Eliminate Hepatits for ever

Eliminate Hepatits for ever
                                                                                                                                                               by Anuradha Dash
In recent decades viral Hepatitis has not received the attention it deserves from the global community. These infections can be prevented , but most people don’t know how. We need to be serious about Hepatitis , the great killer , promote actions to prevent it and provide a Hepatitis free environment to the future generation. Taking action now will save 7 million lives by 2030.
2017 is a pivotal year for viral Hepatitis .At the world health assembly WHO Member states are set to adopt the first ever Elimination strategy for viral Hepatitis with ambitious targets and a goal to eliminate Hepatitis as a public health threat by 2030. This will be the first time national government sign up and commit to the goal of eliminating the viral hepatitis. To achieve elimination, greater awareness , increased diagnosis and key interventions including universal vaccination , blood and injection sefety, harm reduction and treatment are all needed. This means every activity that addresses viral hepatitis is a step towards elimination . Our small sincere effort can eliminate Hepatities forever. Dr Manoj Kumar Das has been working as Head of  Department of  gastroenterology in SUM & IMS Hosptal Bhubaneswar.

What is hepatitis ?

Hepatitis is an inflammation of the liver , most commonly caused by a viral infection. There are five main viruses, type A, B, C, D and E responsible for causing viral Hepatitis. These viruses are of greatest concern because of the burden of illness and death they cause globally and in India. Particularly types B and C infections leading to chronic desease to hundred of millions of people and together are the most common cause of liver cirrhosis (scarring) and cancer in our country.

How Hepatitis Viruses are transmitted.
Hepatitis A and E infections are transmitted by injestion of contaminated food and water. Hepatitis and C occur as a result of contact with blood and infected blood fluids – the same as the human immunodeficiency virus (HIV) enters our body . But Hepatitis B is 100 times more infectious than HIV. Common mode of these transmission of these virus are receipt of contaminated blood and blood products, invasive medical procedure using contaminated equipments, sharing needles for injections, and blades for shaving, infected mother to baby at birth , from family member to child and also by sexual contact. The Hepatitis B and c viruses can survive outside the body , in the environment for at least 7 days inspite of all adverse conditions. They do not spread by sharing eating utensils, sharing food or drinks, breastfeeding or hugging , caughing, sneezing or mosquito bite. So the infected people should not be discriminated at the work place and in the society.

what are the concern about Hepatitis ?
Approximately 500 million people worldwide are infected with Hepatitis B and C , if left untreated and unmanaged , Hepatitis B or C can lead to advanced liver scarring ( (cirrhosis) and other complications, including liver cancer or liver failure. While many people worry more about contracting AIDS than Hepatitits , the reality is that every year 1.5 million people worldwide die from either Hepatitis B or C much faster than they would from HIV/AIDS. In India ,the number of death due to Hepatitis B virus liver related diseases exceeds the total number of deaths due to AIDS in one year. In our country , every year about one lakh die due to HBV related liver diseases. Most people who were infected with HBV or HCV are unaware of their infection . 95% of people living with the viral Hepatitis don’t know that they are carrying a deadly infection . They are at high risk of carrying liver disease and complications and unknowingly transmit the infection to other people.
what are the clinical menifestation ?
Hepatitis Aand E cause acute infection , which subsides within a couple of months, whereas Hepatitis B and C in addition cause chronic infection which persists beyond six months . Acute infection occurs with limited or no symptoms, or may include symptoms such as jaundice ( yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdomonal pain. Most persons fully recover , but a small proportion of persons can die from acute hepatitis . Hepatitis E is the commonest and hepatitis B the second common cause for accute Hepatitis in India . Pregnant women are at risk of death if they acquire Hepatitis E infection during pregnancy. Hepatitis B is the common cause of chronic Hepatitis, cirrhosis and liver cancer in India .
can viral Hepatitis be prevented?
Viral hepatitis can be prevented . prevention of Hepatitis A and E transmission can be achieved by improvements in sanitation and sewage disposal, measures for water and food safety , and health education on hygiene practices. Safe and effective vaccines are widely available for the prevention of the Hepatitis A and HEV vaccine has recently been licenced, which will available in India soon. For Hepatitis B vaccines are available since 1982,which has an out standing record of safety and effectiveness. It can be administered at any age and even in pregnancy. Protection lasts for lifelong, no booster injection is required. So vaccination once in the lifetime can prevent the deadly Hepatitis B infection. 300.000 cancer deatha a year can be prevented by Hepatitis B vaccination . There is no vaccine for Hepatitis C, research is on, prevention of HCV infecton depends on prevention of transmission into our body.
Do we have treament for viral Hepatitis?
Those who are already infected and diagonised early very effective treatments are available which can control and cure the infection. 4,000 people die every day yet life saving medicine exist. For very advanced disease liver transplantation is the option, where the liver is changed with another healthy liver. Early diagnosis provides the best opportunity for effective medical support and prevention of further spread . Early diagnosis of those with chronic infection allow people to take precautions to protect the liver from the additional harm, specifically by abstaining from alcohol and tobacco consumption and avoiding certain drugs that are known to be toxic to the liver
why world Hepatitis day celebrated ?
The annual campaigning marked on 28 july, aims not only to rais awareness among general public and infected patient , but also urgently promote improved access to Hepatitis service, particularly prevention,interventions, and step towards the elimination of hepatitis by 2030. The day of 28 July chosen for world Hepatitis day in honor of the birthday of Nobel Laureate Professor Baruch Samuel Blumberg , discover of the Hepatitis B virus and d first Hepatitis B developer of the first Hepatitis B vaccine.

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