he World Hepatitis Day is observed annually with the main goal of generating awareness among people about the global burden of hepatitis and its treatment. Every year thousands of people die due to the disease. For Pakistan hepatitis poses a major healthcare challenge.

The liver is a vital organ. It filters blood, processes nutrients and fights infections. Hepatitis is an inflammation of the liver caused by viruses (viral hepatitis), exposure to chemicals, use of drugs and alcohol or an overactive immune system.

“Hepatitis A and E are food- and water-borne. These are caused because of unhygienic conditions and eating food prepared in unsanitary environment. Whereas types B and C are blood-borne and are transmitted through used syringes, improper sterilisation of surgical and dental instruments, tattoo machines etc,” says Prof Lubna Kamani.

According to Dr Nazish Butt, head of Gastroenterology Department at Jinnah Postgraduate Medical Centre, Karachi, “hepatitis A and E are caused by eating and drinking contaminated food and water. In Karachi, water supply lines are contaminated with sewage; in rural areas, many people consume water from lakes and pond. Animals too drink from the same sources. This is the main reason for contracting types A and E.”

Since a general awareness regarding the disease and its spread is lacking, there is a constant threat to the common people of a deadly exposure to the virus.

Dr Saeed Khan, professor of pathology and head of molecular pathology at Dow International Medical College says that hepatitis D is only found in people who are also infected with hepatitis B, and type E is predominantly found in Africa, Asia and South America.

According to the World Health Organisation’s Eastern Mediterranean Regional Office (WHO EMRO), viral hepatitis is the eighth most frequent cause of mortality globally. It was responsible for 1.34 million deaths in 2015. Approximately 257 million people are chronically infected with hepatitis B and 71 million with hepatitis C worldwide. At this rate, an estimated 20 million deaths will occur between 2015 and 2030, according to estimates.

In Pakistan, almost 12 million people suffer from hepatitis B or C. Each year brings about 150,000 new cases. A majority of the people catch this infection in health care settings without being aware of it. Thus, not only does the virus pose a serious health concern in the country but the lack of education and awareness regarding it amplifies the dangers.

Hepatitis A and E are curable and do not progress to chronic forms; however, type E is dangerous for pregnant women, elderly patients or people who already have a liver problem.

“There are chances of complications from types B and C, leading to liver scarring (cirrhosis) which causes bloody vomiting; filling of stomach with water; dizziness; possibility of liver cancer; and kidney failure. Due to these complications, the patient may have to go through a liver transplant to sustain life. Of course, the patient has to be stable and a donor available. In Pakistan, only two or three facilities can undertake liver transplants,” says Prof Kamani.

What can be done to prevent hepatitis?

The first step is raising awareness among the masses about how it is transmitted. Hepatitis A and E are food/ water-borne illnesses; therefore, eating hygienic food, avoiding outside food, drinking boiled water and washing hands frequently are some of the things advised by doctors. Good hygiene practices can save you from getting hepatitis.

For hepatitis B, C and D, which are blood-borne, the patients are advised to ensure that the instruments used by their doctors etc are sterilised; and needles/ injections used are disposable. At barbershops, one must ensure that a new blade/ razor is used every time. People are also advised to have their own own manicure/ pedicure kits while visiting beauty parlours. In case of a transfusion, one should ensure that the donor blood has been properly screened.

Hepatitis B can also be transferred through sexual contact, if one of the partners has contracted it. Use of condoms during sexual intercourse is therefore recommended.

General safety measures to prevent hepatitis include avoiding an infected person’s personal items, taking precautions when getting body piercings or tattoos and when travelling to areas with poor sanitation.

This disease is a silent killer because most people infected by it remain undiagnosed and untreated for long. This leads to complications, at times leading to death. There is a dire need to launch mass awareness campaigns employing the expertise of healthcare professionals to generate a larger understanding of the threat the disease poses. Only then can people follow safety guidelines.

The writer is a freelance journalist studying mass communication at the University of Karachi