Protection From Hepatitis B– Hepatitis awareness.

Standard

hepatitisHepatitis awareness – Protection from HBV.

The hepatitis B Virus (HBV) interferes with the functions of the liver and activates the immune system.  This triggers a specific reaction. The consequence of pathological damage to the liver results in the liver becoming inflamed. Though most individuals overcome this infection, a small percentage cannot, as a result they remain chronically infected. These patients are high risk as they could potentially develop into cirrhosis of the liver or even liver cancer.

HBV transmits through blood or body fluids from an infected person, just like HIV does, and is 50-100 times more infectious.  One could infected HBV by—

  • Prenatal transfer that is from mother during pregnancy
  • Child-to- child transmission
  • Unsafe blood and blood component transfer
  • Sexual transfer
  • Contaminated healthcare equipment

Of these the prenatal and reuse of unsterilized needles and syringes dominate.

Earlier almost all children of developing countries developed HBV but with the widespread use of hepatitis B vaccine, outstanding record of safety and effectiveness has been achieved.

Over one billion doses have been used worldwide since 1982 and the affectivity has been 95%.  Once vaccinated the protection lasts for 20yrs. But as of today there are no boosters recommended by WHO.

 

 

Hepatitis awareness– Hepatitis B Virus.

Standard

hepatitisJuly 28th is world Hepatitis awareness day.

Hepatitis Awareness – Hepatitis B Infection caused by Hepatitis B Virus (HBV) is potentially life threatening and a major global health hazard. It could cause chronic liver disease putting people to a high risk of cirrhosis of the liver and liver cancer. About 240 million harbour chronic liver infection i.e. is long-term liver infection and more 780000 people die annually as a consequence of this. Since 1982 vaccines are available against this., it is has a 95% efficacy rate.

Geographically high rates of infections are found in Amazon and southern parts of eastern and central Europe. Middle east and Indian subcontinent as an estimate of 2-5% of the general population of the chronically infected, while western Europe documents less than 1% of the population. Prevalence’s are highest in sub-Saharan Africa and eastern Asia. People are infected during childhood and 5-10% are chronically infected. HBV causes an acute illness with symptoms that could last for several weeks. Yellowing of the skin and eyes, dark urine, extreme fatigue, nausea, vomiting, and abdominal pain are seen.

The transmission of HBV is usually from mother to child or person to person in early childhood.  This- accounts for more than one-third of the chronic infections in areas of endemicity. Sexual transmission, transmission through contaminated needles are also high in areas of endemicity. HBV can survive for 7 days outside the human host, and if it comes in contact with a person who is not immunized it can cause infection.  But it is not spread through contaminated food or water, nor can it be contracted by casual contact. The virus takes about 30- 180 days to incubate, and  virus may be detected 30 -60 days after infection.

Most people do experience any symptoms when the infection is in the acute phase, however, some people have presented  with yellowing of the skin and eyes, dark urine, extreme fatigue, nausea, vomiting and abdominal pain, these symptoms last for several weeks. Some people harbour the disease in a chronic form which has the potential to progress into liver cirrhosis or liver cancer. Healthy individuals have a recovery of 90% and  are completely rid of the virus within 6 months.

The risk of HVB becoming chronic depends on the age that a person gets infected. Children exposed below the age of 6yrs tend to develop chronic infection. Less than 5% of healthy adults who contract HBV become chronic. Of 15-20% of the adults who became chronically infected from childhood, die of HBV related liver disease like cirrhosis or cancer.

As diagnosis is not possible on clinical grounds, blood tests would be required. This helps to identify chronic and acute condition,by focusing on the HB surface antigen HBsAg. WHO recommends that all blood donations should be screened so that it is transferred to the recipient.

There is no specific treatment for Hepatitis B.  Care is aimed at maintaining adequate nutritional balance, and comfort this includes replacement of fluids lost due to vomiting and diarrhoea. People with chronic hepatitis B can be treated with drugs, including interferon and antiviral agents. Treatment can slow with progression  to cirrhosis and cancer and improve long-term survival . liver cancer is the most fatal complications of hepatitis B and occurs at an age when people are most productive and have family responsibilities.

