Webinar: Acute Hepatitis B in a Rural Hospital

This case study presents a patient who was admitted via the Emergency Department to our rural surgical ward—initially suspected to have cholecystitis or pancreatitis—but was ultimately diagnosed with acute hepatitis B. In May 2024, “Gary,” a 53-year-old man, presented to a 100-bed rural public hospital with fever, chills, night sweats, upper abdominal pain, anorexia, and unintentional weight loss of 6 kg. Gary disclosed a physical altercation eight weeks earlier with a man known to be an IVDU. During the fight, Gary sustained lacerations to his knuckles and forearms, which were exposed to the other man’s blood.

Approximately seven weeks after the incident, Gary became acutely unwell and was admitted to hospital. While reviewing daily inpatient pathology, the Infection Prevention and Control (IPC) team noted his lab results, were consistent with an acute hepatitis B infection. The IPC nurse recognized the serology pattern and escalated care accordingly.

This case study will explore Gary’s clinical journey, including diagnostic challenges, infection control responses, and care coordination. It also highlights opportunities for process improvements, particularly in rural healthcare settings.

Alison is a Clinical Nurse Consultant in Infection Prevention and Control at West Gippsland Healthcare Group, Victoria. Whilst Alison’s’ background is cardiac nursing, having worked in HDU, Critical Care, Stress testing and Cardiac Pulmonary Rehabilitation. Alison is currently completing a Graduate Certificate in Infection Prevention and Control (IPC). She has worked in IPC assisting with Hand hygiene and audits before taking a small permanent position early in January 2020, just before the pandemic. Alison works solely in IPC now, has gained qualification in Immunisation, Blood borne Virus testing. Alison has a Diploma in family Counselling.

Geraldine Freriks is the Infection Prevention and Control Nurse Unit Manager at West Gippsland Healthcare Group. A dedicated nurse since 1987, she has worked across various specialties, primarily Oncology, Haematology, and Palliative Care, holding coordinating roles at St Vincent’s, Dandenong, Box Hill Hospital and West Gippsland Healthcare Group.In 2016, Geraldine transitioned into Infection Prevention and Control, contributing significantly to the sepsis project at West Gippsland Healthcare Group. Over the past four years, she has played a key role in the Warragul COVID-19 response and worked at the Public Health Unit. Passionate about infection prevention, she is committed to education, reducing antimicrobial resistance and improving patient outcomes.

Geraldine has completed studies in Oncology, Haematology, Palliative Care, Management, and Infection Prevention and Control.

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