Micronesia achieves regional goal for reducing hepatitis B in children

SUVA, Fiji, 24 April 2018 – The Federated States of Micronesia (FSM) has achieved a significant public health victory by reducing the prevalence of hepatitis B among children to less than 1 percent. FSM joins 18 of 36 other countries and areas in the WHO Western Pacific Region that have been verified by an independent panel as having met this goal by 2017.

Hepatitis B is a virus that spreads through blood and other bodily fluids and attacks the liver. It is often transmitted during pregnancy or childbirth. Most babies who are exposed to the virus show no symptoms, but the infection increases their risk of later developing serious problems including cirrhosis and liver cancer by 15%-25%. There is a safe and effective vaccine against hepatitis B.

Dr Shin Young-soo, Regional Director for WHO in the Western Pacific, congratulated FSM: “This is a major milestone for the Federated States of Micronesia and for the entire Western Pacific Region. A generation of children will be able to grow up without the fear of developing the life-threatening liver diseases that hepatitis B can lead to,” says Dr Shin.

FSM is made up of more than 600 islands spread across the western Pacific Ocean. Historically, hepatitis B was highly endemic in the country, and most new infections were among babies or young children. FSM has made tremendous strides in combating the virus since the hepatitis B vaccine was added to their national immunization programme in 1988. Doses are given to babies at birth, 2 months, 4 months, and 6 months of age.

In addition to strengthening vaccination, some of the other ways that FSM has made such good progress in preventing hepatitis B transmission are by screening pregnant women for hepatitis B and referring those that are infected for care and treatment, as well as screening other family members for hepatitis B. FSM also provides hepatitis B immunoglobulin (made from plasma that contains antibodies that protect against the virus) to infants whose mothers have chronic hepatitis B infection to prevent transmission.

Getting certified

In 2016, a serosurvey was conducted (blood tests among a nationally representative group of 5-year-olds to measure what proportion are chronically infected with the virus) to evaluate whether the country had achieved the WHO regional target of decreasing hepatitis B prevalence to below 1% among children by 2017 and measure progress towards the global target of <0.1% to eliminate hepatitis B as a public health threat by 2030. The survey found that the prevalence of hepatitis B among first graders in FSM is 0.28%.

“The serosurvey confirmed what we were already seeing on the ground: that a rigorous programme including preventative screening and vaccination, as well as treatment, delivers results. FSM can serve as an inspiration to other similarly situated countries and areas in the Region,” says WHO Country Liaison Officer in FSM, Dr Eunyoung Ko.

This being said, work remains to be done in FSM to wipe out all forms of viral hepatitis—A, B, C, D and E—by 2030. The country’s geography makes it challenging to achieve high vaccine coverage in certain areas, such as in the outer islands or in areas where there are no state-run hospitals. It can also be challenging to ensure every child gets the complete hepatitis B vaccine series by arranging ‘catch-up’ vaccination for those who miss scheduled doses.

“Hepatitis is preventable with timely vaccination, starting with the first dose being given within 24 hours of birth whenever possible. Here in FSM we have made great progress in combating the disease, but one infection is still one too many. That’s why we will continue working closely with WHO to ensure every child is given the opportunity to live a life free of this disease,” says Magdalena Walter, Secretary of Health and Social Affairs of FSM.

The burden of hepatitis B

Hepatitis B is a major global health problem, with nearly 260 million people around the world living with the disease, and nearly 800 000 die from hepatitis B-related liver disease every year. Some 115 million people in the WHO Western Pacific Region have chronic hepatitis B, accounting for 45% of infections worldwide.

About 9 in 10 people with chronic hepatitis B do not know they have the infection until liver disease has already developed. This includes mothers who may unknowingly transmit hepatitis B to their newborns.

While almost 9 in 10 mothers in the WHO Western Pacific Region deliver their babies in a health facility, countries should encourage every mother to be screened for hepatitis B so that those who have chronic infection know about it and understand the importance of getting the vaccine and possibly treatment as soon as possible.

WHO works closely with countries and partners to promote vaccination against hepatitis B among babies as a key part of implementing the Regional Action Plan for Viral Hepatitis in the Western Pacific 2016-2020 and the Global Health Sector Strategy on Viral Hepatitis 2016–2021.

Notes to editors

The 18 other countries and areas previously verified as having met the regional target of reducing the prevalence of hepatitis B among children to less than 1% are: American Samoa, Australia, Brunei Darussalam, China, the Commonwealth of the Northern Mariana Islands, the Cook Islands, French Polynesia, Guam, Hong Kong SAR (China), Macao SAR (China), Malaysia, Mongolia, New Zealand, Niue, Palau, the Republic of Korea, Singapore and Tokelau.

For more information, contact: Mr Ruel E. Serrano, WHO Regional Office for the Western Pacific, Tel: +63 2 528 9993, Mob: +63 908 891 4532, Email: serranor@who.int