HEPATITIS

Are you fit-to-fly? What is HEPATITIS A?

An infection caused by the hepatitis A
FACTS 1
A

virus (HAV) that affects the liver. It can

lead to inflammation which disrupts the
liver’s function. Risk of HAV is higher in countries with high
infection rates, poor sanitation and unclean food and water.
Going on a holid
ay? Ensure that How is HAV transmitted?1
eventualities incl you have covere
uding protecting d all • Contaminated food and drinking water
you are abroad. your health while • Contact with an infected person
Falling sick durin
fun, but some di g a vacation is no
seases are prev What are the complications of HEPATITIS A infection?2
entable. • Hepatitis A affects the liver which will require weeks to
As the Malaysia
n Society of Infe months to recover
Chemotherapy ctious Diseases
(MSIDC), we reco and • Infected individuals with chronic liver failure are at high risk
necessary part gnise that a
of enjoying your of acute liver failure
ahead and ensu holiday is to plan • An infected child may carry the disease for longer periods
re that you and
risks are minimise yo ur family’s health than adults (up to 10 weeks)
d during travels. • Death rates are higher in infected adults aged 50 years
T his bo ok let aim s and above
to hel p ra ise aw ar
for pr eve nt ive tr ave en es s on the ne ed
l me dic ine . Re ad on
abo ut the dis eas es , to lea rn mo re
vac cin ati on s and how
to pr ote ct you rs elf
. te r
ptomshsow: up within 3-6 w
1
eeks af

r th e se sydm only
tch fo an m ay
Wa cur su ddenly

Fatigue
oms oc
(Sympt fection)
in
Loss
an HAV

Fe ver Appetite
omiting
Na usea & V hes
Bod y A c
Professor Datin

Urin e
Dr Hamimah Hj
ins
President Hassan

Da r k Joint Pa
Malaysian Society
of Infectious Dis
eases and Che
mothe

Ja und ice
rapy (MSIDC)

1. Hepatitis A. Accessed on June 2009 from http://www.emedicinehealth.com/hepatitis_a/article_em.htm

2. Fiore AE et al. Prevention of hepatitis A Through Active or Passive Immunization. Recommendations of ACIP MMWR May 19, 2006/ Vol.55/No.RR-7.

What is HEPATITIS B?
A potentially life-threatening liver
infection caused by the hepatitis B
virus (HBV) which is 50-100 times
more infectious than HIV. HBV infects almost 2 billion people
worldwide and results in about 600,000 deaths every year.
Risk factors include close contact with a hepatitis B infected
person, multiple sex partners, visiting places with high infection
rates, tattoos or acupuncture treatments.
How is HBV transmitted?3
• Unprotected sex
• Infected personal hygiene items
• Wounds coming into contact with infected fluids or items
• From mother to baby at birth
What are the complications of HEPATITIS B?4
• Chronic liver disease
• More than 350 million infected people live with long-term
(chronic) liver infections
• About 25% of adults who were infected during childhood die
from liver cancer or cirrhosis (scarring of the liver)
IS B VER
HEPATIT TYPHOID FE
3 FACTS What is TYPHOID FEVER? 5 FACTS
An acute and severe high fever
caused by the Salmonella typhi
bacteria which may last 10-14 days.
It is estimated that 22 million people experience typhoid fever
and 216,000 die from it each year.6 The bacteria is widespread
in Southeast Asia countries, sub-Saharan Africa and Latin
America. Risks factors include HIV/ AIDS and contact with an
infected individual or a weakened immune system by
medications like corticosteroids.
How is Salmonella typhi transmitted?5
• Ingesting contaminated food and water
• Close contact with an infected individual
What are the complications of TYPHOID FEVER?7
One of the most dangerous consequences is intestinal
bleeding, which is marked by these symptoms:
• sudden drop in blood pressure
• shock (blood not flowing properly to the body, causing
organ damage)
• blood in stools
• nausea, vomiting, severe pain and sepsis (blood infection)

