Eradicating Hepatitis

The world is confronted by new diseases such as MERS almost every year, but ironically the biggest number of casualties is caused by 'old' diseases for which treatments and even vaccines are readily available. Millions of people especially in the Least Developing Countries (LDCs) die every year needlessly because they lack access to treatment and vaccines for these diseases.

Hepatitis is one such disease which still claims more than 1.4 million lives every year. The prevalence of Hepatitis is so high that the World Health Organisation (WHO) has declared a special day to raise awareness on this disease. On July 28, countries around the world will hold special events to mark World Hepatitis Day. The date of July 28 was chosen for World Hepatitis Day in honour of the birthday of Nobel Laureate Professor Baruch Samuel Blumberg, discoverer of the hepatitis B virus and developer of the first hepatitis B vaccine.

Awareness

On World Hepatitis Day, 28 July 2015, WHO and partners will urge policy-makers, health workers and the public to act now to prevent infection and death from hepatitis under the general theme "Prevent Hepatitis". Millions of people across the world now take part in World Hepatitis Day, to raise awareness about viral hepatitis, and to call for access to treatment, better prevention programs and government action. On World Hepatitis Day, events will take place around the world focusing on preventing hepatitis B and hepatitis C.

Viral hepatitis is an inflammation of the liver caused by a virus. There are five different hepatitis viruses, hepatitis A, B, C, D and E. Worldwide 400 million people are living with hepatitis B or C. (The WHO together with the World Hepatitis Alliance has organised a 4,000 Voices campaign to raise a voice in their support).

In particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer. Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of contact with infected body fluids. Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment and for hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact. Acute infection may occur 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 abdominal pain.

Prevented

Every year 1.5 million people die from various forms of viral hepatitis and yes, nearly all of these deaths could be prevented. According to the WHO, with better awareness and understanding of how we can prevent hepatitis we can eliminate this disease and save 4,000 lives a day. That is why in 2010 the World Health Organization made World Hepatitis Day one of only four official disease-specific world health days, to be celebrated each year on the 28th July (the others are TB, Malaria and AIDS/HIV). In May 2014, World Health Assembly delegates from 194 governments adopted a resolution to promote global action to prevent, diagnose, and treat viral hepatitis.

The most pathetic aspect of the Hepatitis saga is that a vaccine exists that is almost 100% effective at preventing hepatitis B, yet there are an estimated 240 million people living with chronic infection. However, what is needed even more is access to information on the diseases, especially the preventive measures that can be taken.

Fatalities

Unsafe blood, unsafe injections, and sharing drug-injection equipment can all result in hepatitis infection. More than two million people a year contract hepatitis from unsafe injections. Using sterile, single-use syringes can prevent these infections. Approximately 780,000 persons die each year from hepatitis B infection. A safe, effective and reasonably priced vaccine can protect from hepatitis B infection for life. In many countries, this is administered free of charge. In case you somehow contract the disease, effective medicines exist to treat hepatitis B and C.

The disease is prevalent in Sri Lanka as well, but fatalities are low compared to many other developing countries thanks to our excellent healthcare system. Nevertheless, several steps have been proposed to eradicate all forms of this disease from the country. (Hepatitis A accounts for the majority of cases in Sri Lanka and it is endemic in almost all parts of the country and occurs throughout the year).

Among the major proposals are: Establish a National Task force on control and prevention of Hepatitis in Sri Lanka; Strengthen surveillance (particularly laboratory surveillance) of Hepatitis; Improve excreta disposal systems at local administrative level; Ensure safe drinking water; Introduce of Hepatitis A vaccine for high risk groups; Strengthen law enforcement to ensure environmental sanitation and ensure universal infant immunization against hepatitis B. This particular vaccine has been available for 15 years.

Reminder

The print and electronic media have a bigger role to play in this context by disseminating information on the ways of transmission and prevention of various forms of Hepatitis. The old adage that 'prevention is better than cure' applies here too, as preventive measures often cost nothing. For example, if an effort is made to consume only safe water and immunize all children (not just hepatitis but also against all other life threatening diseases), the prevalence of Hepatitis can be drastically reduced. But people do need to receive more knowledge on preventive measures.

While the Hepatitis Day is a timely reminder of what should be done to contain Hepatitis, those efforts must not be confined to one day or one month, but continue throughout the year in all provinces with the assistance of WHO. There is a false notion that many of the 'old' diseases such as TB, Malaria and Hepatitis are no longer prevalent.

Even though there is a drop in the rate of infection, these diseases remain a threat to our society, especially the children. All possible efforts must be undertaken to prevent their spread.