LifeStyle

Opening the Doors to Healthier and Stress-Free Living

One sees them quite often—the ones who quickly dash out of the bathroom stall or urinal area and go out the door without washing their hands. They touch the door handle as they exit, leaving the next person to touch the knob, thereby spreading their germs and, perhaps, their disease. As these persons go about their day, who knows whom they infect by normal contact. What is even scarier is the many other unobserved people who do not wash up after using the restroom.

Colds, flu, strep throat, and other illnesses could be reduced tremendously if people took the time to wash their hands thoroughly. Even more important, the incidence of other diseases like hepatitis A and E could also be reduced.

One hears occasionally about someone contracting hepatitis A and E via food. This happens more often than is widely known and could be easily avoided if everyone used proper sanitization techniques. Unfortunately, when handling food in the public arena, one person with such an illness can infect multitudes of people, causing illnesses to spread.

The following is a brief overview of the different kinds of hepatitis:

Hepatitis A: is a liver disease caused by the Hepatitis A virus.

Who is at risk: Anyone.

Transmission: Fecal-oral; food/waterborne outbreaks; blood borne (rare); Household/sexual contacts with infected persons; International travelers; Persons living in American Indian reservations, Alaska Native villages, and other regions with endemic hepatitis A; during outbreaks: day care center employees or attendees; sexually active homosexual men, intravenous drug users.

Symptoms: Jaundice, fatigue, abdominal pain, loss of appetite, intermittent nausea, diarrhea

Prevention: Good personal hygiene and proper sanitation. Vaccines are also available for long-term prevention of hepatitis A virus infection in persons two years of age and older. Immune globulin is available for short-term prevention of hepatitis A virus infection in all ages.

Treatment: No chronic infection.

Hepatitis B: Hepatitis B is a serious disease caused by a virus that attacks the liver. The virus, which is called hepatitis B virus (HBV), can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death.

Who is at risk: Intravenous drug users; sexually active heterosexuals; men who have sex with men; infants/children of immigrants from disease-endemic areas; infants born to infected mothers; hemodialysis patients; health care workers; low socioeconomic level.

Transmission: Blood borne, sexual, and perinatal.

Symptoms: Jaundice, fatigue, abdominal pain, loss of appetite, intermittent nausea, and vomiting.

Prevention: Hepatitis B vaccine available since 1982. Screening pregnant women and treatment of infants born to infected women; routine vaccination of 0-18 year olds; catch-up vaccination of high-risk groups of all ages; and screening of blood/organ/tissue donors.

Treatment: No chronic infection.

Hepatitis C: is a disease of the liver caused by the hepatitis C virus. This is a viral illness that causes the liver to become inflamed. It is one of the leading causes for liver transplants in the United States and that about 4 million people in the U.S. have the disease. As a result, it has been reported that 1 out of 5 people infected with Hepatitis C come down with cirrhosis of the liver. Because this virus can live in the body for 10 to 20 years without any symptoms, it has been called the “Silent Epidemic.”

Who is at risk: People who engage in unprotected sex, intravenous drug use, and body tattooing and piercing under non-sterile conditions. Persons who were notified that they received blood from a donor who later tested positive for Hepatitis C; any person who has ever injected illegal drugs, even if one experimented a few times many years ago; received a blood transfusion or solid organ transplant before July, 1992; received a blood product for clotting problems produced before 1987; have ever been on long-term kidney dialysis; have evidence of liver disease (e.g., persistently abnormal ALT levels).

Transmission: Unprotected sex; intravenous drug use, and body tattooing and piercing under non-sterile conditions.

Symptoms: jaundice, extreme fatigue, abdominal pain, fever, itching, joint pain, loss of appetite, intermittent nausea, and vomiting.

Prevention: Screening of blood/organ/tissue donors; Counseling to reduce/modify high-risk practices.

Treatment: Drugs are licensed for the treatment of persons with chronic hepatitis C; Treatment is effective in 10-40% of persons. More than 90 percent of the people who contract A or B recover and become immune. There are also vaccines available for A and B, but not for hepatitis C.

Hepatitis D (Delta): HDV infection can be acquired either as a coinfection with hepatitis B (HBV) or as a superinfection of persons with chronic HBV infection. HDV is dependent on HBV for replication.

Who is at risk: Intravenous drug users; sexually active heterosexuals; men who have sex with men; infants/children of immigrants from disease-endemic areas; infants born to infected mothers; hemodialysis patients; health care workers; low socioeconomic level.

