Talking about that alphabet of viruses on World Hepatitis Day
By Mary Wade Burnside
After all, there are five types of hepatitis, an inflammation of the liver — A, B, C, D and E.
Today happens to be World Hepatitis Day, but that is not the reason for the notoriety.
Hepatitis has been creeping — and in some instances, exploding — into the news in the past few years.
First it was hepatitis C. Anyone born between 1945 and 1965 should automatically be tested for Hep C. Of the estimated 3.2 million people chronically infected with hepatitis C in the U.S., approximately 75 percent were born during that time frame.
Hepatitis B also has been on the rise in West Virginia. The number of Hep B cases in West Virginia nearly doubled between 2011 and 2015, going from 1,232 to 2,436. It might seem like a small number, but West Virginia has the highest instance per capita of hepatitis B in the nation, as well as the highest rate of hepatitis C.
And West Virginia was part of a nationwide hepatitis A outbreak that began with unsheltered individuals in San Diego and reached the Mountain State in March 2018. The outbreak was determined to be over by Aug. 24, 2020, by which time 2,732 cases had been reported to the state Office of Epidemiology and Prevention Services, part of the West Virginia Department of Health and Human Resources.
It included an outbreak that took place at a fast-food restaurant in Morgantown in October 2019 that required Monongalia County Health Department to reach out to customers who had been there during a certain time frame to offer them a hepatitis A vaccine.
Because there are three primary types of hepatitis, an inflammation of the liver, they can be difficult to tell apart. Some of these infections — hepatitis A, B and C — are caused by a virus. Here is a breakdown:
• Hepatitis A travels via the oral-fecal route, i.e., from eating food or drinking water that has been contaminated. It has an acute stage and can be resolved, although it also can require hospitalization and cause death. If infected children contaminate their fingers and then touch an object, other children who touch that object and then put their fingers in their mouths can become infected. Same goes for restaurant employees who do not wash their hands thoroughly after using the restroom. There is no cure but there is a vaccine. In 2018, according to the Centers for Disease Control Prevention, 12,474 new cases were reported and increased 850% between 2014 and 2018.
• Hepatitis B is more likely to be transmitted sexually or through the sharing of needles. The opioid crisis has contributed to the rise in Hep B. According to the CDC, 3,322 new hepatitis B cases were diagnosed in 2018. Like hepatitis A, there is no cure but there is a vaccine. Incidence in children is low because of childhood vaccinations. More than half of the cases occurred in individuals ages 30-49 years.
• Hepatitis C is blood-borne, so it can be contracted by sharing needles or also from getting an organ transplant, blood transfusion or blood products before July 1992. In 2018, there were 3,621 new cases reported, largely among individuals 20-39 years old, which is consistent with those impacted by the opioid crisis. There is a cure, albeit an expensive one, but no vaccine to prevent it.
Symptoms of hepatitis A, B and C can all include jaundice, or a yellowing of the skin or eyes; fever, loss of appetite, nausea, vomiting; abdominal pain; gray-colored bowel movements and dark urine.
With hepatitis A and B, prevention includes getting vaccinated (either individual vaccines for each one or Twinrix, which protects against both), as well as avoiding behaviors that can lead to the viruses.
For hepatitis A, this includes thorough hand-washing after going to the bathroom and before cooking and eating food. For hepatitis B, this includes not sharing needles and razors and avoiding sex with an infected person.
Because there is no vaccine to prevent hepatitis C, avoiding behavior that leads to this virus and getting tested are your best defenses.
Hepatitis D and hepatitis E are very rare and someone must have hepatitis B in order to develop hep D and hep E. And while it is rare, hep E is especially virulent for pregnant women.
In addition to getting the vaccine, another way to avoid hepatitis A is good hand hygiene. It is recommended to wash hands thoroughly with soap and water for 30 seconds --
about the time it takes to sing the “Happy Birthday” song twice — after using the bathroom and before eating or preparing food.
MCHD Clinical Services offers free testing for hepatitis B and C as well as vaccines for B and C: either individually or as the dual vaccine. Call 304-598-5119 to make an appointment.