Watch out for

these symptom
s: 3
Fever ptoms:
5

Chills r these sym

Tired n ess Watch out fo
Ap pet ite Los s
Head ac he H ig h F e ve r
Ap pe tit e Lo ss
Vo mi tin g P e rs is te n t
Musc le a nd Joint A c hes Hea d ac he
Diarrh oe a
Dark Urin e Joi nt A c hes
Pale Stools Ja u n d ic e M us c le a nd
Tired n ess
3. Hepatitis B. Accessed on June 2009 from http://www.emedicinehealth.com/hepatitis_b/article_em.htm 5. Typhoid fever. Accessed on June 2009 from http://www.medicinenet.com/typhoid_fever/article.htm
4. Hepatitis B. World Health Organization. Accessed on June 2009 from http://www.who.int/mediacentre/factsheets/fs204/en/print.html 6. Crump JA, Luby SP, Mintz ED. The global burden of typhoid fever. Bull World Health Organ 2004;82:346-53.
7. Typhoid fever- Complications. Accessed on June 2009 from http://www.mayoclinic.com/health/typhoid-fever/DS00538/DSECTION=complications
 INFLUE
NZA
What is INFLUENZA?8 FACTS OCC
AL
GOC
Influenza epidemics are seasonal, What is MENINGOCOCCAL disease?11 MENIN ACTS
F
affecting 5-15% of the world’s A potentially fatal infection caused
population, and resulting in 250,000-500,000 by the Neisseria meningitidis bacteria
Influenza related death in a year. It is caused by viruses that affecting the brain and spinal cord.
infect the respiratory tract and everyone is at risk especially It can also cause septicaemia (blood poisoning).
children, the elderly, nursing home residents, people with The bacteria is commonly found in close communities and
HIV/AIDS and chronic pulmonary or cardiovascular disorders. countries under the ‘meningitis belt’ - sub-Saharan Africa.
Individuals at risk of infection are those performing the Haj and
How is INFLUENZA virus transmitted?9
Umrah, smokers and people with respiratory tract infection,
• Droplets from coughs and sneezes of an infected person
HIV/AIDS, anaemia or malnutrition.
• Direct contact with contaminated items
How is Neisseria meningitidis transmitted?11
What are the complications of INFLUENZA?10
• Droplets from coughs and sneezes of an infected person
• May lead to secondary bacterial infections like pneumonia
• Close contact like kissing (saliva)
especially in children, the elderly, and people with chronic
illness What are the complications of MENINGOCOCCAL
• Worsen conditions like heart disease, lung disease, asthma, disease?12
chronic pulmonary disease, diabetes and myocardial • Up to 5-10% of infected children die
infarction • About 10-15% who survive a meningococcal infection
• May cause death in patients with impaired immunity would likely suffer from mental disorders, deafness,
paralysis, kidney failure or seizures

s:
11

Watch ou sym ptom

t for thes
e sympto for these V o m it in
g
ms: 9 h out
High fever Watc ro a t he
Sor h
e t Hea d ac
G en eral W ea App et ite L os ht s
kn es s a nd Fa s rig ht L ig
tig ue F e ve r Dis lik e B
He ad ac he s
M us c le a nd t A c he es s
Jo in t A c hes
im b s a n d Jo in D ro w s in
So re Throa t L
C ou gh k
S ti ff N ec
R ed , wa te ry
e yes
8. Influenza. Accessed on June 2009 from http://www.who.int/topics/influenza/en 11. Meningococcal Disease: Frequently Asked Questions. Department of Health and Human Services. Centers for Disease Control and Prevention.
9. What is Influenza? Accessed on June 2009 from http://www.medicinenet.com/influenza/article.htm Accessed on June 2009 from http://www.cdc.gov/meningitis/bacterial/faqs.htm
10. Flu In Adults. Accessed on June 2009 from http://www.emedicinehealth.com/flu_in_adults/page2_em.htm 12. Meningitis Meningococcal. Accessed on June 2009 from http://www.nlm.nih.gov/medlineplus/ency/article/000608.htm
 Adakah anda terlindung daripada Are you guarded against
penyakit berkaitan perjalanan? travel-related diseases?
Simpan senarai semak ini agar anda sentiasa tahu Keep this check-list so that you will always know which
perlindungan mana yang telah anda terima. Juga, bawa ia protection you have received. Also, bring it when visiting
apabila berjumpa doktor supaya dia boleh mengesahkan your doctor so he/she can certify you Fit-To-Fly!
bahawa anda Layak Untuk Terbang!

