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.