knew that the projection would be upstairs, so I went that way. I needed a familiar face.
I found Jason and ease APLC to screen volunteers. On a table were a couple of laptops for entering the registration data base and preparation of a label to each tubePatient. I was not aware that the staff was distributing this information twice - once on the site and then again in the new database programmers THE HIP was designed for them. It 'been a good thing that I learned from this, our programmers are now creating the opportunity for employees to easily upload the Excel spreadsheet application directly in the database, making data-entry duplication. Other tables were set with test tubes, rubber gloves and disposable syringes for blood collection. The projection room was veryorganized, with signs in English and Chinese.
After taking some photos for THE HIP Facebook page, I went back to sit down in conference Tse-Ling Fong, MD, a specialist in the liver to the APLC. I was very excited to attend his lecture, I had a lot of reading of hepatitis B and was seeking to fill any gaps in my knowledge. I was also curious to see what kind of questions from the audience would be. Dr. Fong approached the front of the room and stood under a bright redTo increase the portion of Gilead campaign "B Here" to raise awareness of hepatitis B in Asian-American - a slide with a large white "B". Except for that massive B brilliantly on Dr Fong, was the rest of the Chinese-language film. Then he began to speak in Chinese. He spoke with the same voice, with his voice calm and measured, and also seemed to him that I hold to be sure he did not have to study English. No, it was definitely speaks Chinese.
The experience was a little 'surreallook like a ventriloquist's dummy. I was sure that he switch to English in a few minutes. He did not. I turned to the man next to me. "Do you think that will do the entire speech in Chinese?"
"Yes," he said. I groaned. "You need me to translate for you?" offered. I smiled, happy to finally feel welcome, but he refused. The man pointed to the questionnaire in hand. "You know, this is a test for hepatitis B?" I explained that I worked on a project to make public relations andDesigning a database for the group, Dr. Fong, so yes, I know. It felt good to finally make a statement. I reminded him that Asians were not the only infected with hepatitis B, but he seemed convinced.
I left my seat and walked over, crouching in the aisle to take pictures. When I am with what had happened, I filled my form for the poll, and then I heard Dr. Fong, try to identify Chinese phrases to identify. It 'was unnecessary. The red paper with white B has remained themocking me all the time. Many of the questions from the audience seemed specific results of previous performance, I greeted outside the lab reports on how each question was asked to manage derivatives. There were probably about 70 people in the conference and in the afternoon of Thursday to people so they were definitely interested in the topic. This presentation has been publicized on Chinese newspapers, and was held in a community center in a predominantly Chinese, other events wereoften to the local health fairs or churches in the API community.
When the class is over, a man with thick glasses made an announcement in Chinese. My neighbor said that the system - a series of numbers would be called out and when the number was down to my form for the survey in this area, I could go for screening. I said as if to say 37 in China, so I could tell when it was called. Right. I think having seven syllables. Fortunately, Mimi saw me and took meupwards. The people in my registry, made a label tube of my blood, and asked me who printed the information control.
As Mimi, the band tourniquet on his arm and felt for my vein with the finger, I looked away, a little 'stunned. "You're not going to pass out on me, right?" Mimi asked aloud. "I've never had anyone faint on me." A number of older patients I smiled and chuckled. My neighbors appeared at the presentation table in front of me and rolledSleeves for the nurse. "Everything is good, right?" I nodded and took a deep breath, my eyes focused intently on my arm. I imagined the excitement, we realize that if I would have fainted. "What was he doing there?" would chatter to each other. "I do not know this was a screening for hepatitis B?"
Blood was drawn without fainting, and I gathered my things to leave. A young man offered me a bottle of water on my way out of the screening room and then down a couple ofwomen delivered by a bright pink boxes local bakery. A gift! Wonderful, wonderful, unexpected gift! I went out to the bright sunlight, without words. An old Chinese man stood at the door, apparently with his box just as surprised as me. We looked at each other and smiled.
"It 'nice, yes?" He pointed to his chest.
"It 'great!" I accepted. "I'm starving."
Excited as a child, I snatched the pink box, once I reach my car. There was a small puddingCup with fruit on top (I ate it once) and cut two triangles, a sandwich with the crust. The bits in one to three layers to slip in a row like a ladder. It was white, pink and gold, ham and mayonnaise all slippery from the strange, cheese foam. I ate everything and I loved it. If I had a cup of tea, I think it would sleep there, very satisfied.
