Health officials want public to be aware of hepatitis

Press, 21 April 1984, Page 19

Health officials want public to be aware of hepatitis

By

OLIVER RIDDELL

To get hepatitis is not a death warrant, but few diseases give rise to so much fear and discomfort, or have so many unpleasant complications. The Department of Health is publishing material to increase public awareness of hepatitis, in the hope that more cases will be detected earlier. Several causes of the liver infection known as hepatitis are known. The two most common forms in New Zealand are the virus hepatitis A. (sometimes called infectious hepatitis) and B. (which used to be called serum hepatitis). Until recently it was hard to tell the two apart; both have fairly long incubation periods. Before 1964, the diagnosis had to be made on the patient’s history — for example, having had a blood transfusion three months before becoming ill would suggest B. In 1964, the surface antigen was discovered — in Australia. The test for it means that B. can not be diagnosed accurately. Laboratory tests are much more sophisticated and can detect other aspects of the disease. When an antigen is detected in the blood it shows the patient is infectious. Dr C. J. Clements, assistant director (disease prevention) with the Division of Health Promotion, Department of Health, says most people expect a patient with hepatitis to go yellow or “jaundiced.” However, a lot of people with hepatitis B. never go yellow and that means they may never realise they have had it Others go yellow and feel quite ill, with fever, sickness, itching of the skin, stomach pains, or signs of cold. More than 200 million people around the world are thought to have had hepatitis 8., with about one-third in South-East Asia. . Dr Clements says there seems to tie a great variation between ethnic

groups in their ability to catch the virus. Because of this, very many more Maoris and Pacific Islanders in New Zealand tend to catch hepatitis B. than Europeans. Newly arrived migrants from South-East Asia also have a higher rate. Hepatitis A. is caught in unhygienic conditions, but not so hepatitis B. Anyone who is infectious places others at risk. It is passed on in human body fluids'and very small amounts are enough to ensure that the virus finds a new person to infect. Using the toothbrush of an infected person, or his razor, or kissing, or having sex with them, can all pass on the disorder. Once one member of a family gets it, the chances are that other family members will get it too. This has nothing to do with hygiene, or lack of it, and Dr Clements says it is unfortunate that this idea still lingers in some people’s minds. Some groups of people are very much at risk from hepatitis B. because of their lifestyle — tattoo artists and their clients, prostitutes, male homosexuals with a high rate of partners, and intravenous drug abusers. It is no longer possible to catch hepatitis B. from blood transfusions. All blood donors are now screened for it, and all blood used for transfusion in New Zealand is virus-free. Hepatitis B. cannot be caught twice; once gives an immunity in the future. But the patient is still vulnerable to other forms of the virus. The incubatian period of hepatitis B. is 60-90 days. Most adults get

over the jaundice and are feeling better within three months. Children usually have a quicker recovery. A small number of people, however, do not get rid of the virus from their bloodstreams for a long time, often for many years, although they feel well. These carry the disease. Only a small number of adults become carriers; infants and young children are more likely to become carriers, probably because their immune system is not mature enough to deal with the virus. Carriers are more likely to develop cirrhosis or cancer of the liver in later life. They need regular medical checks so that the early signs of disease can be detected. No treatment exists for hepatitis; prevention is the only cure. Dr Clements says two ways of preventing hepatitis B. have been developed. Temporary protection can be given using immunoglobulin injections and, recently, a vaccine, not available in New Zealand, has been developed. He says that although the vaccine is a major breakthrough in controlling hepatitis 8., there must be safeguards before introducing it. However, work in other countries suggests the vaccine is highly effective. The department is looking into the possibility of introducing the vaccine free of charge for children at risk, thus treating the likely carriers. The department is reviewing overseas studies to ensure that the vaccine will be safe for use in New Zealand. bb