Compulsory vaccination of tattoo artistes

As part of its effort to reduce the risk of Hepatitis B transmission, the Public Health Department has issued a regulation binding tattooists to be vaccinated against the virus or else their licence will not be renewed.

The head of the Disease Surveillance Unit, Charmaine Gauci said that apart from the three-course vaccination, a blood test measuring the effectiveness of the vaccine in developing antibodies would also be carried out.

In a minority of people the vaccine does not raise the desired level of antibodies. In such cases the department will recommend an annual Hepatitis B test.

The unit has been recommending vaccination for tattooists for a number of years, with the majority following this recommendation.

"We believe it is imperative to protect tattooists since the use of needles puts them among the groups at high risk of contracting Hepatitis B. By protecting them we are also protecting the client."

She said there has never been a case of hepatitis among local tattooists - there are 10 licensed tattooists in Malta.

Like Hepatitis C and HIV, Hepatitis B is transmitted either through sexual contact with an infected person, from an infected woman to her baby during delivery, through needle sharing and contact through broken skin.

Another risk factor is the transfusion of infected blood products, but Dr Gauci pointed out that in Malta blood is screened for a number of diseases before transfusion. However, this could still take place in developing countries.

On the other hand, Hepatitis A can be contracted through eating contaminated food.

Although there is no vaccination to protect against Hepatitis C and HIV, one does exist for Hepatitis B. In fact, it has been offered to children through the national schedule since 1988. Like all other hepatitis types, Hepatitis B is an inflammation of the liver which could lead to cirrhosis and other types of cancer.

Dr Gauci said that while the body may appear to clear the virus, the sufferer might remain a carrier for life.

Doctors are legally bound to inform the unit about any Hepatitis B cases, in which case it follows up both the patients and their close contacts.

Tattooing was illegal in Malta up to 1976, when the Health Division decided it made more sense to regulate the practice.

Dr Gauci did not rule out that similar licence conditions would be applied to other high-risk professions in the future.

The Public Health Department is also looking into the possibility of issuing regulations with regard to tattooing without the use of needles and body piercing. Last summer several people reported adverse reactions from henna tattoos.

Dr Gauci said there was a list of substances that could be used for henna tattooing. Research was ongoing to determine how this process could be regulated.

Signs and symptoms of Hepatitis B

¤ Loss of appetite

¤ Vomiting

¤ Fever

¤ Joint pain

¤ Nausea

¤ Abdominal pain

¤ Jaundice

Further information about the virus can be found on the Disease Surveillance Unit's website http://www.health.gov.mt/dsu/a_to_z/disease/hepatitis_b.htm