Wednesday, May 19 was World Hepatitis Day, and the whole month of May is dedicatedHepatitis awareness. Currently, 800,000 to 1.4 million Americans are chronically infected with HBV infects a real tragedy, because there is a vaccine. The APLC Mimi Chang, MSN, NP, explains that most of those infected are foreign born or children of immigrants new and simply do not know to be vulnerable. "Hepatitis B is a silent disease. Patients have no symptoms until the liver is severely damaged." He added that a bigger problem for the APLC that many patients, the testinsurance or are underinsured or not positive and can not afford care. "Patients who have HIV Medi-Cal automatically, but there is no system for those with hepatitis B. They are similar diseases, but it's covered, and one is not. CDC funds for HIV is much larger The viral hepatitis. "patients to avoid treatment until they need surgery or liver transplantation to create a financial burden much heavier on the health system than it would if theirCondition was monitored and controlled.
The U.S. health care system needs all its people, sick or healthy, welcoming recent immigrants or fourth generation American. My neighbor offered to translate, Mimi is a joke on me to relax and feel good boxed lunch, still has a long way to go me comfortable and, well, wanted. If we do not, at least for our fellow citizens - especially when the financial stability of our country and, above all, that's lifethe game? Sound policies to strengthen awareness and dissemination to provide timely treatment, the warm welcome, to feel that all Americans need good our country once again.
Fortunately, my test came back negative for hepatitis B antigen and negative for the antibodies that have no immunity against the disease should be vaccinated. This is a series of 3 shots, $ 17 each at a reduced price to the APLC. The next time I will try to take the liver APLC another specialist, Dr. Ho Bae, will, if it is aTalk in Korean. I have no doubt that going as good as the first time.
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CDC recommends that people born in these countries or born to parents from these countries for the treatment of hepatitis B were tested
ANNEX: List of countries with HBsAg prevalence of 2% ‡
Afghanistan, Albania, Algeria, Angola, Armenia, Azerbaijan, Bahrain, Bangladesh, Belarus, Benin, Bhutan, Bosnia-Herzegovina, Botswana, Brunei, Bulgaria, Burkina Faso, Faso, Burundi, Cambodia, Cameroon, Cape Verde,Central African Republic, Chad, China, Comoros, Congo, Croatia, Cyprus, Czechoslovakia (including the Czech Republic and Slovakia), the Democratic Republic of Congo (Zaire), Djibouti, East Timor, Ecuador, Egypt, Equatorial Guinea, Eritrea, Estonia , Ethiopia, Europe, Iceland, Gabon, Gambia, Ghana, Glorioso Islands, Guatemala, Guinea, Guinea-Bissau, Guyana, Haiti, Honduras, Hong Kong, India, Indonesia, Iran, Iraq, Ivory Coast, Jamaica, Japan, Juan de Nova, Iceland, Kazakhstan, Kenya, Korea, Kuwait, Laos,Latvia, Lebanon, Lesotho, Liberia, Libya, Lithuania, Macedonia, Madagascar, Malawi, Malaysia, Maldives, Mali, Mauritania, Mauritius, Mayotte, Moldova, Montenegro, Morocco, Mozambique, Myanmar (Burma), Namibia, Nepal, Nigeria, Oman , Pakistan, Philippines, Poland, Qatar, Reunion, Romania, Russia, Rwanda, Sao Tome and Principe, Saudi Arabia, Senegal, Seychelles, Sierra Leone, Singapore, Slovenia, Somalia, South Africa, Spain, Sri Lanka, St. Helena, Sudan, Swaziland, Syria, Taiwan, Tajikistan,Tanzania, Thailand, Togo, Tomelin Iceland, Tunisia, Turkey, Turkmenistan, Uganda, Ukraine, United Arab Emirates, Uzbekistan, Venezuela, Vietnam, Western Sahara, Yemen, Yugoslavia, Zambia, Zimbabwe.
Retrieved from:
Journal of Viral Hepatitis, Volume 17, p.28-33. The information can also be found at CDC, MMWR report for September 19, 2008, Figure 3 and Table 3.
