Outbreaks have occurred in day care centers, but the risk is low if hygienic precautions are used, particularly when changing babies and handling diapers. The disease has also been transmitted sexually among homosexual men and it often occurs in intravenous drug users. Blood screening and vaccinations have significantly reduced the rate of infection, but drug users who share needles are at considerable risk. Hepatitis B may also be transmitted through sexual activity. Pregnant women with hepatitis B can transmit the virus to their babies.
Children are more likely than adults to become chronic carriers.
The virus can be passed from cuts, scrapes, and other breaks in the skin. Also at risk are hospital workers exposed to blood products, staff members of institutions for mentally impaired people, prisoners, and emigrants from areas where the disease rate is high. Contaminated medical instruments, including fingerstick devices used for more than one individual, have been known to transmit the virus. B. It is not common in the U.S. except in intravenous drug abusers and people who require multiple transfusions. Those who recover from hepatitis B are immune to further infection from both hepatitis B and D viruses.