WORLD Hepatitis Day, recognised annually worldwide on July 28, was launched by the World Hepatitis Alliance in 2008 in response to the concern that chronic viral hepatitis did not have the level, nor the political priority, seen with other communicable diseases such as HIV/AIDS, tuberculosis and malaria. In May 2010, the World Health Assembly passed resolutionWHA63.18 on viral hepatitis, which provides official endorsement of World Hepatitis Day.

This year’s theme, “Think Again”, calls for a change in attitude to viral hepatitis and urge policymakers, health-care professionals and the public to “think again” about this silent killer or “viral time bomb”.

Viral hepatitis is inflammation of the liver caused by a virus. There are different hepatitis viruses, hepatitis A, B, C, D, and E, which are distinct, but all cause inflammation of the liver. These viruses cause short term, or acute infection, however, the hepatitis B, C and D viruses can also cause long-term infection, called chronic hepatitis, which can lead to life-threatening complications such as liver scarring, liver failure and liver cancer.

In Jamaica, the most common forms of the virus are hepatitis A, B and C. Hepatitis A is spread mainly through food or drinking water that has been contaminated by the faeces of an infected person or eating raw shellfish that have come from water contaminated by sewage. There is a vaccination for hepatitis A and it does not need a special medication for treatment as the body is often able to clear the infection itself within a few weeks.

Hepatitis B is highly infectious and is usually transmitted through blood or other body fluids – that is saliva, semen and vaginal fluid – of an infected person, or mother to child during childbirth.

There is a vaccination that can prevent infection. If you have not been vaccinated, to reduce the chances of exposure, it is best to use condoms, and to avoid sharing needles or items such as toothbrushes, razors or nail scissors with an infected person. It is also wise to avoid getting tattoos or body piercings from unlicensed facilities. Drugs, which slows the replication of the virus and occasionally result in its clearance, are available to treat this infection.

Hepatitis C is different from B in that the body is generally unable to clear the virus itself, known as ‘pontaneous clearance’, and the infection becomes chronic. Four out of five people develop a chronic infection which may cause cirrhosis and cancer after 15-30 years if left untreated. There is no vaccination for hepatitis C and it is mainly spread through blood-to-blood contact. Individuals who have received a blood or blood component tansfusion or an organ transplant before screening started in 1992 is at risk and should be tested. Currently, injection drug use is the primary mode of transmission in the US; therefore, those who use or have used illicit injection drugs, even only once, as well as intranasal drug users who share paraphernalia, should be tested for hepatitis C virus (HCV) infection. Other transmission methods include body piercing, tattooing and commercial barbering when performed without appropriate infection control measures, and there is a risk to babies born to infected mothers. HCV screening is also recommended in health care, emergency and public safety workers after a needle stick injury and current sexual partners of HCV-infected persons.

New drugs are just becoming available for hepatitis C that can cure 90 per cent or more of people who take them. This makes elimination of hepatitis C a real possibility in the future, even though there is no vaccine. Unfortunately, of the population estimated to have hepatitis C, less than half is diagnosed. With awareness low, people don’t think about whether they are at risk.