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,
is believed in many Asian cultures to bring good luck and longevity while deflecting negativity. Folded like the
"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.
has been spearheading the Jade Ribbon Campaign through public service announcements in various media such as newspapers, magazines, TV, radio, billboard, and buses targeting communities with large API populations. The ALC also holds numerous seminars for health professionals and the public, cultural fairs, conferences, and HBV screening/vaccination events.
[
]
3 For Life
One of the ALC's largest achievements was the founding o
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.
LIVERight
The Answer to Cancer (A2C) run was founded by Adrian Elkins, a 20-year-old student at Southern Oregon University who was diagnosed with liver cancer in 2002. Had he known during his childhood that his ethnicity and chronic hepatitis B infection increased his chance of developing liver cancer by 100%, he would have been regularly monitored for liver damage. He had no idea that hepatitis B – a disease he contracted at birth in Calcutta, India – causes 80% of the world's liver cancer cases. Adrian battled his disease for ten months, working tirelessly to organize an event to raise money for liver cancer research. Adrian saw the first-ever A2C run take place on August 8, 2003. Thanks to the generous support of friends, families and numerous companies, the 2003 Answer to Cancer Race was able to raise more than $20,000 for three charities and reach out to more than 240 participants. Adrian died only eight days after this first race.
Adrian Elkins inspired the Asian Liver Center to start LIVERight on the go!, a 5K Run/Walk to raise awareness about hepatitis B and liver cancer in the Asian Pacific Islander community.
On April 30, 2005 in San Francisco's Golden Gate Park, the Asian Liver Center and the Answer to Cancer Foundation hosted LIVERight, the first 5K run/walk to raise awareness about hepatitis B and liver cancer.
On November 11, 2006, the 2nd annual LIVERight was held at Stanford's Sand Hill Fields. The community event had 700 registered participants, 100 volunteers, and raised over $135,000.
The 3rd Annual LIVERight 5k Run/Walk took place on May 10, 2008. It had over 600 registered runners and raised over $100,000 to fight hepatitis B and liver cancer.
The 4th Annual LIVERight 5k Run/Walk was held on Saturday, May 2, 2009 at Golden Gate Park in San Francisco, California. The over 400 runners raised over $100,000 to fight liver cancer and hepatitis B.
The goal of LIVERight was not only to raise money to support ALC's outreach efforts, but more importantly to educate and increase awareness of this pressing public health issue. Educational displays, informational booths and course signs were unique and significant components to the event. The education allowed participants to learn more about hepatitis B prevention and treatment, as well as hear the real stories about the lives lost and won to liver cancer.[Annual LIVERight 5K Walk/Run.]
Jade Ribbon Campaign reusable bag
99 Ranch Market and the Asian Liver Center at Stanford University joined together to create the Jade Ribbon reusable shopping bag
A reusable shopping bag, sometimes called a bag-for-life in the UK, is a type of shopping bag which can be reused many times, in contrast to single-use paper or plastic shopping bags. It is often a tote bag made from fabric such as canvas, natu ...
—an environmentally-friendly way to raise awareness about an urgent health concern for Asians. The eco-friendly reusable shopping bag, along with educational materials on hepatitis B, was made available from July 24 to August 31 in 2009 with every donation of two dollars or more to the Jade Ribbon Campaign to support hepatitis B education and outreach.[JRC Reusable Shopping Bag. http://liver.stanford.edu/Outreach/JRC_shoppingbag.html ]
Team HBV collegiate chaptersTeam HBV
is the official chapter of th
and is currently the only student-run, non-profit, collegiate organization in the United States that addresses the high incidence of hepatitis B and liver cancer in the Asian and Pacific Islander community.[Team HBV.< >]
The mission of Team HBV is to advance the goals of the ALC at college campuses across the United States to help fight hepatitis B and liver cancer worldwide.
Adopted by the Asian Liver Center in Fall 2006, the first official Team HBV chapters were founded i
CornellDuke
an
University of California, Berkeley
There are now Team HBV Collegiate Chapters at Duke, Cornell, UC Berkeley, Stanford, Brown, UC Davis, Harvard, Wesleyan, the University of Pennsylvania, Rice, Wesleyan, and UC San Diego, and international chapters at Jiaotong University in China, Central University for Nationalities, Tsinghua University, and Minzu University of China.
The Inaugural Team HBV Collegiate Conference, organized by the Asian Liver Center, brings together individuals representing Team HBV chapters worldwide, Jade Ribbon Campaign advocates, and hepatitis B and liver cancer experts. The conference provides a professional forum for Team HBV chapters to share insights, best practices, and strategies to advance hepatitis B outreach, education, and communication. The first Team HBV Collegiate Conference took place November 2009 at Stanford University.
