The onset of the illness is generally insidious. Clinical signs and symptoms include various combinations of anorexia, malaise, nausea, vomiting, abdominal pain and jaundice. Skin rashes, arthralgia, and arthritis can also occur. Overall fatality rates generally do not exceed 2 percent in the acute phase of the disease, but chronic active hepatitis leads to cirrhosis in 25 percent of carriers and these carriers have a risk of developing liver cancer that is 12 to 300 times higher than that of other persons.
Transmission occurs when infected secretions penetrate the skin or mucous membranes of a new host.
As a sub-group of this category, surgeons, anesthesiologists, emergency department physicians, dentists, pathologists, blood bank personnel, phlebotomists, and I.V. therapy nurses stand the greatest chance of infection. Health care workers that are at slightly less risk of exposure and infection are clinical laboratory staff, respiratory therapists, nurses in emergency departments and critical care units. Persons with moderate exposure include housekeeping personnel who handle needles or sharp instruments and nonsurgical and medical house staff. Statistics derived from surveys conducted by the CDC show that as many as 68 percent of the U.S. hospitals have instituted hepatitis B vaccination programs. On the other hand, the surveys have also disclosed that perhaps as few as 24 percent of physicians have received the vaccine, and only 36 percent of high-risk workers in hospitals with programs have been vaccinated.