World Hepatitis Day

Welcome to another health update from the Port Moresby General Hospital.

Another very important day will happened globally on the Tuesday, July 28 - World Hepatitis Day.

This week we wanted share with you the Global Impact of hepatitis, the symptoms, and treatments.

This is a terrible disease that can have devastating affects when left untreated.

This is a disease that affects Papua New Guinea with numerous cases diagnosed every year.

 If you have any of the symptoms please consult your local Urban Health Clinic and get tested today. 

From World Health Organisation 
 

On World Hepatitis Day (28 July) WHO highlights the urgent need for countries to enhance action to prevent viral hepatitis infection and to ensure that people who have been infected are diagnosed and offered treatment.

This year, the Organisation is focusing particularly on hepatitis B and C, which together cause approximately 80% of all liver cancer deaths and kill close to 1.4 million people every year.

Know The Risks
WHO is alerting people to the risks of contracting hepatitis from unsafe blood, unsafe injections, and sharing drug-injection equipment. Some 11 million people who inject drugs have hepatitis B or C infection. Children born to mothers with hepatitis B or C and sex partners of people with hepatitis are also at risk of becoming infected. WHO emphasises the need for all health services to reduce risks by using only sterile equipment for injections and other medical procedures, to test all donated blood and blood components for hepatitis B and C (as well as HIV and syphilis) and to promote the use of the hepatitis B vaccine. Safer sex practices, including minimising the number of partners and using protective barrier measures (condoms), also protect against transmission.

Get Vaccinated
WHO recommends vaccinating all children against hepatitis B infection, from which approximately 780 000 people die each year. A safe and effective vaccine can protect from hepatitis B infection for life. Ideally, the vaccine should be given as soon as possible after birth, preferably within 24 hours. The birth dose should be followed by 2 or 3 doses to complete the vaccine series. WHO also recommends vaccinating adults who are at increased risk of acquiring hepatitis B. These include people who frequently require blood or blood products (for example dialysis patients), health-care workers, people who inject drugs, household and sexual contacts of people with chronic hepatitis B, and people with multiple sexual partners.

Get Tested, Seek Treatment
Medicines are now available that can cure most people with hepatitis C and control hepatitis B infection. People who receive these medicines are much less likely to die from liver cancer and cirrhosis and much less likely to transmit the virus to others. WHO, therefore, urges people who think they might have been exposed to hepatitis to get tested so they can find out whether they need treatment to improve their health and reduce the risk of transmission.

Global Momentum To Tackle Hepatitis
‎In September this year, countries will have the opportunity to share best practice at the first-ever World Hepatitis Summit to be held in Glasgow, Scotland. The summit, which is co-sponsored by WHO, the Scottish Government and the World Hepatitis Alliance, aims to raise the global profile of viral hepatitis, to create a platform for exchange of country experiences and to focus on working with countries to develop national action plans.

What Is Hepatitis? 
Hepatitis is inflammation (swelling and pain) of the liver and affects millions of people worldwide causing acute and chronic liver disease and killing close to 1.4 million people every year. The various forms of viral hepatitis include hepatitis A, B, C, D and E. While all these viruses affect the liver, they are spread in different ways and have different treatments. Most liver damage is caused by 3 hepatitis viruses A, B, and C. 

Hepatitis can be caused by alcohol and some other toxins and infections, as well as from our own autoimmune process (the body attacks itself). About 250 million people globally are thought to be affected by hepatitis C, while 300 million people are thought to be carriers of hepatitis B. Not all forms of hepatitis are infectious. Alcohol, medicines, and chemicals may be bad for the liver and cause inflammation. Other viruses may also cause hepatitis, such as the yellow fever virus and the virus that causes glandular fever. ‘Chronic hepatitis’ means ongoing inflammation of the liver, regardless of the underlying cause.

Remember: The liver is important for a range of functions in the body. These include regulating metabolism, making proteins, storing vitamins and iron, removing toxins and producing bile.  If the liver doesn’t work properly, it can cause serious illness or sometimes even death. 

Health Risks of Hepatitis - 
Viral hepatitis is often preventable. However, it is still considered a serious health risk because it can:
- Destroy liver tissue.
- Spread from person to person.
- Weaken the body's immune system.
- Cause the liver to fail.
- Cause liver cancer (hepatitis B and C).
- Cause death.

Types of Hepatitis

Hepatitis A - Hepatitis A is a viral disease that affects the liver. It most commonly comes from contaminated food or water. This form of hepatitis never leads to a chronic infection and does not cause chronic liver disease. Symptoms may last for several weeks, but full recovery usually occurs. Occasional deaths from hepatitis A have occurred due to chronic liver infection.

How is Hepatitis A Spread? 
A person can get hepatitis A from:
- Eating food or drinking water carrying the virus. (Infected food and water is usually a problem in developing nations where poor sanitation is common).

Prevention of Hepatitis A
- Wash your hands with soap after going to the toilet
- Only consume food that have just been cooked
- Only drink commercially bottled water, or boiled water if you're unsure of water sanitation
- Only eat fruits that you can peel if you are somewhere where sanitation is unreliable
- Only eat raw vegetables if you are sure they have been cleaned/disinfected thoroughly
- Get a vaccine for hepatitis A if you live or travel to places where hepatitis may be endemic.

Hepatitis B - Hepatitis B is a viral infection that causes liver inflammation and can lead to serious illness or death. It is spread through unsafe sex and other activities where blood or body fluids are exchanged. It can also be passed from an infected mother to her baby.  Once infected, a person can spread the virus even if he or she does not feel sick. Immunisation is the best way to reduce the risk of infection.

