Hepatitis A - the common Jaundice

Most of us in India are aware of and have probably been vaccinated against hepatitis B. Given the fact that so many of us are protected from hepatitis B, have you ever wondered why we still have so many cases of jaundice especially in the months of summers and monsoons?
The reason is jaundice due to poor food, water and sanitation, meaning hepatitis A and hepatitis E virus.

The most important thing to realize that taking hepatitis B vaccination will not protect you against these forms of jaundice since they are caused by a different virus.

Today we are going to talk in some more details about Hepatitis A.
Hepatitis means inflammation (swelling) of the liver. While there are many infections that can cause this, in India the commonest cause in children and one of the most common causes in adults is Hepatitis A. Hepatitis A virus is spread from person to person by putting something in the mouth that has been contaminated with the stool of a person with hepatitis A. This type of transmission is called fecal-oral. For this reason, the virus is more easily spread in areas where there are poor sanitary conditions or where good personal hygiene is not observed. Casual contact, as in the usual office, factory, or school setting, does not spread the virus. Persons with hepatitis A virus infection may or may not have any signs or symptoms of the disease. Older persons are more likely to have symptoms than children. If symptoms are present, they usually occur abruptly and may include
• fever,
• tiredness,
• loss of appetite,
• nausea,
• abdominal discomfort,
• dark urine, and
• jaundice (yellowing of the skin and eyes).
Symptoms usually last less than 2 months; a few persons are ill for as long as 6 months. The average incubation period (i.e., time taken from transmission from one person to the other) for hepatitis A is 28 days (range: 15–50 days).
The diagnosis cannot be made without doing a blood test (IgM Hepatitis A antibody- cost approx. Rs. 600/-), since the symptoms of all types of hepatitis are the same. Other tests like the liver function tests are useful in finding out the extent of the disease. The good news is that once you have the disease, you develop antibodies that provide life-long protection from future infections. After recovering from hepatitis A, you will never get it again and you cannot transmit the virus to others.
Treatment is essentially supportive, and with adequate rest and minimum use of anti-fever and anti – vomiting medicines a patient should generally recover within 15- 30 days. However 15 % of patients (mostly adults) may have a prolonged course of illness lasting even as long as 6-9 months!
Prevention rests on maintaining a good personal hygiene. Always wash your hands after using the bathroom, changing a diaper, or before preparing or eating food. Avoid outside food and water especially food that is undercooked/ uncooked (like salad etc.). Since proper food and water in India is still a pipe-dream, a more feasible way is to take the Hepatitis A vaccine. This is a very safe and highly effective vaccine (more than 90 % effective) with no major side-effects. It can be given to anyone above 1 year of age. Two doses are needed for life long protection and these need to be given 6 months apart. The vaccine is effective a month after the first dose is given.
With proper cooking habits, care about water and outside food and proper vaccination at the right time, we can ensure that we do not have to suffer Hepatitis A disease.
Dr. Gaurav Gupta, Consultant Pediatrician, practicing in Charak Clinics, Phase 7, Mohali.

My Radio Talk on Big 92.7 FM

Just gave a talk on the common ear problems in children, including ear pain and infections and tips on ear cleaning, to the Chandigarh edition of BIG 92.7 FM.
Some photographs from the event, I enjoyed it.
I have been planning for an audioblog/ podcast, want to spread the word around - however unsure of the potential audience, and of course the time for the same ...
Any comments would be really appreciated

Influenza Vaccine - Now Available for season 2009 -2010 in India - FAQs

Influenza (also called "the flu") is a viral infection in the nose, throat and lungs. About 10 to 20 percent people get the flu each year. Some people get very sick. Tens of thousands die every year in India because of the flu and complications.

What are the Symptoms of FLU?

The flu may cause fever, cough, sore throat, a runny or a stuffy nose, headache, muscle aches and tiredness. Some people describe the flu as the worst cold of their life. If you get the flu, you should feel better after one or two weeks. But in some people, the flu leads to serious, even life-threatening diseases, like pneumonia. Some people are more likely to get the serious complications. A vaccine (the flu shot) is recommended for these high-risk people to protect them from the flu.

Who is at higher risk?

You have a higher risk of flu complications if you:

• Less than 5 years age
• Are 60 years of age or older
• Are a doctor, nurse or working in a hospital
• Have a lung problem, such as asthma or emphysema
• Have Diabetes
• Have a suppressed immune system
• Have a problem with your kidneys
• Have heart disease or other long-term health problems

If you are in any of these risk groups, you should get the flu vaccine every year.

Even if you're not at higher risk, you may want to get the flu vaccine so you don't get sick with the flu.

What is the flu vaccine?

The flu vaccine is an injection. It contains killed viruses. You can't get the flu from the vaccine because the viruses are dead. Instead, the vaccine protects you from the flu. When a "live" virus shows up, your defenses are ready. These defenses keep you from getting the flu. Because flu viruses change from year to year, you must get the shot each year to be protected.

When should I get the vaccine?

You should get the vaccine at the beginning of the flu season, sometime in September onwards. You can get the shot later in the year too, but because flu season usually begins in the winter months, it would be best to be protected before that time.

If I get a flu shot, can I still get the flu?

Yes. Even with a flu shot, you aren't 100 percent protected. Each year, the flu vaccine contains three different strains (kinds) of the virus. Depending on the strains used, the Flu vaccine is 70 to 90 percent effective in preventing the flu in healthy people under 65 years of age. If you're older than 65, the vaccine is less likely to prevent the flu. Even if you get the flu after the vaccine, your flu symptoms should be milder than if you didn't get the vaccine. You'll also be less likely to get complications from the flu.

Is the vaccine safe?

Yes. The flu vaccine is safe for all age groups over six months of age. There are very few side effects too. Your arm may be sore for a few days. You may have a fever, feel tired or have sore muscles for a short time. If you have a severe allergy to eggs, you shouldn't get the shot.

Do you take the FLU vaccine?

Yes, I have personally been taking the FLU vaccine for the last 3 years, ever since it was made available in India.

Will the vaccine be effective against swine flu?

As of now we do not really know, however we must remember that Seasonal Flu kills far more people than Swine Flu, and it is as serious a disease. For the high risk people mentioned above, taking this vaccine is a great way to reduce complications from this common disease.

Dr Gaurav Gupta

Child Specialist,

Charak Clinics, Phase VII, Mohali

91-172-5092585, 91-172-4663775