Single dose. Children receiving Single dose. Booster dose can offer
INFLUENZA protection for the first time require a
HEPATITIS A longer protection*
PROTECTED second dose PROTECTED Satu dos. Dos booster boleh menawarkan
DILINDUNGI Satu dos. Kanak-kanak yang menerima
DILINDUNGI perlindungan yang lebih lama*
perlindungan buat kali pertama
memerlukan dos kedua.
Protection Date / Tarikh Perlindungan Protection Date / Tarikh Perlindungan
1st Dose / Dos pertama 2nd Dose / Dos kedua 1st Dose / Dos pertama Booster

Single dose. Boosters may be Three doses over six months

HEPATITIS B
required if risk of infection remains*
Tiga dos dalam tempoh enam bulan
Satu dos. Booster mungkin diperlukan PROTECTED
MENINGOCOCCAL
jika risiko jangkitan masih ada* DILINDUNGI
PROTECTED
DILINDUNGI

Protection Date / Tarikh Perlindungan Protection Date / Tarikh Perlindungan

1st Dose / Dos pertama Booster 1st Dose / Dos pertama 2nd Dose / Dos kedua 3rd Dose / Dos ketiga

* It is recommended you discuss with your doctor on the necessary follow-up steps /
Anda disyorkan berbincang dengan doktor mengenai langkah-langkah susulan yang perlu Single dose. Boosters may be
TYPHOID FEVER required if risk of infection remains*
Get your loved ones and yourself Fit-To-Fly! DEMAM KEPIALU

Speak with your doctor to learn more about diseases commonly PROTECTED Satu dos. Booster mungkin diperlukan
DILINDUNGI jika risiko jangkitan masih ada*
contracted during travels and how you can be protected against them.
Dapatkan keluarga tersayang dan diri anda Layak Untuk Terbang! Protection Date / Tarikh Perlindungan
Berbuallah dengan doktor anda untuk mengetahui lebih mengenai penyakit-penyakit yang
1st Dose / Dos pertama Booster
biasanya dijangkiti semasa perjalanan dan bagaimana anda boleh dilindungi daripadanya.
 SENA RAI SEM A K NEG A RA
C H E C K - L IST
C O U N TR Y
Country List IS B
13 14,15

Senarai Negara
HEPATITIS A 13
HEPATIT TYPHOID FEVER13 INFLUE
NZA
DEMAM KEPIALU
MENIN
GOCO
CCAL 13

Australia

Austria

Belgium

Brunei / Brunei Darussalam

Cambodia / Kemboja

Canada / Kanada

China

Egypt / Mesir

France / Perancis

Germany / Jerman

Greece

Hong Kong / Macau

India

Indonesia

Ireland

Italy / Itali

Japan / Jepun

Mexico

For more information on required or recommended protection for other countries and vaccinations, visit www.cdc.gov/travel/destinations/list.aspx
Before you get on board, find out if you need protection in the country you are going to **
Sebelum anda berangkat, dapatkan maklumat sama ada anda memerlukan perlindungan di negara yang akan anda pergi **