Most people recover from the virus within six months, but sometimes the virus will cause a lifelong, chronic infection, possibly resulting in serious liver damage. 

How is Hepatitis B Spread?  
Hepatitis B may be transmitted by:
- Having sex with an infected person.
- Sharing dirty needles.
- Being in direct contact with infected blood.
- Getting needle stick injuries.
- Mother to unborn child.
- Being in contact with an infected person's body fluids.

Prevention of Hepatitis B 
- Tell the partner if you are a carrier, ask your partner if they are a carrier
- Practice safe sex
- Only use clean syringes that have not been used by anyone else
- Do not share toothbrushes, razors, or manicure instruments
- Have a hepatitis B series of shots if you are at risk
- Only allow well-sterilized skin perforating equipment (tattoo, acupuncture, etc.).

Hepatitis C - Hepatitis C is a blood-borne virus that causes inflammation of the liver. It is commonly spread through sharing unsterile needles, syringes and other injecting drug equipment. There is currently no vaccine to prevent hepatitis C infection, but treatment is effective for some people. When the initial infection lasts for more than six months, it is called chronic hepatitis C, which may lead to cirrhosis and liver cancer. Hepatitis C is considered to be among the most serious of the hepatitis viruses. 

Many people may not feel ill when first infected with hepatitis C while others may find their urine becomes dark, and their eyes and skin turn yellow (this is known as jaundice), or they may experience a minor flu-like illness. These symptoms may disappear within a few weeks, but this does not necessarily mean that the infection has been cleared. 

How is Hepatitis C Spread?  
Hepatitis C may be transmitted by:
- Tattoo and body piercing equipment that has not been properly cleaned, disinfected or sterilised
- Sharing toothbrushes, razor blades or other personal items that could have small amounts of blood on them
- One person’s blood coming into contact with open cuts on another person
- Pregnancy or childbirth – there is a five percent chance of a mother with chronic hepatitis C infection passing on the virus to her baby during pregnancy or childbirth. Breastfeeding is safe unless nipples are cracked or bleeding
- Blood-to-blood contact during sex – sexual transmission rates of hepatitis C are very low, but the risk is increased with certain sexual practices or circumstances where there is the possibility of blood-to-blood contact (for example, sex during menstruation, and rough sex that can cause a tear. 

Prevention of Hep C - 
- Never share needles.
- Avoid direct exposure to blood or blood products. 
- Don't share personal care items. 
- Choose tattoo and piercers
- Practice safe sex. (It is rare for hepatitis C to be transmitted through sexual intercourse, but there is greater risk of getting hepatitis C if you have a sexually transmitted disease, HIV, or multiple sex partners or if you engage in rough sex). 

Hepatitis D ​- Only a person who is already infected with hepatitis B can become infected with hepatitis D. Hepatitis D infection can occur as a co-infection, which means it occurs at the same time as hepatitis B infection; or it can occur as a superinfection in people who already have chronic hepatitis B. Infection is through contact with infected blood, unprotected sex, and perforation of the skin with infected needles. The liver of a person with Hepatitis D swells. 

Prevention - Use the same guidelines as for hepatitis B. Only a person who is infected with hepatitis B can become infected with hepatitis D. 

Hepatitis E - Hepatitis E is transmitted via the faecal-oral route and can be spread by eating or drinking contaminated food or water. The highest rates of hepatitis E infection occur in regions where there is poor sanitation and sewage management that promotes the transmission of the virus.  Hepatitis E causes an acute (short-term) illness but does not cause a chronic (life-long) infection.

Prevention - At present, no vaccine exists for the prevention of hepatitis E. As hepatitis E is spread through the fecal-oral route, prevention of hepatitis E relies primarily on having access to clean drinking water and using good personal hygiene.

Signs and Symptoms

Many people with hepatitis experience either mild symptoms or none at all. The initial phase of hepatitis is called the acute phase.
The symptoms are like a mild flu and may include:
- Diarrhoea
- Fatigue
- Loss of appetite
- Mild fever
- Muscle or joint aches
- Nausea
- Slight abdominal pain
- Vomiting
- Dark urine
- Light-coloured stools
- Jaundice (yellowing of the skin and whites of the eyes)

If you are experiencing many of these symptoms, please see your doctor at your local urban health clinic and get tested.

Tests and Diagnosis and Treatment     

Hepatitis A Treatment - There is no treatment specifically for hepatitis A. The doctor will advise the patient to abstain from alcohol and drugs during the recovery. The vast majority of patients with hepatitis A will recover spontaneously.    

Hepatitis B Treatment - There is no treatment for “acute” hepatitis B as most adults will naturally clear the virus.  Treatment is available for “chronic” hepatitis B. Your doctor will advise which method is right for you. 

Hepatitis C Treatment – Hepatitis C infection is treated with antiviral medications intended to clear the virus from your body. Your doctor may recommend a combination of medications.

Hepatitis D Treatment - There is no specific treatment for hepatitis D. 

Hepatitis E Treatment – There is no treatment for hepatitis E. Hepatitis E is caused by a virus which means antibiotics are of no value in the treatment of the infection. Treatment of hepatitis E infection is supportive and involves bed rest and fluid replacement.               

Remember: If you think you may have hepatitis it is important to see your doctor at your local urban health clinic and get tested. 

Related Post

• Asylum seekers in Nauru needing medical care to be flown to PNG, not Australia