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The Jade Ribbon Campaign (JRC) was launched by the Asian Liver Center at Stanford University in May 2001 during Asian Pacific American Heritage Month to help spread awareness internationally about hepatitis B (HBV) and liver cancer in Asian and Pacific Islander (API) communities.

The objective of the Jade Ribbon Campaign is twofold: (1) to eradicate HBV worldwide; and (2) to reduce the incidence and mortality associated with liver cancer.

Considered to be the essence of heaven and earth, Jade is believed in many Asian cultures to bring good luck and longevity while deflecting negativity. Folded like the Chinese character “人” (ren) meaning "person" or "people," the Jade Ribbon symbolizes the spirit of the campaign in bringing the Asian and global community together to combat this silent epidemic.

Outreach Efforts


Since the campaign's founding, the Asian Liver Center (ALC) have been spearheading the Jade Ribbon Campaign through public service annoucements in various media such as newspapers, magazines, TV, radio, billboard, and buses targeting communities with large API populations. Moreover, the ALC also holds numerous seminars for health professionals and the public, cultural fairs, conferences, and HBV screening/vaccination events.

One of the ALC's largest achievements was the founding of 3 for Life in September 2004, a pilot program in collaboration with the San Francisco Department of Public Health that provided low-cost hepatitis A and B vaccinations and free hepatitis B testing to the San Francisco community every first and third Saturday of the month for a year. The program tested and vaccinated over 1,200 people -- 50% of which were found to be unprotected against HBV and 10% to be positive for HBV. Upon the completion of 3 for Life in September 2005, the ALC currently is working on plans to launch a similar screening/vaccination program to service the large API population in Los Angeles.

A National Asian Interest Fraternity, Pi Alpha Phi, has taken the agendas of the Jade Ribbon Campaign as its national Philanthropy event. Holding yearly events and awareness campaigns, the issue of HBV is starting to spread amongst young Asian-Americans on American campuses as well.

Why should Asians and Pacific Islanders be aware of hepatitis B?


While 0.3% of the United States population has chronic hepatitis B infection, APIs make up more than half of the 1.3-1.5 million known hepatitis B carriers. Depending on the country of origin, 5-15% of foreign born APIs are hepatitis B carriers. In some Pacific Rim countries, as many as 10-20% of the population are hepatitis B carriers.Source needed

Despite the availability of the hepatitis B vaccine, vaccination rates are low and hepatitis B remains a global health problem. Therefore, many children worldwide remain unvaccinated and many adults may be chronic carriers. In the U.S., many API youth and adults have not been tested or vaccinated. The World Health Organization (WHO) estimates that there are 350-400 million people with chronic hepatitis B and many are not even aware of their condition.Centers for Disease Control and Prevention. World Health Organization. Although most hepatitis B carriers have no symptoms, they can still transmit the infecton and develop liver cancer.

Why is hepatitis B often not diagnosed?


The danger of hepatitis B lies in its silent transmission and progression. Many chronic hepatitis B carriers are asymptomatic (have no symptoms) and feel perfectly healthy. Carriers may exhibit normal blood tests for liver function and be granted a clean bill of health. The diagnosis cannot be made unless your doctor orders specific blood test for the presence of the hepatitis B surface antigen (HBsAg), a marker for chronic infection. Since the detection of hepatitis B is so easily missed, even by doctors, it is also up to the patient to specifically request the HBsAg test. Early detection not only benefits the infection from being passed silently from one child to another, and from one generation to another.

How is hepatitis B transmitted?


Most APIs are infected by HBV at birth by their carrier mothers (perinatal infection). Individuals who are infected at birth can develop liver cancer at age 35 or eariler. Also, individuals infected at birth will carry the virus for life, regardless of future vaccination. Transmission is also common during early childhood through direct contact with blood of infected individuals, occurring from contact between open wounds, sharing contaminated toothbrushes or razors, or through contaminated medical/dental tools. Hepatitis B can also be transmitted by blood transfusions, sharing or reusing needles for injection or tattoos, and unprotected sex.

Common misconceptions


  • Hepatitis B is NOT transmitted through food/water.
  • Hepatitis B is NOT transmitted through casual contact, such as hugging or shaking hands.
  • Hepatitis B is NOT transmitted through kissing, sneezing, or coughing.
  • Hepatitis B is NOT transmitted through breastfeeding.
  • Vaccination does NOT help individuals who are already infected with Hepatitis B.

How is hepatitis B life-threatening?


