World Hepatitis Day, 28 July 2012

Hepatitis is widely acknowledged as a serious illness. But when one considers that over two billion people have been infected with hepatitis B alone in a global population of seven billion, it is clear just how great a problem hepatitis really is.

As part of the Government Employees Medical Scheme's (GEMS) ongoing effort to educate existing and future members on a range of healthcare topics, we would like to explore certain important healthcare issues. This article looks at the subject of hepatitis this World Hepatitis Day, 28 July 2011.

What is hepatitis?
Hepatitis is when the liver becomes inflamed, typically as a result of a viral infection. It is classified according to five main types - namely A, B, C, D and E. Globally, types B and C together are the primary cause of liver cirrhosis and cancer, devastating the lives of hundreds of millions and often leading to death.

Below you will find more information on hepatitis A, B and C, which are the most common types of the disease in South Africa.

Hepatitis A

What causes the infection?

Hepatitis A is found in the faeces of an infected person. It is most commonly spread when people eat or drink food or liquid that has come into contact with the virus. For example, if a waiter does not wash his or her hands after using the bathroom and then serves customers their food and drink, they can become infected with the virus. Babies and small children who are not yet familiar with hygiene practices can spread the disease. Sexual contact with an infected person can also be a risk for contracting hepatitis A.

What happens if I have hepatitis A?

Hepatitis A tends to be less severe with the majority of people recovering completely within a matter of months and remaining immune from further infections. However, in rare cases hepatitis A can be dangerous to one's health.

Symptoms include:
o Fatigue
o Nausea
o Fever
o Aching muscles
o Pain on the right side of the stomach
o Lack of appetite
o Weight loss without any changes to diet or exercise routine
o Jaundice - yellow skin
o Dark urine or stools

What should I do if I think I have hepatitis A?

The best thing to do is to visit your doctor who will do a test to see if you are infected. You will not need to take any medication and your liver will most likely heal on its own. During this time you need to rest, drink plenty of water, eat healthily, avoid toxic substances such as alcohol and tell your doctor about any medication you may be taking. If you do not get better by yourself you may have to the hospitalised.

It is also important to help prevent the spread of hepatitis A by telling the people who live with or are intimate with you that you are infected. Washing your hands regularly and thoroughly with soap and avoid sexual intercourse until the infection has cleared.

How can I prevent hepatitis A?

 Get vaccinated against it if you are at risk of contracting it when travelling or in your day-to-day environment.
 Wash your hands properly after using the bathroom, after changing nappies and before preparing food.
 Do not eat or drink anything that you think may have been prepared in unhygienic circumstances.
 Always wash your dishes and glasses in hot water with dishwashing liquid.
 Stop children from putting inedible objects into their mouths.

Hepatitis B

What causes the infection?

Hepatitis B virus is extremely infectious; in fact it is 50 to a 100 times more infectious than HIV. In infected people it is found in bodily fluids such as blood, semen, sweat, tears and even breast milk. If you are exposed to any of these bodily fluids of an infected person you will most probably contract hepatitis B.

What happens if I have hepatitis B?

You may not know that you have the illness as you may not experience any symptoms and you will probably recover quickly. However, if it persists for a long period of time and you are not receiving treatment then damage can be caused to your liver.
Symptoms include:
o Nausea
o Fatigue
o Skin rash
o Stomach ache
o Diarrhoea or constipation
o Aching joints
o Jaundice - yellowing of the eyes or skin, usually only after other symptoms have started to disappear

What should I do if I think I have hepatitis B?

You should visit your doctor, as, while the infection will most probably go away on its own, it is better not to take any risks with the health of your liver. During your period of recovery you should do much the same as you would if you had hepatitis A, namely rest, drink plenty of water, eat healthily, avoid toxic substances such as alcohol and tell your doctor about any medication you may be taking.

If you have chronic hepatitis B and your liver has been damaged you can still live an active and fulfilling life with the proper treatment, regular check-ups and by following your doctor's instructions carefully.

It is very important that you tell the people who you live with or are intimate with that you have hepatitis B and to try not to allow any of your bodily fluids come into contact with others.

How can I prevent hepatitis B?

 The hepatitis vaccine is the most effective method of preventing infection. It usually comes in a series of three or four shots and is highly recommended for adults who are at risk of contracting the illness. It should be administered to babies, children and teenagers.
 Wash your hands properly after using the bathroom, after changing nappies and before preparing food.
 Do not eat or drink anything that you think may have been prepared in unhygienic circumstances.
 Always wash your dishes and glasses in hot water with dishwashing liquid.
 Stop children from putting inedible objects into their mouths.

Hepatitis C

What causes the infection?

Hepatitis C is not as infectious as hepatitis B as you can only contract it when you are exposed to the blood of an infected person. However, it is still a major health problem with over 130 million people in the world having a chronic hepatitis C infection at present. If you share needles with another person to inject drugs, have a vaccination with a used needle or get a tattoo with a needle that has not been properly sterilised, you are at risk of contracting hepatitis A. The illness can also be passed on from mother to child or accidentally from a patient to a healthcare worker, although these types of cases are very rare. It is not yet known whether you can contract hepatitis C from having sexual contact with an infected person. You cannot get hepatitis from hugging, kissing or sharing food with an infected person.

What happens if I have hepatitis C?

Like other types of hepatitis, you may not know that you have it straight away and often not until you already have some liver damage. It can take years to reach this point. While there are some cases where the infection clears up quickly, the majority of sufferers develop chronic hepatitis C. If left untreated it can lead to serious liver disease such as cirrhosis and cancer.

Symptoms include:
o Nausea
o Extreme exhaustion
o Aching muscles and joints
o Stomach ache
o Itching skin
o Dark urine
o Jaundice - yellow eyes and skin, usually only after other symptoms are starting to disappear

What should I do if I think I have hepatitis C?

Most of the time people find out that they have hepatitis C when they are being tested for something else because it does not always present with symptoms and therefore you may not ever think you need to be tested for it. If you think you may have been exposed to hepatitis C at some point or if you are showing any of the symptoms you should visit your doctor for a test. If you do have hepatitis C then you may need to take anti-viral medicine, though this is not necessarily right for everybody. If you only have mild liver damage you will probably be able to recover without using medicine.

When recovering from hepatitis C it is very important to look after your body by eating healthy food, exercising and resting. You should avoid drinking alcohol, smoking, and taking any drugs or medicines that may be difficult for your liver to process.

How can I prevent hepatitis C?

Unfortunately there is no vaccine available for preventing hepatitis C. However, you can avoid contracting it and help to prevent the spread of it by ensuring that you are only ever vaccinated with a new needle, by not sharing needles with others and, if you want to get a tattoo, by only ever visiting a clean and reputable tattoo parlour that uses properly sterilised needles.

For any GEMS member queries please phone the GEMS call centre on 0860 00 4367 or visit our website at www.gems.gov.za. GEMS will assist you in every way possible to ensure your family's health and wellbeing.

Sources:

1. The World Health Organization, www.who.int
2. WebMD, www.webmd.com
3. The South African Medical Research Council, www.mrc.ac.za