Medical

The Facts About Hepatitis. Do You Need Vaccinated Before Traveling?

The World Health Organization (WHO) in a July 2016 report, estimates that 400 million people worldwide have hepatitis B and C. This is 10 times the number of those infected with HIV.

In 2014 the Center for Disease Control (CDC) reported that close to 20,000 Americans died from Hepatitis C alone and approximately 1.25 million people have chronic hepatitis B.

Both hepatitis B, C, and D are preventable and treatable today.

Anatomy:

  • The liver is in the right upper quadrant of the abdomen just below the rib cage in 99.9% of people. Note: In an extremely rare condition called situs inversus, organ placement is reversed.
  • The liver filters toxins from the body.
  • It produces bile for digestion and stores glycogen, vitamins, and minerals.
  • Synthesis of proteins and blood factors occur here.
  • It has many other functions. The liver and kidneys can be viewed as the body’s major filters.

Hepatitis in general:

  • It is an inflammation of the liver. Hepatic (liver), – itis (inflammation)
  • Lettered (A,B,C,D,E) and etc.) forms of hepatitis are viral forms.
  • Because of abnormal liver function, old blood cells cannot be broken down properly and this causes jaundice, a yellow color in the whites (sclera) of the eyes and the skin turns yellow (icterus)
  • Other causes are heavy alcohol use, medications, toxins, seafood, and illegal drugs. It is also seen with yellow fever, mono-nucleosis, malaria, and parasitic infections (strictly speaking, the latter two are not hepatitis but cause jaundice) among other conditions.
  • Most cases resolve spontaneously.

Many people are unaware of having hepatitis.

  • Types B, C, and D have chronic (long lasting) forms and can lead to liver cancer.

Types of viral hepatitis, how they are spread, and other facts:

Hepatitis A:

  • Spread by fecal (poop) oral transmission. Usually from contaminated food or water.
  • Occurs in epidemics (groups of people)
  • Vaccinations are available
  • Generally takes 4 weeks for vaccine to be effective.

Hepatitis B:

  • Spread by infected blood. Usually needle/ razor sharing, saliva, semen (unprotected sex), through open wounds, and transfusions (extremely rare).
  • Does not typically occur in epidemics.
  • Vaccinations are available and are now recommended for all newborns.
  • Spread from mother to infant.
  • Chronic hepatitis B requires long term treatment and monitoring.
  • 350 million people worldwide have this in the chronic form according to the WHO.
  • The vaccination for hepatitis B also prevents hepatitis D.

Hepatitis C:

  • Spread by blood transmission and other body fluids like hepatitis B. Note: If there is a cut on your lips and you share a joint or cigarette with an infected individual you run the risk of infection.
  • Does not occur in epidemics.
  • Has a chronic form.
  • Medications are available to treat over the course of weeks.
  • There is no vaccination.

Hepatitis D:

  • Spread through wounds and blood.
  • Uncommon in the U.S.
  • Occurs together with hepatitis D.
  • Does not occur in epidemics.
  • Chronic potential.
  • Vaccination for hepatitis B gives immunity to hepatitis D.
  • Passed from mother to infant.
  • There is no specific treatment.

Hepatitis E:

  • Is a water born virus.
  • Usually seen in epidemics from unsanitary water ingestion.
  • There is no specific treatment and usually resolves on its own.
  • Does not cause liver cancer.
  • Vaccination approved in China only.

Prevention:

  • The best practice is prevention by avoiding contaminated food and water sources. See: Prevention and Treatment of Traveler’s Diarrhea, not sharing needles, razors, or tooth brushes, protecting open wounds, and getting vaccinated.
  • The treatment of hepatitis is long-term as is the follow-up monitoring. The possibility of advancing to the chronic form and liver cancer is also a possibility. For these reasons, I highly recommend the vaccine for A and B hepatitis.
  • Eating raw oysters and poorly cooked clams can put you at risk for hepatitis A.
  • Some vaccines must be given in a series starting up to 6 months prior to travel. Check with your physician.

Symptoms:

The first few days, either no symptoms or;

  • Usually begins like a viral infection or the flu
  • Nausea, vomiting, mild abdominal pain
  • Low grade fever
  • Joint and muscle aching

As the infection continues;

  • Jaundice (yellowing of skin and eyes)
  • The urine darkens
  • Headache
  • Hives, rash, and/or itching skin
  • Stool becomes much lighter

Treatment:

Other than prevention and supportive care, little can be done in the field. It is imperative to get to a medical facility where testing can be done and equally important to follow-up.

 

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