Transmission: The modes of HDV transmission are similar to those for HBV (blood borne, sexual, and perinatal), with percutaneous exposures the most efficient. Sexual transmission of HDV is less efficient than for HBV. Perinatal HDV transmission is rare. A patient can acquire hepatitis D virus infection at the same time as he/she is infected with the hepatitis B virus. This is called co-infection. A patient with hepatitis B can be infected with hepatitis D virus at any time after acute hepatitis B virus infection. This is called super-infection.

Symptoms: Jaundice, fatigue, abdominal pain, loss of appetite, intermittent nausea, and vomiting.

Prevention: Hepatitis B vaccine available since 1982. Screening pregnant women and treatment of infants born to infected women; routine vaccination of 0-18 year olds; catch-up vaccination of high-risk groups of all ages; and screening of blood/organ/tissue donors. HBV-HDV co-infection can be prevented with either pre- or postexposure prophylaxis for HBV. However, no products exist to prevent HDV superinfection of persons with chronic HBV infection. Thus, prevention of HDV superinfection depends primarily on education to reduce risk behaviors.

Treatment: Interferon-alpha is used to treat patients with chronic hepatitis B and hepatitis D infection. Some studies have suggested that a dose higher than that usually used for hepatitis B infection may be beneficial.

Hepatitis E: HEV is transmitted primarily by the fecal-oral route and fecally contaminated drinking water is the most commonly documented vehicle of transmission. Although hepatitis E is most commonly recognized to occur in large outbreaks, HEV infection accounts for more fifty percent (50%) or more of acute sporadic hepatitis in both children and adults in some high endemic areas. Unlike hepatitis A virus, which is also transmitted by the fecal-oral route, person-to-person transmission of HEV appears to be uncommon. However, nosocomial transmission, presumably by person-to-person contact, has been reported to occur. Virtually all cases of acute hepatitis E in the United States have been reported among travelers returning from high HEV-endemic areas.

Who is at risk: All the risk factors for infection among persons with sporadic cases of hepatitis E have not been defined, yet it has been determined that travelers to developing countries, especially pregnant women, are at risk.

Transmission: Transmitted through fecal/oral route. Outbreaks associated with contaminated water supply in other countries. Unlike hepatitis A virus, which is also transmitted by the fecal-oral route, person-to-person transmission of HEV appears to be uncommon. However, nosocomial transmission, presumably by person-to-person contact, has been reported to occur. Virtually all cases of acute hepatitis E in the United States have been reported among travelers returning from high HEV-endemic areas.

Symptoms: May have none. Some persons have mild flu-like symptoms, dark urine, light stools, jaundice, fatigue and fever.

Prevention: Prevention of hepatitis E relies primarily on the provision of clean water supplies. Prudent hygienic practices that may prevent hepatitis E and other enterically transmitted diseases among travelers to developing countries include avoiding drinking water (and beverages with ice) of unknown purity, uncooked shellfish, and uncooked fruits or vegetables that are not peeled or prepared by the traveler. No products are available to prevent hepatitis E.

Treatment: No evidence of chronic infection has been detected in long-term follow-up of patients with hepatitis E.

Hepatitis G: Hepatitis G virus is an RNA virus within the flavivirus group and is distinctly related to hepatitis C.

Who is at risk: People who receive blood transfusions; infants born to infected mothers; and intravenous drug users.

Transmission: HGV is transmitted through blood transfusions and intravenous drug users as well as body tattooing and piercing under non-sterile conditions.

Symptoms: jaundice, extreme fatigue, abdominal pain, fever, itching, joint pain, loss of appetite, intermittent nausea, and vomiting.

Prevention: Screening of blood/organ/tissue donors; Counseling to reduce/modify high-risk practices.

(Please note that the purpose of this article is not to replace medical expertise, but has been written merely for informational benefit. --aam)

Borland Groover Articles. http://www.borland-groover.com/articles/hepatiti.htm
Center for Disease Control. Viral Hepatitis. http://www.cdc.gov/ncidod/diseases/hepatitis/index.htm
Hepatitis Central. “Hepatitis G Virus Infection: A Work in Progress,” Annals of Internal Medicine, 1 November 1996. 125:772-773. http://www.hepatitis-central.com/hcv/hgv/work.html
Hepatitis Education Project http://www.scn.org/health/hepatitis/
Hepatitis Foundation International. http://www.hepfi.org/
Jones, M. L. (2001). “Hepatitis C: The ticking time bomb of Kentucky's prisons,” LEO, January 31, 2001.
MDConsult http://home.mdconsult.com/das/patient/view/41/5470.html/top?sid=20147610
Worman, H.J. (1995) “Hepatitis D,” Current Papers in Liver Disease. http://www.hepnet.com/hepd/wormhdv.html