Country List IS B
13 14,15

Senarai Negara
HEPATITIS A 13
HEPATIT TYPHOID FEVER13 INFLUE
NZA
DEMAM KEPIALU
MENIN
GOCO
CCAL 13

Philippines / Filipina
Russia / Rusia

Saudi Arabia / Arab Saudi

Singapore / Singapura

South Africa / Afrika Selatan

South Korea / Korea Selatan

Spain / Sepanyol

Switzerland

Taiwan

Thailand

United Arab Emirates /

Emiriah Arab Bersatu

United Kingdom

United States of America /

Amerika Syarikat

Vietnam
13. CDC. Traveller’s Health. Available at http://www.cdc.gov/travel/destinations/list.aspx. 14. CDC. Health information for international travel 2008. Atlanta: US Department of Health and Human Services, CDC; 2008. Available at http://www.cdc.gov/travel/contentyellowbook.aspx 15. CDC. Prevention and control of influenza: recommendations of the Advisory
Committee on Immunization Practices (ACIP), 2008. MMWR. 2008; 57 (RR-7)

Required and recommended protection in the country / Pelindungan yang diperlukan / disyorkan di negara tersebut
** This list is only a general indication of disease protection you may need. Your doctor is the best person to discuss on steps to take for a healthy and disease-free holiday /
Senarai ini hanya merupakan indikasi am mengenai perlindungan penyakit yang mungkin anda perlukan. Doktor anda adalah orang terbaik untuk membincangkan langkah-langkah yang perlu diambil bagi
percutian yang sihat dan bebas penyakit.

Untuk maklumat lebih mengenai perlindungan perjalanan ke negara-negara lain dan pemvaksinan, layari http://www.cdc.gov/travel/destinations/list.aspx
 Adakah anda layak
FAKTA
HEPATITIS
Apakah Hepatitis A? A
1

untuk terbang? Jangkitan yang disebabkan oleh virus

hepatitis A (HAV) yang menjejaskan hati.
Ia boleh menyebabkan radang yang
mengganggu fungsi hati. Risiko HAV adalah lebih tinggi di
negara-negara dengan kadar jangkitan yang tinggi, sanitasi
yang tidak baik serta makanan dan air yang tidak bersih.
Pergi bercuti? Pa
stikan anda telah Bagaimana HAV merebak?1
kemungkinan ter mengambil kira
masuk melindun semua
berada di luar ne gi kesihatan sem • Makanan dan air yang tercemar
gara. Jatuh sakit asa anda
menyeronokkan semasa bercuti • Sentuhan dengan orang yang dijangkiti
, tetapi seseten tidak
gah penyakit bo Apakah komplikasi jangkitan Hepatitis A?2
leh dicegah.
Sebagai Persatu • Hepatitis A menjejaskan hati yang memerlukan beberapa
an Penyakit Berja
Malaysia (MSIDC ngkit dan Kemot minggu hingga bulan untuk sembuh
), kami sedar ak erapi
menikmati percu an keperluan un • Individu yang dijangkiti dengan kegagalan hati kronik adalah
tian ialah peranc tuk berisiko tinggi untuk kegagalan hati akut
memastikan ba angan awal serta
hawa risiko kesih • Kanak-kanak yang dijangkiti boleh mengalami penyakit
anda diminimum atan anda dan ke
kan semasa perja luarga untuk tempoh yang lebih lama berbanding orang dewasa
lanan. (sehingga 10 minggu)
Bu ku kec il ini bertuj • Kadar kematian adalah lebih tinggi bagi orang dewasa yang
ua n unt uk me mb a ntu
perlun ya uba t pen ceg me nin gka tka n kes ed dijangkiti yang berusia 50 tahun ke atas
aha n d ala m per jala ara n
me nge tah ui leb ih me na n. Ba ca se la nju tny
nd ala m me nge nai pen a unt uk
bag aim a na unt uk me yak it, pem vak sin a n d a n
lind ung i d iri a nd a.. da lam
la ini:
1
lihatan
hanya ke
la-geja n mungkin
asi geja tiba-tiba da AV:)
Aw a berlaku denganpas jangkitan H
(Gejal
6 mingg
u sele
Penat
masa 3-
aka n
Dema m e lera m
Hila ng s
ta h
Loya & mun n
ge lap Sakit bad a
Profesor Datin
a rna
Dr Hamimah Hj

g berw
Presiden Hassan
nd i
enc in Sakit se
Persatuan Pen

A ir k
yakit Berjangkit
dan Kemoterap
i Malaysia
ng
Demam kuni
(MSIDC)