Without appropriate management and screening, one in four hepatitis B carriers (25%) dies from liver cancer or cirrhosis (liver damage leading to scarring and eventually death from liver failure).Source needed Some develop cancer as early as 30 years of age. Every year, approximately one million people worldwide die from the disease because they are not diagnosed before the point where current treatment can be effective. Because so many carriers feel perfectly healthy even with early liver cancer, the disease can progress without the carrier even knowing. When symptoms do appear, it is often only at the late stages of the disease. All chronic hepatitis B carriers, whether they feel healthy or sick, are at risk for developing liver cancer or cirrhosis. Finding the cancer when it is small by regular screening remains the best chance of surviving liver cancer.

Hepatitis B is one of the largest health threats for Asians. All individuals of Asian descent should request the hepatitis B surface antigen test (HBsAg) to identify infection. Also, individuals should request the hepatitis B surface antibody test (HBsAb) to identify immunity. 5%-10% of those vaccinated do not develop the antibodies and are not protected. The only way to prevent deaths from liver cancer is to identify chronic HBV carriers early enough for treatment.

Statistics


Global Statistics

United States Statistics

  • HBV is the biggest health disparity between Asian American and White Americans.
  • 10% of Asian Americans are chronically infected versus less than 0.3% of the general population.Source needed
  • 1.4 million people are chronically infected in U.S. and more than half are Asian.Source needed
  • Liver cancer incidence is 6 - 13 times higher for Asians.Source needed
  • Liver cancer mortality remains higher than other cancers despite advances in research and medical technology:Source needed.
{| class="wikitable" width="500" style="text-align: center; margin: 1em auto 1em auto" Trends in 5-Year Survival by Year of Diagnosis in the U.S. Site 1974-76 1983-85 1992-99 Breast cancer 75% 78% 87% Colon cancer 51% 58% 62% Prostate cancer 67% 75% 98% Liver cancer 4% 6% 7%
  • There are more HBsAg-positive (chronically infected with HBV) API women than women of other ethnicities: Estimated expected births to HBsAg-positive women: United States, 2002. Draft of 2005 ACIP HBV Guidelines.
{| class="wikitable" width="500" style="text-align: center; margin: 1em auto 1em auto" Incidence of Chronic HBV in the U.S. by Ethnicity Maternal Race/Ethnicity 2002 Births Estimated Maternal HBsAg Prevalence Estimated Births to HBsAg(+) Women Non-Hispanic 2,298,156 0.13 2,988 African American 593,691 0.5 2,968 Asian Pacific Islander (foreign born) 175,264 8.9 15,598 Asian Pacific Islander (U.S. born) 35,643 1.4 499 Hispanic 35,643 1.4 499 Other 42,330 0.5 212 Total 4,021,726 23,054
  • API population has increased 4x since 1980 (14.4 million in 2002)Source needed.
  • Foreign born API: 2.5 million in 1980 and 8.3 million in 2002Source needed.
    • 75% came from countries with chronic HBV rates of 8-15%Source needed.
  • APIs tend to live in large househoulds; 20% live with 5 or more peopleSource needed.
  • Many API seek medical treatments from Traditional Chinese Medicine (TCM) practictioners.
    • No rountine blood tests and medical check-ups.
    • Under-reporting of both acute and chronic HBV infection.

China Statistics

{| class="wikitable" width="400" style="text-align: center; margin: 1em auto 1em auto" HBVZ Sun et. al., J Med Virol 2002, 67:447-450 HIV/AIDSUNAIDS/WHO Epidemiological Fact Sheet. 130 million with chronic HBV 650,000 with HIV 10% of population < 0.05% of population 500,000 die of liver cancer and/or liver failure each year 44,000 died of AIDS in 2003

Rates of Hepatitis B InfectionSource needed

  • Chronic HBV infection rates in U.S. and Western Europe (lowest): 0.1-0.5%
  • Chronic HBV infection rates in Asia, Pacific and sub-Saharan Africa: 10% (5-20%)
  • Chronic HBV infection rates in API Americans: 7% (approximately 840,000)
    • Foreign born API: 9% (range 5-15%)
    • U.S. born API: 1.4%
  • Chronic HBV infection rates in Caucasian, Hispanic, or African American: 0.1%, 0.1%, 0.5%

References


See also


External links


Health organizations | Hepatitis | Viruses | Wikipedians who support the Jade Ribbon Campaign | Ribbon symbolism

 

This article is licensed under the GNU Free Documentation License. It uses material from the "Jade Ribbon Campaign".

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