The HB- vaccine is the mainstay for prevention. WHO recommends that it should be administered as soon as possible preferable within 24hrs. Of birth.  The birth dose should be followed by 2-3 doses. The dosage would a first one at birth while the 2nd and 3rd given at the same time as the 1st and 3rd dose of DTP. All children and young adults below the age of 18yrs should receive the vaccine if they live in a country where there is low or intermediate endemicity. High risk people should also be vaccinate. The high risk people are—

  • People who require constant blood or blood product transfers,
  • People interned in prisons.
  • Drug abusers,
  • Household and sexual contacts of people with chronic HBV infection
  • People with multiple sexual partners, health workers and others exposed to blood and blood products through work.
  • People who are not vaccinated, but are travelling to areas of endemicity.

Since its debut in 1982 billion doses of hepatitis B is in used worldwide. Since 1992 many member states have made it part of their vaccination schedule.

The WHO is working in the following areas to prevent and control viral hepatitis.

  • Raising awareness, promoting partnerships and mobilizing resources.
  • Formulating evidence based policy and data for action
  • Prevention of transmission
  • Promoting access to screening and care treatment services.

Hepatitis B is a viral that attacks the liver and can cause both acute and chronic disease. The virus is transmitted through contact with blood or other body fluids from an infected person. About 780,000 people die each year as a consequence of hepatitis B. Hepatitis B is an important occupational hazard for health workers. It is preventable by using a vaccine.

World Hepatitis awareness Hepatitis C

Standard

hepatitisJuly 28th is the world Hepatitis awareness day.

The Hepatitis C virus causes both acute and chronic infection.

Acute is something that is happens quickly, it is usually asymptomatic and rarely life-threatening. About 15-45% of the infected people spontaneous heal within 6 months and do not require treatment. The other 55-85%  go into the chronic stage. Of whom 15-30% could develop into cirrhosis of the liver in 20 yrs.

Geographically hepatitis C is found world wide. Though central and east Asia and northern Africa are most affected. The epidemic  could be concentrated in high risk populations like people use infected needles, or could be general. There are multiple strains of HCV virus and their distribution.

Transmission  is blood borne. And common pathways are

  • Use of infected needles.
  • Use of contaminated medical equipment without adequate sterilization.
  • Transmission of contaminated blood.
  • Transmission through body fluids and from mother to her fetus these are however rare.

Hepatitis however does not spread through breast milk, food, water or casual contact like hugging or kissing or share food with an infected person.

Symptoms  show after a period of 2 weeks or 6 months of incubation. About 80% of the people do not exhibit any symptoms. Those do exhibit acute symptoms may show fever, fatigue, decreased appetite  nausea, vomiting, abdominal pain, dark urine, grey-colored faeces, joint pain and jaundice.(jaundice is the yellowing of skin and whites of the eyes.)

Screening and diagnosis of the early stage is rare, as it is asymptomatic.  Many a times it remains undiagnosed until serious liver damage has developed.

The diagnosis of HCV is in 2 steps.

  • Screening for anti HCV antibodies with a serological test – this identifies people who have been infected with virus.
  • If the serological test is positive, a nucleic aci test for HCV-RNA  is needed to confirm  chronic strong immune response without the need for treatment. Although no longer infected they will still test positive for anti-HCV  infection  because 15-45% of the people infected with HCV spontaneously clear the infection.

Once the person is diagnosed of harboring hepatitis C the liver is damaged is assessed for fibrosis and cirrhosis. This can be done by non-invasive test. The treatment plan and disease management is decided after identifying the strain. There are 6 strains of HCV.

Getting tested:

Early diagnosis can prevent further destruction  from the disease and transmission of the virus. high risk population could periodically be screened for the infection. And high risk include

  • People who inject drugs.
  • Recipients of blood products from probable unsafe source.
  • People undergo going invasive health care procedures in healthcare facilities with inadequate infection control practices.
  • People who sexual partners of HCV infected people.
  • People using intranasal drugs.
  • People who have had tattoos or piercing.