1. Hepatitis A. Accessed on June 2009 from http://www.emedicinehealth.com/hepatitis_a/article_em.htm

2. Fiore AE et al. Prevention of hepatitis A Through Active or Passive Immunization. Recommendations of ACIP MMWR May 19, 2006/ Vol.55/No.RR-7..
 FAKTA FAKTA
IALU
IS B DEMAM KEP
Apakah HEPATITIS B? HEPATIT Apakah DEMAM KEPIALU?
3 5

Jangkitan hati yang berpotensi membawa Demam panas akut dan teruk
maut disebabkan oleh virus hepatitis B disebabkan oleh bakteria Salmonella
(HBV) yang merupakan 50-100 kali lebih typhi yang boleh berlanjutan sehingga 10-14 hari. Dianggarkan
menjangkitkan berbanding HIV. HBV 22 juta orang mengalami demam kepialu dan 216,000 meninggal
menjangkiti hampir 2 bilion orang di seluruh dunia dan dunia akibatnya setiap tahun.6 Bakteria ini meluas di negara-
mengakibatkan lebih kurang 600,000 kematian setiap tahun. negara Asia Tenggara, Afrika sub-Sahara dan Amerika Latin.
Faktor-faktor risiko termasuk sentuhan rapat dengan orang yang Faktor-faktor risiko termasuk HIV/AIDS dan sentuhan dengan
dijangkiti hepatitis B, pasangan seks yang ramai, melawat individu yang dijangkiti atau yang mempunyai sistem imun yang
tempat-tempat dengan kadar jangkitan tinggi, tatu atau rawatan lemah disebabkan rawatan perubatan seperti corticosteroids.
akupunktur.
Bagaimana Salmonella typhi merebak?5
Bagaimana HBV merebak?3 • Mengambil makanan dan minuman yang tercemar
• Seks yang tidak dilindungi • Sentuhan rapat dengan individu yang dijangkiti
• Barang kebersihan peribadi yang dijangkiti
• Luka yang bersentuhan dengan cecair atau barang yang Apakah komplikasi DEMAM KEPIALU?7
dijangkiti Salah satu daripada komplikasi yang paling berbahaya adalah
• Daripada ibu kepada bayi semasa kelahiran pendarahan usus, dikesan dengan gejala-gejala berikut:
• tekanan darah jatuh dengan tiba-tiba
Apakah komplikasi HEPATITIS B?4 • kejutan (darah tidak mengalir dengan baik dalam badan,
• Penyakit hati kronik menyebabkan kerosakan organ)
• Lebih daripada 350 juta orang yang dijangkiti mengalami • darah dalam najis
jangkitan hati (kronik) jangka panjang • loya, muntah, sakit teruk dan sepsis (jangkitan darah)
• Lebih kurang 25% orang dewasa yang dijangkiti semasa zaman
kanak-kanak meninggal dunia akibat kanser hati atau sirosis
(hati berparut)

