What is Hepatitis and its various types:
Hepatitis is inflammation of liver that may be caused by different viruses, bacteria, drugs, or excessive alcohol intake. The most common causative viruses are hepatitis A, B, C, D, E, F and G. The condition can be self-limiting (healing on its own) or can progress to fibrosis (scarring) and cirrhosis.
Cases of Hepatitis in Pakistan:
Hepatitis is fatal disease and spreading rapidly in Pakistan. The prevalence data estimated Hepatitis B at 3-5 % and Hepatitis C at 7-10 %.In Pakistan more people die of Hepatitis every day than terrorism in a year. Pakistan owes the highest burden of end stage liver disease as result of a public health intervention, namely mass vaccination for small pox in late sixties and early seventies. Small pox was eradicated but the menace of HCV was born. At present number of patients infected with either Hepatitis C or B in Pakistan exceed 15 million (15000000). If we consider that cost of treatment of one person is around Rs 30000 then total cost is Rs 225 billion.
Prime Minister program of Hepatitis prevention and control was launched in August 2005.
Reasons of Spreading of Hepatitis in Pakistan:
A new study conducted by Pakistan Council of Research in Water Resources PCRWR after tests of water sources across 24 districts in the country found that over 80 per cent of them provided water which was unsafe for drinking. PCRWR says 250,000 children die each year in Pakistan asa result of water born illnesses which stem from drinking impure water.
According to World health Organization , Among the infectious causes, hepatitis A and hepatitis E are associated with inadequate water supplies and poor sanitation and hygiene, leading to infection and inflammation of the liver.
Hepatitis A and E viruses, while unrelated to one another, are both transmitted via the faecal-oral route, most often through contaminated water and from person to person. Hepatitis A could also be transmitted via food contaminated by infected food-handlers, uncooked foods, or foods handled after cooking. Hepatitis A has also caused outbreaks transmitted through injecting or non-injecting drug us
2-Role of Commonly taken Foods:
Hepatitis A can be spread by eating or drinking food or water contaminated with the virus. This is more likely to occur in countries where Hepatitis A is common and in areas where there are poor sanitary conditions or poor personal hygiene. The food and drinks most likely to be contaminated are fruits, vegetables, shellfish, ice, and water. In the United States, chlorination of water kills Hepatitis A virus that enters the water supply.
Hepatitis is passed on by poor hygiene/lack of hand washing. It is passed in the blood/body fluids or in dirty water. I suppose street foods prepared by vendors in small stands may not have the cleanest preparation and make it easier to pass along the virus.
Food items and various dishes saled and served in Low standard Restaurants in Pakistan which are substandard mostly and these must be avoided and if you want to eat them than prepare at home or check for quality of Restaurants.. These are playing a vital role in spreading HEPATITIS.
§ Chicken tikka
§ Chicken Karahi
§ Daal Chawal
§ Seekh kabab
§ Peshawari Chappal Kabab
§ Taka Tuk
§ Fried fish
§ Halwa Poori
§ Kashmiri Subz Chai (Green Tea)
§ Baraf ka Gola
§ Murgh Chanay
§ Fruit Chaat
§ Dahi Bhalley
3-Re use of Syringes:
Pakistan is today notorious for many things, but in the last 20 years, drug production and addiction has increasingly become just one of them. Widespread drug abuse may be indicated by the fact that almost five percent of the adult population is using drugs in Pakistan. As a proportion of drug abusers, heroin users have increased from 7.5 percent in 1983 to a shocking 51 percent a decade later in 1993.
Nowadays, the main cause of hepatitis C transmission is considered to be the inadequate use of needles and syringes. Inappropriately sterilized medical items that enter in direct contact with patients’ blood (during surgical interventions) are also considered to be a common means of hepatitis C transmission nowadays. Drug addicts that commonly share needles and syringes are also very exposed to contracting hepatitis C virus. Therefore, drug injection is an important risk factor in hepatitis C transmission. As indicated by statistics, intravenous drug use accounts for around 50 percent of overall cases of hepatitis C transmission. Statistics also reveal that intra-nasal drug use (especially cocaine) accounts for around 5-10 percent of overall cases of hepatitis C transmission.
4- Sexual Contact:
Hepatitis A is also classed as a sexually transmitted disease (STD) because it can be passed on sexually.Sexual promiscuity is yet another risk factor of hepatitis C transmission. Lack of sexual protection and frequent change of sexual partners considerably increase the risks of contracting hepatitis C virus. Statistics indicate that unprotected sexual intercourse accounts for around 15 percent of overall cases of hepatitis C transmission. Despite this fact, it is very important to note that hepatitis C transmission through body secretions isn’t always possible. Although hepatitis C virus can be sexually transmitted due to exchange of body fluids, not all body secretions can transmit this type of virus. For instance, even if the presence of hepatitis C virus can be revealed in saliva or tears, these body secretions can’t spread the infection to other people.
Other Reasons For Hepatitis spreading:
• Viral diseases, such as glandular fever and cytomegalovirus.
• Severe bacterial infections.
• Amoebic infections.
• Medicines, eg paracetamol poisoning and halothane (an anaesthetic).
• Toxins: alcohol and fungal toxins, eg toadstool poisoning.
• Autoimmune hepatitis. This is a disease in which a number of liver cells are destroyed by the patient's own immune system. Autoimmune hepatitis can also sometimes occur as acute hepatitis. The cause is unknown.
• Inborn metabolic disorders, such as Wilson's disease (disorder of the body's copper metabolism) and haemochromatosis (disorder of the body's iron metabolism).
How to Prevent from Hepatitis:
1. Practice safe food and water precautions
§ Boil it, cook it, peel it or leave it!
§ Always wash your hands before eating and drinking.
§ Eat only food that has been well cooked and is still hot when served. Avoid uncooked foods, especially shellfish and salads.
§ eat hot food hot and cold foods cold
§ Drink and use ice from only purified water that has been boiled or disinfected with chlorine or iodine, or commercially bottled water in sealed containers. Carbonated drinks, including beer, are usually safe.
§ Avoid unpasteurized dairy products.
§ Avoid food from street vendors.
§ Avoid swimming in polluted or contaminated water.
§ Brush your teeth with purified or bottled water.
2. Get vaccinated
You should get vaccinated if you are:
§ travelling to Areas and locations where Hepatitis A occurs; and
§ visiting areas where drinking water may be unsafe and poor sanitation and hygiene conditions exist.
Muhammad Rehan Gul
Doctor of Pharmacy
The university of Lahore.