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A preventable disease
What is Hepatitis-A? HEPATITIS-A virus is a highly contagious liver infection. It causes inflammation that affects the liver’s ability to work. This is significant because the liver performs hundred of tasks that are essential for health and life. People are most likely to contract hepatitis A from contaminated food or water, or from close contact with someone who’s already infected. APPEARANCE OF DISEASE: Some people may have and carry hepatitis A and yet, never develop signs and symptoms. Infected people have the virus for upto three weeks before developing any problem when signs and symptoms appear. These include: * Fatigue * Nausea and vomiting * Abdominal pain or discomfort, especially in the area of your liver on the right side beneath your lower ribs. * Loss of appetite * Low grade fever * Yellowish colour of skin and the whites (jaundice) * Not all people with hepatitis A develop jaundice. It occurs when your liver is not able to remove the residue of old red blood cells known as billirubin. Eventually, the level of billirubin builds up and is deposited in the skin of the infected person and gives a yellow colour to the skin. * Muscle pain * Itching CAUSES OF HEPATITIS A: A human liver performs more then 500 functions that include processing of most of the nutrients absorbed in our intestine, removing drugs, alcohol and other harmful substances from our blood stream and manufacturing bile. Because of the complexity of the liver and its exposure to so many potentially toxic substances, it would seem especially vulnerable to disease. But the liver has an amazing capacity for regeneration. It can heal itself by replacing or repairing injured cells. It is so constructed that it enables the healthy cells to take over the functions of damaged cells. Hepatitis-A is one of the six currently identified strains of viral hepatitis. All the strains differ in severity and in the way they spread. Hepatitis-A is usually transmitted via the fecal-oral route. That means that someone with the virus handles food we eat without washing hands, after using the washroom. We can also contract the virus by drinking contaminated water, eating raw shellfish from water polluted with sewage or being in close contact with the person who is infected. WHO IS AT RISK? * People are at a high risk if they travel or work in regions with high rates of hepatitis A. These include many countries in Africa, Asia, Central America and South America. * Travellers are at some risk even if you stay in luxury hotels and are not careful about what they eat. * Life at American Indian, Alaskan natives or other communities that lack proper public services are vulnerable to hepatitis A outbreaks. * Homosexuality. * Working in a research setting where you may be exposed to the virus * Have haemophilia, or receive clotting factor concentrates for another medical condition. In rare cases hepatitis A may be transmitted through blood transfusions. In general, food handlers, healthcare workers and children who attend child care are at increased risk of contracting hepatitis A, although outbreaks of hepatitis A sometimes occur in child care settings, they can be prevented if workers follow good hygiene practices. People who consume dirty drinking water, that mixed with sewerage, are also at risk. The global situation HEPATITIS-A is responsible for 1.5 million death cases worldwide. The highly endemic areas are: • Africa, • Asia (part of it) • Latin America • Cuba • Middle East • Eastern Europe Intermediate endemic areas: • South Africa • Argentina • Mexico • Thailand • Taiwan and China • Southern Europe Low endemic areas: • Northern Europe • France • North America • Japan • Hong Kong • Singapore • Australia • New Zealand In UK, the disease is believed to be responsible for 10-20 per cent cases of liver failure. In the USA, 10-30 per cent of the cases require hospitalization. In France, Hepatitis-A virus is the principle cause of liver failure (23 per cent) in children and account for 10 per cent of liver transplants. In Argentina 20 per cent of liver transplants are carried out because of Hepatitis-A virus related fulminant. PAKISTAN: A study conducted in a renowned Karachi hospital from January 1991 to August 1998, 2735 patients of Hepatitis-A were identified and out of these 2735 patients, 232 were admitted in the hospital. Among them, 30 patients developed progressive hepatic dysfunction and liver failure. Among the admitted patients with Hepatitis-A related liver failure, 83.3 per cent were encephalopathies at presentation and 36.7 per cent of the patients died. According to a recent study, conducted in a hospital in Peshawar, a total of 360 children were evaluated and out of them 82 had Hepatitis-A. Perventing Hepatitis-A? VACCINES: Hepatitis-A is a highly contagious disease. We can protect ourselves by receiving vaccine against Hepatitis-A virus and immunoglobuline, which is a prepared form of antibodies. By having two shots of Hepatitis-A vaccine we can prevent ourselves from Hepatitis-A for decades. DURING TRAVEL: If you are travelling in a region where Hepatitis-A outbreak occurs, first vaccinate yourself, wash all fruits and vegetables yourself before you eat and avoid raw or undercooked meat and fish. Be sure to drink bottled water and avoid ice cubes in beverages. If bottled water is not available, boil tap water for at least 10 minutes before drinking it. Don’t forget to use bottled water for mouthwash as well. FOOD HYGIENE PRACTICES: Simply washing your hands well and often can help protect you from infection with a number of viruses and bacteria. Wash hands after using washrooms, before preparing food or eating and after changing the child’s diaper. Don’t share towels, eating utensils or toothbrushes. If you have Hepatitis-A then protect others by: • Avoiding sex • Wash your hands thoroughly after using bathroom and dry your hands with a disposable towel. • Keep your utensils separate and wash utensils and dished with plenty of hot, soapy water. • Don’t prepare food for others while you are actively infected with Hepatitis-A. HOW DO WE TREAT HEPATITIS A: • No specific treatment exists for Hepatitis-A. • Take adequate nutrition and if nauseated, eat small snacks throughout the day instead of three large meals. • Eat soft, easily digested food such as soup or broth, yogurt and toast may be the most appealing. • Avoid alcohol during the acute phase of illness. COMPLEMENTARY AND ALTERNATIVE MEDICINE: The herb ‘milk thistle’ (silybum marianum) has been used for centuries to treat jaundice and other liver disorders. Today, scientific studies have confirmed its healthy impacts on liver. Silymarim seems to stimulate the production of antioxidant enzymes that help the liver to neutralize toxins. It also seems to increase the production of new liver cells and even improve the severs scarring of cirrhosis. But it will not cure hepatitis and it won’t protect you from contracting the virus. Diagnosing a Hepatitis-A patient SOMETIMES a hepatitis patient can be diagnosed by the symptoms you have that include yellowish colour of eyes and the urine. Some laboratory tests can accurately diagnose whether the patient has been infected or not. Doctors may check the amount of billirubin and look for elevated blood levels of enzymes known as aminotransferases. The patient will also require a blood test called Radioimmunoassay to pinpoint the exact type of Hepatitis he or she has. THE COMPLICATIONS: In most cases of Hepatitis-A, the liver heals completely in a month or two with no lasting damage. Older people with other medical problems, such as congestive heart failure, diabetes and anaemia may take much longer time to recover and are likely to have a more serious course of the disease. In rare cases, life threatening conditions, liver failure may develop especially in those people with chronic liver disease or a liver transplant. | ||
Though less talked about in Pakistan, Hepatitis-A is a dangerous disease. The threat may, however, vanish if things are managed properly|
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