Hepatitis C does not always require treatment as the immune system in most people can clear the infection. When necessary the goal of the treatment is to cure. The cure rate dependents on factors like the strain of virus and treatment given. The appropriate approach of treatment is decided after carefully  screening the patient.  The current standard treatment is an antiviral therapy which is a combination f interferon and ribavirin.  This combination is effective against all the strains.  Unfortunately this is poorly tolerated by in some patients and is not widely available globally either. this makes management of the treatment a little complex, many patients do not finish their treatment.

Scientific advances have lead to the development of new antiviral drugs for hepatitis C which is much more effective, safer and better tolerated than existing therapies. These therapies are known as oral directly acting antiviral agents. Therapies simplify hepatitis C by significantly decreasing monitoring requirements and by increasing cure rates.  Though the production cost of DAA is low, the intial price set by the pharmaceutical companies are high and access to these drugs could be difficult even in high income countries.

WHO is launching new guidelines for screening care and treatment of persons with hepatitis C in April 2014.  These are the first guidelines dealing with hepatitis C treatment produced by WHO and complement the existing guidance on prevention of transmission of blood borne diseases in including HCV.

These guidelines are intended for the policy makers, government officials and others working in low-and middle income countries who are developing programs for the screening, care and treatment of persons with HCV infections. These guidelines will help expand of  treatment services to patients with HCV infections as they provide key recommendations in these areas and discuss considerations for implementations.

Prevention of HCV is on three planes, primary, secondary and tertiary. There are no vaccines for HCV so primary prevention of infection depends on  reduction of the risk of exposure to the virus, in healthcare settings, and high risk populations,  here are some examples of the primary prevention interventions recommended by WHO

  • Hand hygiene—including surgical hand preparation, hand washing and use of gloves.
  • Safe handling and disposal of sharps and waste.
  • Safe cleaning of equipment
  • Testing of donated blood
  • Improved access to safe blood.
  • Training of health personnel.

Secondary and tertiary prevention for infected with the HCV WHO recommends-

  • Education and counselling on options for care and treatment.
  • Immunization with the hepatitis A and B vaccines to prevent co-infection from hepatitis viruses to protect their liver.
  • Early and appropriate medical management and administration of antiviral therapy if appropriate.
  • Regular monitoring for early diagnosis of chronic liver disease.

WHO is working in the following areas to prevent and control viral hepatitis.

  • Raising awareness, promoting partnerships and mobilizing resources.
  • Formulating evidence based policy and data for action.
  • Prevention of transmission
  • Executing ,screening, care and treatment.

Hepatitis C is a liver disease caused by hepatitis C virus it can be both acute and chronic, and can last from a few weeks to a serious lifelong disease. It is blood borne. Significant number of those who suffer from chronic infection  develop liver cirrhosis or cancer. About 350,000-500,000 people die each from HCV.  This is curable 50-90%

though diagnosis and accessibility to the treatment is low. The success rate is  5o0-90% though research is on for vaccine against HCV.

Hepatitis awareness

Standard

hepatitisWorld Hepatitis day July 28th.

Hepatitis is the inflammation of the liver. The condition is self-limiting but sometimes process to scarring called cirrhosis of the liver.  It can also progress to liver cancer.

The most common cause of hepatitis in the world is virus. Through infection, toxicities like alcohol, drugs and some autoimmune diseases can also cause this condition.

Hepatitis could be type A,B, C,D and E. These 5 types are of greatest concern, because they are potential epidemic.

Hepatitis A and E are typically caused by ingestion of contaminated food or water, while B, C and D usually occur as a result of parental contact with infected body fluids. This could happen due to contaminated medical equipments, mother to child at birth, sexual contact or contaminated equipment.

Symptoms of acute infection occurs as jaundice (yellowing of skin and eyes), dark urine, extreme fatigue nausea, vomiting and abdominal pain.

Different hepatitis identified by A, B, C, and E. All these cause liver disease, though vary in important ways.

Hepatitis A Virus (HAV) is present in the faeces of an infected person. This gets transmitted through contaminated water or food. It can spread through certain sexual practises too. If the infection is mild the person recovers and acquires immunity to the strain. It can be severe and life threatening though. The outbreak of this strain is seen in places where sanitation is poor.—vaccines are available for this.

