One -Third Of The World Is Infected With A Silent Killer Hepatitis

Hepatitis — a systemic inflammation of the liver — is often referred to as a silent killer for one simple reason. As the different kinds of hepatitis, many of which are viral in nature, ravage your body, you may not notice any symptoms at all. By the time symptoms start to show, the damage is already extensive. Although many people survive infectious types of hepatitis, viral hepatitis can have a severe impact on a patient's quality of life, and the hepatitis viruses also, collectively, lead to the deaths of at least one million people across the globe each year.

Hepatitis A Through E Found In Nearly Every Nation

The danger of hepatitis is that carriers of the virus do not know they can infect others, and disability and death can come suddenly with little warning after years or even decades of silent infection.

The ABC's of Viral Hepatitis

While hepatitis was once considered to be a single condition with a wide range of symptoms, modern medicine identifies five strains of hepatitis viruses that cause the majority of infections. Scientists only identified the virus that causes the most common form of hepatitis, hepatitis A, in 1973.

Hepatitis A is both the most common and the mildest form of viral hepatitis. People infected with this strain of hepatitis begin to spread the virus 14 to 21 days after exposure, before they develop the characteristic jaundice, yellowing of the eyes and skin. The damage to the liver in hepatitis A is caused by the immune system's attack on the virus, rather than the virus itself.

This strain of hepatitis is spread by fecal-oral contact. In the developing world, it most commonly strikes infants and toddlers under the age of 2 who acquire the virus from their mothers. In the industrialized world, it most commonly strikes children aged 5 to 17 who are exposed to virus when infected children do not wash their hands after using the toilet. After six weeks to two months, people who have hepatitis A cease to be infectious.

Hepatitis B, on the other hand, is a life-long infection. First seen under the electron microscope in 1970, hepatitis B is passed from person to person through blood-to-blood or sexual contact.

Nearly 350 million people worldwide carry a hepatitis B infection. As long as the immune system does not attack the virus, there are no symptoms. In any given year, however, there is about a 2% chance the immune system will try to get rid of the virus by attacking the liver. The infection can lead to cirrhosis of the liver or liver cancer. Treatments for hepatitis B are interferon, which works in about 1/3 of the people given it, or liver transplant.

Hepatitis C was once known as non-A, non-B hepatitis, until the virus was identified in the 1980's. Before the late 1980's, the only way to diagnosis this form of hepatitis was by testing for enzymes that  indicate liver damage. Many other conditions cause elevation of these liver enzymes, but doctors tended to label any elevation of liver enzymes as non-A, non-B hepatitis. Since the condition was thought to be associated with homosexuality in men and intravenous drug abuse in women, doctors commonly dismissed their patients as "not worthy" of medical attention on the presumption they must be hiding illicit lifestyles.

Doctors now know that most cases of hepatitis C occur in people who received contaminated blood products in medical procedures. In Egypt, 22% of the population acquired hepatitis infections through contaminated drugs intended to treat parasites. Like hepatitis B, hepatitis C can remain dormant in the liver for many years until the immune system activates a process that can lead to cirrhosis or liver cancer. Over 170,000,000 people in the world carry the hepatitis C virus.

Two "New" Forms of Viral Hepatitis

Hepatitis A, B, and C infect nearly 500,000,000 people worldwide, but they are not the only known strains of the disease. There are also hepatitis D and hepatitis E.

Hepatitis D is a virus that has a structure unlike hepatitis A, B, or C. It is a unique infection that requires the help of the hepatitis B virus to make copies of itself and infect liver cells. In about 1% of cases, hepatitis D infection results in rapid destruction of the liver and death unless there is a successful liver transplant. In 99% of cases there is minimal effect on health.

Only people who are already infected with hepatitis B get infections with hepatitis D, but hepatitis D infections are uncommon where hepatitis B infections are most common, in China, Japan, and Taiwan. Most of the 15 million people who have chronic hepatitis D infections live in Italy, North Africa, the Amazon Basin, and the Pacific islands of Samoa, Hiue, and Hauru. It is most commonly spread to children through contact with infected people who have cracks in the skin (especially cracks in the skin of the nipples when the breastfeeding mother has the disease) or by multiple blood transfusions.

Hepatitis E is a virus that is spread in the same way as hepatitis A, although it is more likely to be spread through contaminated water supplies, particularly after storms, than through food. Like hepatitis A, the virus is transmitted from infected people before they develop any symptoms. Unlike hepatitis E, about 4% of people who get hepatitis E infections die of liver failure.

This strain of hepatitis is most likely to strike people aged 15 to 40, and pregnant women are especially prone to develop complications. The disease causes blood clots in the placenta that cause death in up to 40% of women who come down with hepatitis E during their second or third trimesters.

Over 100,000 people were infected with hepatitis E from contaminated water in northeastern China in 1988. About 2% of the population of the United States has been infected with hepatitis E, mostly during foreign travel. Once hepatitis E infection occurs, the virus may stay in the liver for life, although the virus is only infectious during the third week after exposure.

What can you do to avoid becoming one of the two billion people in the world who has been infected with hepatitis A, B, C, D, or E? Here are some simple suggestions:

1. Wash your hands before and after you use the toilet, and before you eat.
2. When traveling to destinations where food safety is questionable, eat cooked food and avoid iced drinks.
3. Avoid raw shellfish that may have been harvested from contaminated waters.
4. Boil water when contamination is suspected. Chlorination alone may not kill hepatitis viruses.
5. And, although most public health authorities are hesitant to put it quite so explicitly, avoid any sexual practice that involves bleeding. Sexual transmission of the virus is most likely when heterosexual couples have sex during the female partner's menstrual period and when homosexual couples involve in practices that induce anal bleeding, or when couples use devices that cut or cause abrasion to the sex organs.

Immune boosters to prevent hepatitis A and vaccinations to prevent hepatitis B are controversial but effective, at least for preventing infection with the virus.