San Francisco Hep B Free
San Francisco Hep B Free is a citywide campaign to turn San Francisco into the first hepatitis B free city in the nation. This unprecedented 2-year-long campaign beginning April 2007 will screen, vaccinate and treat all San Francisco Asian and Pacific Islander (API) residents of hepatitis B (HBV) by providing convenient, free or low-cost testing opportunities at partnering health facilities and events.
The SF Hep B Free campaign puts San Francisco at the forefront of America in fighting chronic hepatitis. It will be the largest, most intensive healthcare campaign for Asian and Pacific Islanders in the US This initiative has received national attention and is being looked to as a model by the California legislature. Mayor Gavin Newsom
Gavin Christopher Newsom (born October 10, 1967) is an American politician and businessman who has been the 40th governor of California since 2019. A member of the Democratic Party, he served as the 49th lieutenant governor of California fr ...
, Assemblywoman Fiona Ma and Supervisor Ed Jew are leading the effort with more than 50 healthcare and Asian Pacific Islander organizations. The SF Board of Supervisors and SF Health Commission have passed unanimous resolutions supporting SF Hep B Free.
Cal Hep B Free
Cal Hep B Free is a student-led, not-for-profit health promotion pilot program launched on September 15, 2008 at the University of California, Berkeley. Supported by numerous student organizations on campus and endorsed by Vice Chancellor of Student Affairs Harry Le Grande, City of Berkeley Public Health Division, and California Assemblywoman Fiona Ma, the major student-initiated campaign effort brings together university students, faculty, and administration at UC Berkeley in an effort to screen, vaccinate, and treat high-risk ethnic groups, particularly individuals of Asian and Pacific Islander (API), Middle Eastern, Eastern European, Russian, and African descent for hepatitis B (HBV). The Cal Hep B Free campaign will allow UC Berkeley to join San Francisco Hep B Free, the largest healthcare campaign in the US to target APIs in the US, at the forefront of America in fighting chronic hepatitis B.
The slogan for Cal Hep B Free is: B SMART, B TESTED, B FREE! and outlines the specific objectives of the campaign:
# B SMART: Dispel misconceptions and create campus awareness about the health risks of HBV and the importance of screening for HBV.
# B TESTED: Promote routine hepatitis B screenings and assist and direct students, faculty, and staff to campus and other local sites where they may obtain free or low-cost screenings.
# B FREE: Design and implement a unique, coalition-partnership model that involves campus and local entities to maximize awareness and sustainability. Knowledge is power and can prevent what you don't know from killing you!
Erik's DeliCafe Partnership
JoinJade campaign at Stanford University partnered with three Erik’s DeliCafe locations to promote hepatitis B and liver health awareness in Santa Clara County, where an estimated 31,273 people are living with chronic hepatitis B. The collaboration aimed to promote testing, as diagnosis and regular monitoring significantly reduce a chronic carrier’s chance of developing liver cancer.
International efforts
Qinghai Project
Home to a large population of ethnic minorities of low socioeconomic status, the Qinghai province is a remote, often neglected, rural region of China with a high prevalence of chronic hepatitis B. Since many children 5 years of age and older in Qinghai were not vaccinated against the hepatitis B virus at birth, a private-public partnership was formed between the Ping and Amy Chao Foundation, the ZeShan Foundation, the Asian Liver Center at Stanford University, the China Center for Disease Control and Prevention, the Chinese Foundation for Hepatitis Prevention and Control, and the Qinghai government. Using the existing provincial China CDC structure, this private-public partnership in Qinghai resulted in a unique two-part school-based immunization program to educate and provide free Hep B vaccination for all children in kindergarten and grade school within the region.
Prevalence and risks for Asians and Pacific Islanders
While 0.3% of the United States
The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territori ...
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 in the US are hepatitis B carriers. In some Pacific Rim countries, as many as 10-20% of the population are hepatitis B carriers.
Despite the availability of the hepatitis B vaccine, vaccination rates outside the US are low and hepatitis B remains a global health problem. Therefore, many children worldwide remain unvaccinated and many adults may be chronic carriers. The World Health Organization (WHO)
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...
estimates that there are 350-400 million people with chronic hepatitis B and many are not even aware of their condition.["Hepatitis"]
by World Health Organization
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...
Although most hepatitis B carriers have no symptoms, they can still transmit the infection and develop liver cancer.
Reasons for lack of diagnosis
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. Chronically infected individuals may exhibit normal blood tests for liver function and be granted a clean bill of health. The diagnosis cannot be made without a specific blood test for the presence of the hepatitis B surface antigen
In immunology, an antigen (Ag) is a molecule or molecular structure or any foreign particulate matter or a pollen grain that can bind to a specific antibody or T-cell receptor. The presence of antigens in the body may trigger an immune respons ...
