The Hepatitis virus is commonly known as jaundice. Viral Hepatitis is an infectious disease affecting the liver causing widespread damage and even leading to necrosis (death of liver tissue). Basically, viral hepatitis is caused by either of the five known straits of the Hepatitis virus.

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).

All these viruses give rise to illnesses nearly similar in their expression. The most common source of infection in humans is the Hepatitis B Virus, since it is most potent in human blood and liver tissue.

Spread
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.

Tattooing or acupuncture can also spread infection if inadequately sterilized needles are used. The means of non–parental transmission are uncertain but discovery of HBSAG (Hepatitis B surface antigen) or viral DNA in body fluids such as semen, urine and vaginal secretions suggests various mechanisms. Children are most commonly affected and conditions of overcrowding and poor sanitation facilitate its spread. Asymptomatic individuals and some patients with chronic liver disease my carry the virus for a lifetime.

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.

Investigations of Hepatitis B

• 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 of Hepatitis B
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.

These small precautions will save you and your family from disease. Let us join hands to a healthier tomorrow and make the WHO dream of ‘Health for All’ by 2000 AD come true.