Worldwide more than 400 million people are living with Hepatitis B or C. Every year almost 1.4 million people die from viral hepatitis. That is 4,000 lives a day!
The World Health Organization has set World Hepatitis Day as one of only 4 official disease-specific world health days, to be celebrated each year on July 28th. “Viral hepatitis can be prevented. It is up to all of us to act,” (WHO). That is why St. Maarten Medical Center has joined with millions across the world to take part in raising awareness about viral hepatitis.
Internist Dr. Samay Nadery has been enjoying work at the St. Maarten Medical Center for just over 18 months. In speaking about common diseases on the island in internal medicine, they are grouped in three groups:
- Infectious diseases most commonly seen are HIV, Hepatitis, Lung infection and Urinary tract infections, Dengue and Chikungunya.
- Noninfectious diseases are mainly Metabolic Syndrome; (Diabetes, High Cholesterol, Hypertension and Obesity). Kidney Diseases are also common.
- Common autoimmune diseases such as Rheumatoid arthritis and Lupus.
While screening is not widely done on the island for viral Hepatitis, the number of Dr. Nadery patients with Hepatitis B and C virus are significant.
The facts about Hepatitis
“In speaking about Hepatitis, we need to know that there is bloodborne Hepatitis; which are B, C and D; the transmission is via blood, semen and other fluids of the body. The other types, Hepatitis A and E are acquired due to unsafe water, inadequate sanitation and poor hygiene,” explains Dr. Nadery.
We also need to distinguish between acute and chronic hepatitis. Hepatitis A and E are acute and will never cause chronic liver disease. Almost everyone recovers fully from Hepatitis A, if needed with medical alternatives. As it relates to Hepatitis E, like Hepatitis A, there is no specific antiviral treatment. Each year an estimated 56,600 people die from Hepatitis E related cases.
In our region, Hepatitis B and C are more common. Hepatitis D is only found in people who already have Hepatitis B. But Dr. Nadery has not come across this one on St. Maarten.
Globally, approximately 130-150 million people have chronic Hepatitis C infection- “it’s a huge number!” Dr. Nadery exclaims. And 500,000 people die each year from Hepatitis C-related liver disease. Yet, if Hepatitis C infection is treated, more than 90% of patients will be cured because there are good new treatment options for Hepatitis C.
An even greater number of patients are living with Hepatitis B, globally accounting to 240 million resulting in 780,000 deaths each year due to complications of the infection.
Symptoms
Acute Hepatitis can present with:
- Fever
- Jaundice;
- Dark urine;
- Yellow eyes and skin;
- Discomfort in the right side of the abdomen.
If those complaints are combined, one should see their doctor.
If it is a chronic problem with complications, besides the above mentioned, one can get edema-the abdomen gets bigger-or the person can bleed easily.
“In most cases, when I get a patient with Hepatitis B or C it is at the late stage of the disease with complications,” says Dr. Nadery. Sometimes a patient has Hepatitis B or C but do not have any complaints until the damage to the liver is getting worse.
New Treatment options
Persons living with Hepatitis B or C should always visit their doctor regularly who will discuss options on when to begin treatment. Hepatitis B and C does not always require treatment at the beginning. Treatment for Hepatitis B infection does not provide a cure but can suppress the replication of the virus. Therefore, persons who start Hepatitis B treatment continue it for life.
When treatment is necessary for Hepatitis C, the goal is to cure. There is a new generation treatment that makes treatment easier than with the classical treatment.
In St. Maarten we are moving towards the new generation of the medication; which is two different tablets, once a day for three months. The benefits compared to classical treatment are:
- Less side effects;
- Shorter treatment duration;
- 90% success rate;
- Smaller chance of relapse.
“My first patient will receive the new generation medication very soon. Before this treatment was available, my patient received the classical treatment and after six months there was a relapse. So now we are trying the new medication. Studies show that the new generation treatment is more tolerable and I believe this time my patient’s treatment will be more successful,” said Dr. Nadery.
Prevention
Vaccination is the most effective way to protect against Hepatitis A. This is optional for persons who are travelling to countries where there is a high risk of contracting the disease.
In St. Maarten, there is also vaccination for Hepatitis B for children. Health care professionals are also required to take the vaccination for protection in case of accidental exposure to bodily fluids at work. However, the Hepatitis vaccination is not only for children or health care workers. If you think you are at risk, you should request the vaccination from your doctor.
Persons at high risk such as people who inject drugs, people with multiple sex partners, and travelers to and from high risk countries should be screened for Hepatitis regularly. Currently, screening for and reporting on Hepatitis is not structurally done on St. Maarten. With the new hospital information system at the SMMC, reporting Hepatitis cases treated at the hospital can be more efficient and the figures can be used by external parties to raise awareness and maximize efforts to help eliminate the disease.
For every death a voice
In the meantime, our community can raise awareness in simple ways. The World Health Organization is asking just 4,000 people to stand up and be counted in the quest to raise awareness of viral hepatitis. You can provide a voice for the 4,000 lives that will be lost on World Hepatitis Day this year.
Simply tweet the hashtag #4000voices or upload an image to contribute to a collage. Share this article on St. Maarten Medical Center’s Facebook page to raise awareness in your circles. Our voices can become a powerful symbol for the need for action to prevent future deaths.
400 million people is 400 million too many!