Hepatitis B Virus (HBV) is transmitted through exposure to infected blood, semen and other body fluids. HBV can be transmitted from infected mothers to infants at the time of birth or from family member to infant in early childhood. Transmission may also occur through transfusions of HBV- contaminated blood and blood products or medical procedural equipment. Health care workers are also at the risk of HBV.

Hepatitis C Virus (HCV) is mostly transmitted through exposure of infected blood. This is transmitted through blood, body fluids, and contaminated medical equipments. Sexual transmission is also possible but it’s less common. There is vaccine for HCV.

Hepatitis D Virus (HDV) infections occur only in those who are infected with HBV. The dual infection of HDV and HBV can result in more serious disease and worse outcome. Hepatitis B vaccines provide protection from HDV infection.

Hepatitis e virus (HEV) is transmitted through consumption of contaminated water or food. HEV is a common cause of hepatitis outbreaks in developing parts of the world and is increasingly recognized an important cause of disease developed countries. Safe and effective vaccines to prevent HEV infection have been developed though not widely available.

some wellness quick fixes.

Standard

meditationAs a part of our second level of hypnotherapy we are thought EFT I somehow have a block when it comes to that.
Yet I know there quick fixes to feeling better, we are all aware of quick deep conscious breathing that helps to dissipate anxiety and fear.
Our body sends us signals tell us that we need to cleanse ourselves physically, mentally and emotionally. Many times we associate these symptoms with illness. Once we are able to associate the body signs with the cleansing required we are able to heal quickly. Here are some interesting ones that I collected from various friends who are healers.
• Applying pressure to the acupressure points between the thumb and forefinger can release blockage causing pain, tension and fatigue.
• Above technique when applied for 20 seconds, and releasing for 10 secs without letting go, repeat four times relieves headache.
• To breathe freely irrigate your nasal passage with neti pot and warm salt water. As you clear and soothe the sinuses congestion associated with the allergies disappear.
• A drop of shatdrauthagritha in each nostril before bed, allows easy breathing and cleanses the nasal pathway.
• Apple cider vinegar is a powerful purifying and detoxifying agent. Soaking for 20mnts in a warm bath infused with two cups of apple cider vinegar pulls toxins from the body and clears the blocked energy.
• The foods we eat can have a profound impact on our energy and mood. Eating a small yet satisfying meal rich in complex carbohydrate can lift the spirits and help to let go of the feelings of anger, irritability and depression.
• Few minutes of day dreaming and listening to soothing music can help to see circumstances with a new angle.
A wellness elixir—simmer three sliced lemons, one teaspoon of freshly grated ginger, one love freshly minced garlic, one-quarter spoon cayenne pepper in five cups of water till the lemon turns soft and pale, strain a portion of this into a mug . This mixture is potent antibacterial, antiviral and antifungal. This taken three times a day can ensure your symptoms never progress into a full-blown illness.
Of course wellness guru’s advice adding honey into the elixir by tablespoon until we reach our optimum sweetness tolerance, but my exposure to Ayurveda prevents me from adding honey to anything hot, as it becomes medhahaari, or debilitates the muscles.

Safe blood to save the mother,

Standard

blood donationEvery year 14th June is commemorated as the World blood donor day. The global event was held at Colombo this year.

The focus of this year’s blood donation is “Safe blood to save mothers.” The campaign aims to increase awareness on how timely access to safe blood and blood products is an essential part of comprehensive approach to prevent maternal deaths. WHO encourages all countries, and international partners working on blood transfusion and maternal health to highlight this need.

This is achievable, through commemorative events, meetings, publications, dissemination of relevant stories and experiences through media outlet, scientific conferences etc.  About 800 women die due to profuse post-partum bleeding worldwide. The awareness is to reduce this risk.

The objectives of the year’s global campaign

  • Health ministries of countries with high maternal mortality to take concrete steps to make blood and blood products from voluntary donors accessible in health care facilities.
  •  Conducting these awareness programs in partnership with maternal health care program.
  • Early pregnancy patient education to create this awareness.

Public health awareness camp gains would include one to one counselling, media coverage of the enormity of maternal mortality due to bleeding and non-availability of safe blood and blood products. Creating a database of voluntary donors.

The blood donation policy in India      http://unpan1.un.org/intradoc/groups/public/documents/APCITY/UNPAN009847.pdf