In a small, modest office overlooking the heart of Palo Alto, Mie-Na Srein, corporate outreach and programs coordinator for the Asian Liver Center at Stanford University, is persuading corporations in Silicon Valley to take action against hepatitis B.

“When you have the policy in place then all the small things can start falling into place and you have more support and funding to get those things done,” Srein said.

Sixteen years after its establishment as a grass-roots campaign, the Asian Liver Center is thinking big. The nonprofit recently launched a corporate outreach program with a five-step employer tool kit that integrates hepatitis B wellness and education into existing corporate wellness programs. It is an easily implemented wellness program that employers can use to bring visibility to hepatitis B in the workplace for the benefit of their employees and the community’s overall health, Srein said.

People who are foreign-born or have foreign-born parents are much more likely to be living with undiagnosed chronic hepatitis B because of mother-to-child transmission. According to the World Health Organization, one in 10 foreign-born Asian-Americans is chronically infected. The agency recommends all at-risk individuals be screened and vaccinated.

Despite the World Health Organization recommendation,



many Asians and Pacific Islanders remain uninformed, untested, and unprotected. About 40 to 65 percent of Asian-Americans have never been screened, and nearly two-thirds of foreign-born, hepatitis B-infected Asian-Americans are unaware of their infection. When chronic hepatitis B is left undetected and untreated, it can cause premature death from liver failure or liver cancer, killing one in four of those infected.

The Asian Liver Center’s five-step employer tool kit is designed to help solve the problem by connecting employees with the education and tools for preventing hepatitis B. Informational brochures educate workers about the benefits of testing and vaccination, while an online assessment identifies at-risk individuals based on the birthplace of the employee and his parents. The tool kit ensures company-sponsored health care includes prevention, treatment and long-term management for employees found to be chronically infected with hepatitis B, Srein said. It also assists in eliminating hepatitis B discrimination in company policies and practices, she said.

Santa Clara and San Francisco counties host the two largest Asian-American and Pacific Islander populations in the United States, at 33 percent and 34 percent, respectively, according to the U.S. Census Bureau.

Srein is reaching out to employers in Silicon Valley who have an Asian-American and Pacific Islander employee base of at least 20 percent. She asks employers to bring visibility to hepatitis B by expanding their company-sponsored health care to include a one-time blood test, hepatitis B vaccination for unprotected employees, and routine liver cancer screenings, blood tests and doctor checkups for chronically infected employees.

If an Asian-American or Pacific Islander mother is infected, the company agrees to provide the prenatal care for the mother and her baby, including the hepatitis B vaccine and the hepatitis B immune globulin (HBIG) shot.The Asian Liver Center also advises corporations to offer on-site screenings and hepatitis B vaccinations for employees. HepB Free Santa Clara and San Francisco Campaign, partners with the Asian Liver Center, provide the staffing and resources for screening and vaccinating employees.

Juniper Networks, a Silicon Valley communications company, was the first corporation to begin implementing the recommended Asian Liver Center steps into its corporate wellness program.

Srein presents the five-step tool kit as a way for employers to improve employee overall well-being.

“If (a corporation has) 2,000 employees who are all born in China, chances are a certain percentage will be chronically infected (with hepatitis B),” she said. For corporations with a large Asian-American and Pacific Islander employee base, Srein said she believes “hepatitis B needs to be made a fundamental part of wellness. Just like some groups get routine screenings for cholesterol and blood pressure, for (Asian-Americans and Pacific Islanders), hepatitis B is also a vital sign for which screening is absolutely necessary.”

Team HBV at Stanford University, an outreach arm of the Asian Liver Center, is joining Srein in the effort to promote early detection and accelerate the eradication of hepatitis B.

For Catherine Lu, president of Stanford’s Team HBV, hepatitis B is an issue that hits close to home.

“A family member has hepatitis B but didn’t realize until he was tested in college, so there was a pretty big gap between when he was infected at birth and when he found out in college,” she said.

Team HBV, a student-run grass-roots campaign, addresses awareness, prevention and treatment for hepatitis B. The chapter works with Vaden Student Health Center at Stanford to offer free hepatitis B screenings for all students at-risk of chronic infection.

Like Srein, Lu advocates early detection. She helped to develop an incentive-based Screening Initiative Program with a variety of prizes to encourage students to take advantage of the free hepatitis B screenings at Vaden Health Center. During the monthlong initiative last February, 150 students were screened for chronic hepatitis B. Lu hoped to get even more students screened during the third annual Screening Initiative Program last month. “We have made some strides, even if it is just at Stanford, where people have found out they are at risk or need the vaccination.”

Srein identifies Lu as a passionate leader who, like the Asian Liver Center, is confronting hepatitis B in Silicon Valley.

Though the Asian Liver Center’s five-step tool kit has only been in place since mid-August, it has been successful in offering corporations a program that is tangible, concise and actionable.

“At the end of the day, we need something to hand to companies and be able to say: This is exactly what we want you to do,” Srein said.

“We are really out there for the benefit of the people and for the benefit of employee health,” Srein said. She then relaxed into her chair and turned to the final page of the five-step employer tool kit and stressed that through awareness, early detection and vaccination, Santa Clara County can become the first hepatitis-free county in the nation.

Emily Robinson is a junior at Santa Clara University. She is majoring in biochemistry with a minor in public health and is planning to attend medical school.

A portion of this story was corrected on March 8, 2013

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