The five known types are:
- Hepatitis A virus (HAV).
- Hepatitis B Virus (HBV).
- Hepatitis C virus (HCV).
- Hepatitis D Virus (HDV).
- Hepatitis E Virus (HEV).
Considering the spread of infection, the virus, once it enters the blood stream, is virtually (present in all body fluids.) It can be potentially transmitted through the infected patients’ feces, blood, saliva, semen, vaginal fluids and urine.
Modes of transmission
- Through infected blood (during transfusions).
- Through intravenous injection, using infected needles.
- Handling excreta of infected individuals.
- Drug abusers who share needles.
Clinical Features of Hepatitis B
- Prodromal symptoms of fever, chills, headache and malaise.
- Gastrointestinal symptoms such as nausea, vomiting and diarrhea may follow with clay colored stools.
- Enlarged lymph nodes and enlarged liver is evident. Patients with HBV infection often have arthralgia (pain in the joints) as prodromal symptoms.
- Dark yellow urine and yellowish tint to the sclera herald the onset of jaundice.
- An obstruction to the Biliary canaliculi develops, and the urine darkens, and stools become paler. At this time, with adequate management, symptoms usually recede and recovery commences. Usually in about three to six weeks, the patient recovers completely.
- The liver function tests usually state the severity of the disease which include serum bilirubin, SGOT, SAI SGPT.
- Urine for bile salts and pigments.
- Serological tests can identify Hepatitis A & B viruses but are unreliable in acute HCV infections.
Management is symptomatic, dietary and medical. Bed rest is usually advisable till symptoms recede. A nutritious diet containing 2000 to 3000 Kcal daily. If vomiting is severe then intravenous fluids and glucose are recommended.
Vaccination for Hepatitis B
Among available vaccines, a recombinant Hepatitis B vaccine is available (Engerix) capable of providing active immunization in 95% individuals. It provides a high grade of immunity in individuals never affected by HBV. In those already affected, this vaccine is useless. Usually, a dosage of 0.5 ml. containing 10 u gms of the vaccine is advised in infants and children below 11 years of age. An adult dosage of 1 ml. containing 20 u gms is adequate. This has to be repeated at 0,1 and six months to attain adequate immunity. A rapid immunity program may include inoculation of three doses anywhere between six to 10 weeks. Doctors, paramedics, and nurses are at a high risk of infection. They should necessarily get themselves vaccinated. So, let us utilize the creations of doctors and pharmacists in order to protect ourselves from nature’s harmful subjects and live a disease–free life. As it is said “A stitch in time save nine”, similarly, a vaccine in time saves a suffering of a lifetime.
Precautions for Hepatitis B
A few precautions will help immensely in avoiding infections
- Drink boiled and filtered water.
- During travel, carry your own water bag and home made food or drink only sealed mineral water.
- Wash hands with soap and a scrubber before meals.
- Wash vegetables thoroughly before cooking. Eat well cooked food.
- For non–vegetarian food lovers, eat well cleaned and properly cooked meat.
- Avoid eating at open stalls. Stay away from bhel puri and paani puri during the monsoons.
- See your family physician whenever in doubt.