Awasi gejala-gejala ini:3

-gejala ini:
5

Dem a m Sera m sejuk Awasi gejala

rus a n Hila ng se lera ma ka n
Kepen ata n Sakit kepala a n as b e rte
De m a m p
Hila ng se lera maka n Munt a h S ak it k ep al a
Ci rit -b iri t
Sakit otot d a n send i Air kencing berwarna ge lap a n s en d i
S ak it ot ot d
Najis pucat Dem a m k un Kepenata n
in g
3. Hepatitis B. Accessed on June 2009 from http://www.emedicinehealth.com/hepatitis_b/article_em.htm 5. Typhoid fever. Accessed on June 2009 from http://www.medicinenet.com/typhoid_fever/article.htm
4. Hepatitis B. World Health Organization. Accessed on June 2009 from http://www.who.int/mediacentre/factsheets/fs204/en/print.html 6. Crump JA, Luby SP, Mintz ED. The global burden of typhoid fever. Bull World Health Organ 2004;82:346-53.
7. Typhoid fever- Complications. Accessed on June 2009 from http://www.mayoclinic.com/health/typhoid-fever/DS00538/DSECTION=complications
 FAKTA
INFLUE
Apakah INFLUENZA? 8
NZA Apakah penyakit MENINGOCOCCAL?11 A AL
Wabak Influenza adalah bermusim, Jangkitan yang berpotensi membawa FAKT CC
INGOCO
menjejaskan 5-15% penduduk dunia dan maut disebabkan oleh bakteria Neisseria MEN
mengakibatkan 250,000-500,000 kematian meningitidis yang menjejaskan otak dan
berkaitan Influenza setahun. Ia disebabkan oleh virus yang saraf tunjang. Ia juga boleh menyebabkan septisemia
menjangkiti saluran pernafasan dan setiap orang adalah berisiko (keracunan darah). Bakteria tersebut biasanya dijumpai di komuniti
terutamanya kanak-kanak, orang tua, penghuni rumah penjagaan, rapat dan negara-negara di bawah ‘kawasan meningitis’ – Afrika
pesakit HIV/AIDS dan gangguan pulmonari atau kardiovaskular sub-Sahara. Individu yang berisiko dijangkiti adalah yang
kronik. menunaikan Haji dan Umrah, perokok dan orang yang mengalami
jangkitan saluran pernafasan, HIV/AIDS, anemia atau pemakanan
Bagaimana virus INFLUENZA merebak?9 tak seimbang.
• Titisan daripada batuk dan bersin orang yang dijangkiti
• Sentuhan langsung dengan benda tercemar Bagaimana Neisseria meningitidis merebak?11
• Titisan daripada batuk dan bersin orang yang dijangkiti
Apakah komplikasi INFLUENZA?10 • Sentuhan rapat seperti bercium (air liur)
• Boleh menyebabkan jangkitan bakteria sekunder seperti
pneumonia terutamanya pada kanak-kanak, orang tua dan Apakah komplikasi penyakit Meningococcal?12
orang berpenyakit kronik • Sehingga 5-10% kanak-kanak yang dijangkiti meninggal dunia
• Keadaan semakin teruk seperti penyakit jantung, penyakit • Lebih kurang 10-15% yang terselamat daripada jangkitan
paru-paru, asma, penyakit pulmonari kronik, kencing manis dan meningococcal berkemungkinan mengalami masalah mental,
jangkitan miokardial pekak, lumpuh, kegagalan buah pinggang atau sawan
• Boleh menyebabkan kematian pada pesakit yang mempunyai
sistem imun yang lemah

Awasi ge
la ini:
11
jala-geja
la ini: 9 -geja Munta h
a s i gejala
Dema m pa nas Aw al a
S a k it t e
ka k S ak it k ep
P en at d a n le H ila ng se le ra te ra n g
m ah se ca ra m ak a n
Dem a m a ca ha ya
a m ny a
Sa ki t ke pa la d i Tid ak s uk
Sa ki t ot ot d n
a n se nd i d a n se Menga n
tuk
nggota
Sa ki t te ka k S a k it a
ja n
B at uk L eh er k e
M at a m erah
, be ra ir
8. Influenza. Accessed on June 2009 from http://www.who.int/topics/influenza/en 11. Meningococcal Disease: Frequently Asked Questions. Department of Health and Human Services. Centers for Disease Control and Prevention.
9. What is Influenza? Accessed on June 2009 from http://www.medicinenet.com/influenza/article.htm Accessed on June 2009 from http://www.cdc.gov/meningitis/bacterial/faqs.htm
10. Flu In Adults. Accessed on June 2009 from http://www.emedicinehealth.com/flu_in_adults/page2_em.htm 12. Meningitis Meningococcal. Accessed on June 2009 from http://www.nlm.nih.gov/medlineplus/ency/article/000608.htm