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The silent killer

As deadly as the AIDS virus, Hepatitis is a widespread disease in this part of the world. Take precautions and proper measures to combat and eradicate this illness says Shaista Ali

There were times not very long ago, that doctors were only consulted when it was almost too late. People died from a simple bout of flu, and infection untreated by antibiotics, and vaccines were virtually unheard of. Luckily, health awareness created through media and education improved the situation beyond measure. However, in recent times AIDS and HIV infected viruses have taken our focus from an equally fatal virus called Hepatitis.

Hepatitis kills more Asians each year than AIDS and is several hundred times more infectious. “A lot needs to be done to stop its spread and to educate people about this silent killer,” says gastroenterologist and hepatologist Dr Wasim Jafri. According to WHO, there are 350 million chronic hepatitis B carriers all over the world and over half of them live in the Asian continent.

According to Dr SP Dore, a gastroenterologist and liver specialist at Al-Zahra medical centre in Dubai, the treatment of Hepatitis varies from person to person. “For example, we have a 28-year-old patient who is undergoing treatment for Hepatitis C for the past six months and he is responding very well. While another patient, a 44 year old Jordanian woman affected with the same virus has not responded to the treatment at all.”

What is hepatitis?
Hepatitis is caused by the several viruses that attack the liver and which sometimes cause permenant damage. There have also been instances of Hepatitis being caused by non-viral substances such as chemicals, drugs and alcohol. There are several types of Hepatitus which have been given English alphabetical names as A, B, C, D, E and F and surprisingly each one is caused by a different identified virus.

HEPATITIS A - Is generally not serious and effects children below the age of 15. Some researchers also say it is found frequently in adults in the West.
Symptoms - Feeling under the weather, passing dark urine, yellow eyes, loss of appetite, nausea. All this is temporary and settles down in a couple of weeks. Although rare, in some cases Hepatitis A has proven fatal following a linked a complication called Fulmenant Hepatic Failure. One positive outcome of Hepatitis A is that once you have been infected your body produces life long immunity to Hepatitis A and E.
Source of infection -It could be direct contact with an infected persons feaces or indirect fecal contamination of food, water supply and raw shellfish. Contaminated hands and utensils may result in sufficient amounts of the virus entering the mouth to cause infection.

HEPATITIS B - This is the most common form of Hepatitis and is extremely unpredictable. The disease can take hold rapidly and result in a quick death. It also increases the risk of death due to cirrhosis or liver cancer. Spread through sexual intercourse or intravenous drug use, it is 100 times more infectious than AIDS and can be transmitted simply by kissing or sharing a toothbrush, cigarette or sheesha.
Symptoms - The same as Hepatitis A.
Source of infection - It spreads from mother to child at birth or soon after birth. Through sexual contact, blood transfusions or contaminated needles.

HEPATITIS C - Current statistics say that the Hepatitis C virus is far more potent and infectious than HIV virus.
Symptoms - More or less the same as mentioned above, but they vary from patient to patient. In some cases there are no symptoms but the virus lies dormant in the victim. No vaccine has yet been developed to combat Hepatitis C.
Source of infection - Transmission is through blood, infected needles, syringes and sex. The blood should be thoroughly screened before a transfusion. Some patients have sporadic Hepatitis C, the term applied to the disease by unknown mechanisms.

HEPATITIS D - It is mainly found in intravenous drug users who are carriers of Hepatitis B virus. It is an incomplete virus and affects patients who already have Hepatitis B which in turn might further complicate the disease.
Symptoms - The same as other hepatitus infections, but with diarrhoea and abdominal pain. Many cases go undiagnosed because the symptoms are suggestive of a flu-like illness.
Source of infection - Through blood transfussion and contaminated needles. It infects individuals who are already infected with Hepatitis B. It may be transmitted by carriers of Hepatitis B and D.

HEPATITIS E - It is a minor illness in a majority of circumstances, but pregnant women are an exception. The disease can prove fatal for the foetus if timely medication is not provided.
Symptoms - The same as other hepatitis viruses.
Source of infection - Blood transfusions, water contaminated with fecal matter. Passed through a pregnant women to her foetus.

HEPATITIS F - Not much is known about this virus yet. Naturally, our bodies follow a system which after a certain period of illness produces antibodies and police cells which clears the virus on its own. There are exceptions in which patients cannot get rid of the virus which later complicates into cirrhosis of the liver and if that happens then the condition is totally irreversible.
Symptoms - Vomitting of blood and accumulation of water in the abdomem which is called ascites. Another complication is extreme drowsiness resulting from the nuerological disease encephlopathy, which may cause gradual transition into coma for the infected person.

Carrying the virus
A carrier is a person who spreads the virus. Some carriers are infectious, some are not. These can be determined by a simple blood test, with the exception of Hepatitis E, a test for which is yet to be developed.

If a pregnant women develops Hepatitis, it does not increase the risk of still birth and malformation of the baby, but miscarriages have frequently been reported. In fact conception is also difficult in women with chronic Hepatitis.

All pregnant women, therefore, must test for Hepatitis B. However, Hepatitis E does have an unexplained high mortality rate during pregnancy.
Most physicians can care for a patient with an ordinary case of viral Hepatitis, however it is advisable to consult a specialist in liver diseases (hepatologist or gastroenterologist). This may be necessary if complications arise.

Taking precautions
A nutritious and well balanced diet is normally sufficient during the illness. Avoid alcohol in the acute stage of the disease since the metabolism of the alcohol stresses the already affected liver.

Sexual activity does not seem to effect the disease or recovery. but the use of condoms and prophylactics are highly recommended to prevent the diseas from infecting spouses.

Patients who have Hepatitis should not prepare meals or handle food to be eaten by others. A sincere advice to owners of all restaurants and eatery joints is to have all their staff screened for Hepatitis especially Hepatitis B.

Adequate sanitation and good personal hygiene will reduce the spread of Hepatitis A and E. This is especially true in third world countries where extra care should be taken when handling food, and water should always be boiled. Washing hands with medicated soaps is necessary for those involved in treating patients. Those of you planning to travel to areas where Hepatitis ia widespread are advised to take immunoglobin shots before leaving the country. Its protection is effective for two to six months. Appropriate preventive measures can help prevent the onset of Hepatitis A and E.

There are two types of vaccines available to prevent Hepatitis B. The most common vaccination schedule is two shots a month apart followed by a third injection six months after the first one followed by boosters.

A high incidence of liver cancer is found in some African and Asian countries. The number of cases of liver cancer or cirrhosis in patients with chronic Hepatitis C is increasing but whether the cancer rate will ever be as high as with Hepatitis B is still unknown.

There is a tremendous hope for the future through research for irradicating and improving the treatment of chronic Hepatitis. Experts estimate that more than half of all liver diseases could be prevented through media, awareness programs held on TV, schools, education centres and hospitals.

It is estimated that if all newborn children get vaccinated for Hepatitis B, the chances are that this disease can be eliminated within 15 to 20 years. The cost of treatment for hepatitis varies but is approximately Dhs 450 per week and for screening is between Dhs 75 to 150.

Courtesy: Arabianwoman

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