It affects everyone, everywhere. Know it. Confront it

In Pakistan, owing to the lack of preventive measures and treatment facilities, hepatitis prevalence is the highest on the globe. To better understand this silent epidemic, You! talks to Professor Dr. Ghulam Ali Mundra Walla, M.D, Anklesaria Hospital, Karachi...

Sana, a 19-year-old student after coming back from college felt a little feverish. After a while she started having a headache. Her condition got worse as days passed, and she started experiencing nausea and loss of appetite. When she discussed her problem at home, they gave her some tablets and told her she will be fine in no time. After a few days Sana was rushed to the nearby hospital and after conducting various tests, the result was hepatitis C positive. Sana was suffering from mild jaundice for some days now and was experiencing joint pain and her urine was also darker than usual. But Sana didn't consult a doctor. Upon inquiring, the specialists found out that she had sugarcane juice from a local 'thelay wala' which was contaminated with Hepatitis C virus.

Another example is of 28-year-old Zainab who is a school teacher and resident of Gulshan-e-Iqbal. She was having flu like symptoms for some days. But later on she started feeling constant fatigue and muscle aches throughout the day, accompanied by nausea and mild pain in her upper right abdomen. When she consulted a doctor she found that she had Hepatitis B. Due to her ignorance, Zainab's medical condition worsened. Only if she had seen a doctor at the right time, she would be cured at a much earlier stage. 

These are just a few examples that have been cited above. In Pakistan, owing to the lack of preventive measures and treatment facilities, hepatitis prevalence is the highest on the globe.

Unfortunately, every 10th person in the country is suffering from one type of hepatitis or the other. The viral infection varies in severity from a self-limited condition with total recovery to a life-threatening or lifelong disease. Experts reveal that over 20 million people in Pakistan are infected with hepatitis B and C virus - approximately 15 million with C and five million with B and the disease is spreading rapidly. An estimate shows that over 1.5 lac hepatitis patients die annually, which means that over 400 people lose their lives to hepatitis every day.

According to the World Hepatitis Alliance, about 500 million people are currently infected with chronic hepatitis B or C and 1 in 3 people have been exposed to one or both viruses. Various surveys also show that every year 1.4 million people lose their life to the deadly viral disease. The World Health Organization (WHO) data shows that an estimated 325 million people worldwide are living with chronic hepatitis B or C.

But what is hepatitis? To better understand this silent epidemic, You! talks to Professor Dr. Ghulam Ali Mundra Walla, M.D, Anklesaria Hospital, Karachi. "Hepatitis simply means inflammation of the liver. Five types of hepatitis have been detected which are caused by different viruses - Hepatitis A, B, C, D and E. Hepatitis A, B, C and E are viruses while hepatitis D is a parasite which means it needs to feed on some virus to spread in the body. To put it simply, types A and E are short term infections and are known as acute infection, while hepatitis B, C and D are long-term chronic infections," informs Dr Mundra Walla.

"Hepatitis is 99 per cent viral. Usually, people get infected with hepatitis A due to food and water contamination. In our part of the world, hepatitis B and jaundice (hepatitis C) are the most common," he adds.

Regarding the vaccines that are available, Dr Mundra Walla says, "Vaccines are available for hepatitis A and B. But there are no vaccines for the remaining three types. If a child is vaccinated with Hepatitis B vaccine soon after birth then the disease is cured for life. And there are rarely any chances of the virus coming back."

When asked if others are at risk of catching Hepatitis, Dr Mundra Walla shares, "Yes, it is very much transferrable. Hepatitis A and E can be transferred through mouth very easily. Hepatitis B, C and D are transferred by blood - be it a wound, or by the sharing of needles, equipment injecting cosmetic substances, steroids or drugs. Quack dentists and barbers who run their businesses on the footpaths usually transfer these viruses to their customers. Let me explain how! Actually these barbers and unqualified dentists use unsterilized equipment and if a cut or wound is involved in the process then the virus is automatically transferred through the blood.

Can hepatitis be transferred from a mother to her child? In this regard, Dr Mundra Walla states, "Hepatitis E is the most common in pregnant women and if not cured at the right time can also result in death of the mother and her child. Also, expectant mothers who come to me are mostly suffering from Hepatitis B. But that doesn't mean that the virus will be transferred to the child as well. To ensure that the child doesn't catch the virus, we vaccinate the new born with Hepatitis B vaccine."

 

"Sadly, we don't pay heed to our health and avoid going for regular checkups. Even if there are indications that we have some ailment, we just ignore it. I don't blame the people entirely because the healthcare system in Pakistan is in shambles. And ironically most people here resort to 'pirs' and 'hakeems' for the treatment of such chronic diseases. Please stay away from such rituals and consult a qualified doctor," stresses Dr. Mundra Walla. "I advise everyone to get regular blood tests done and get treated as soon as you find out that you have a problem. Hepatitis is a disease that is curable only if one consults a professional at the right time. This disease eats you up from inside slowly and gradually. And because there are hardly any symptoms initially, hepatitis viruses usually go unnoticed," he concludes.

 

WORLD HEPATITIS DAY

In order to spread awareness regarding Hepatitis, the World Hepatitis Alliance (WHA) first launched World Hepatitis Day in 2008. However, it was in 2010 that the United Nations officially declared 28th July as World Hepatitis Day. Now, this day is observed very actively in more than 100 countries worldwide. This year's theme of World Hepatitis Day is 'Eliminate Hepatitis'.

The main aim of observing this day is to raise awareness about viral hepatitis, and to call for access to treatment, better prevention programmes and government action. 

Types of Hepatitis

Hepatitis A is primarily spread when someone ingests the virus from contact with food, drinks, or objects contaminated by faeces from an infected person or has close personal contact with someone who is infected. Hepatitis A does not cause chronic liver disease and is rarely fatal, but it can cause serious symptoms. Hepatitis A can be prevented through improved sanitation, food safety, and vaccination.

Hepatitis B is often spread during birth from an infected mother to her baby. Infection can also occur through contact with blood and other body fluids through injection drug use, unsterile medical equipment, and sexual contact. The hepatitis B virus can cause both acute and chronic infection, ranging in severity from a mild illness lasting a few weeks to a serious, chronic illness.

Hepatitis C is spread through contact with blood of an infected person. Infection can occur through injection drug use and unsafe medical injections and other medical procedures. Mother-to-child transmission of hepatitis C is also possible. Hepatitis C can cause both acute and chronic infections, but most people who get infected develop a chronic infection.

Hepatitis D is passed through contact with infected blood. Hepatitis D only occurs in people who are already infected with the hepatitis B virus. People who are not already infected with hepatitis B can prevent hepatitis D by getting vaccinated against hepatitis B.

Hepatitis E is spread mainly through contaminated drinking water. Hepatitis E usually clears in 4-6 weeks so there is no specific treatment. However, pregnant women infected with hepatitis E are at considerable risk of mortality from this infection. Hepatitis E is found worldwide, but the number of infections is highest in East and South Asia. Improved sanitation and food safety can help prevent new cases of hepatitis E.