(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 person tested, but prevents infection from being passed silently from one child to another, and from one generation to another.
In addition, misconceptions about the endemic nature of hepatitis B in the API population and the efficacy of US vaccination programs has led many individuals and health-care providers to overlook the need for testing for APIs.
Transmission
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 earlier. 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
Contrary to 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.
Mortality risks
Without appropriate management and screening, one in four hepatitis B infected individuals (25%) will die from liver cancer or cirrhosis
Cirrhosis, also known as liver cirrhosis or hepatic cirrhosis, and end-stage liver disease, is the impaired liver function caused by the formation of scar tissue known as fibrosis due to damage caused by liver disease. Damage causes tissue rep ...
(liver damage leading to scarring and eventually death from liver failure). 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 chronically infected individuals 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 people with chronic hepatitis B infection, 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 and Pacific Islanders. 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 individuals early enough for treatment.
Statistics
Global statistics
*350-400 million people worldwide have chronic HBV infection (compare with 40 million living with HIV
The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune ...
)cirrhosis
Cirrhosis, also known as liver cirrhosis or hepatic cirrhosis, and end-stage liver disease, is the impaired liver function caused by the formation of scar tissue known as fibrosis due to damage caused by liver disease. Damage causes tissue rep ...
or liver failure.
United States statistics
*HBV is the biggest health disparity
Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige. Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequitie ...
between Asian American and White American
White Americans are Americans who identify as and are perceived to be white people. This group constitutes the majority of the people in the United States. As of the 2020 Census, 61.6%, or 204,277,273 people, were white alone. This represented ...
s.
*10% of Asian Americans are chronically infected versus less than 0.3% of the general population.
*1.4 million people are chronically infected in US and more than half are Asian.
*Liver cancer incidence is 6 - 13 times higher for Asians.
*Liver cancer mortality remains higher than other cancers despite advances in research and medical technology:
*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.]
*API population has increased 4x since 1980 (14.4 million in 2002)
*Foreign born API: 2.5 million in 1980 and 8.3 million in 2002
**75% came from countries with chronic HBV rates of 8-15%
*APIs tend to live in large households; 20% live with 5 or more people
*Many API seek medical treatments from Traditional Chinese Medicine (TCM) practitioners.["Hepatitis B Virus: A Comprehensive Strategy for Eliminating Transmission in the United States Through Universal Childhood Vaccination: Recommendations of the Immunization Practices"](_blank)
by Advisory Committee on Immunization Practices
The Advisory Committee on Immunization Practices (ACIP) is a committee within the United States Centers for Disease Control and Prevention (CDC) that provides advice and guidance on effective control of vaccine-preventable diseases in the U.S. c ...
China statistics
*1/3 of the world's chronic HBV patients live in China.[ Communicable Disease Surveillance & Response (CSR), ]World Health Organization
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...
. <>
*130 million Chinese (1 in 10) have chronic HBV.[Z Sun et al., J Med Virol 2002, 67:447-450]
*In one day, 3 times more people die of HBV than the entire SARS outbreak.
*In two years, fewer than 10 people have died from avian flu in China.[ Communicable Disease Surveillance & Response (CSR), ]World Health Organization
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...
. <>
Rates of hepatitis B infection
*Chronic HBV infection rates in US 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%)
**US born API: 1.4%
*Chronic HBV infection rates in Caucasian, Hispanic, or African American: 0.1%, 0.1%, 0.5%
See also
*Hepatitis B
Hepatitis B is an infectious disease caused by the '' Hepatitis B virus'' (HBV) that affects the liver; it is a type of viral hepatitis. It can cause both acute and chronic infection.
Many people have no symptoms during an initial infection. ...
* Liver cancer
* Hepatocellular carcinoma (HCC)
* San Francisco Hep B Free
*Hepatitis B in China
Hepatitis B is endemic in China. Of the 350 million individuals worldwide infected with the hepatitis B virus (HBV), one-third reside in China. As of 2006 China has immunized 11.1 million children in its poorest provinces as part of several progra ...
References
{{Reflist
External links
Asian Liver Center at Stanford University
official website
HepBMomsJade Ribbon Campaign ArizonaTeam HBV
official website
Team HBV
at University of California, Berkeley
The University of California, Berkeley (UC Berkeley, Berkeley, Cal, or California) is a public land-grant research university in Berkeley, California. Established in 1868 as the University of California, it is the state's first land-grant u ...
San Francisco Hep B Free
official website
Cal Hep B Free
official website
ThinkB.org
on the dangers of Hepatitis B to the Asian community
Medical and health organizations based in California
Ribbon symbolism
Health campaigns
Green symbols
Hepatitis B