The recent viral outbreak of hepatitis A in Xieng Khuang, that occurred two weeks before annual World Hepatitis Day that is marked on 28 July serves as a reminder that anyone can catch hepatitis.
Dr Juliet Fleischl, WHO Representative to the Lao PDR visited the province with Health Minister Dr Bounkong Syhavong who said, “Hepatitis A is a mild common disease that is frequently seen in the Lao PDR and neighbouring countries. Children under ten may have some symptoms but they will often not have jaundice or yellowing of the eyes and skin.”
Worldwide, about 400 million people are affected by hepatitis and an estimated 95 per cent of people who have hepatitis do not know that they have been infected. There are five different hepatitis viruses, hepatitis A, B, C, D and E. Viral hepatitis kills more than 1.4 million people every year.
Hepatitis A and E are transmitted directly from person to person and through consumption of food and water contaminated by infectious people. Hepatitis E can also be transmitted by eating undercooked or raw pork products. Infections are mild and usually short term although it will take a few weeks to recover fully. Hepatitis A and E viruses are present in the faeces of infected people.
Observing proper hygiene and sanitation practices such as washing hands with soap and water after using the toilet, when preparing food for others, and before eating and drinking will help prevent the spread of infection.
To prevent hepatitis A and E, wash fruit and vegetables in clean water and cook them well before eating.
People who are infected should not prepare food for others. Avoid eating raw meat and shellfish, drink safe and boiled water and do not share glasses, forks, spoons or chopsticks.
On the other hand, Hepatitis B and C occur as a result of contact with infected body fluids, usually blood. Hepatitis B and C viruses can cause long term infections often leading to life-threatening complications like cirrhosis, liver failure or liver cancer.
Effective vaccines and treatments exist for hepatitis B and Laos is committed to preventing mother-to-child transmissions of hepatitis B virus through vaccinations. All newborn babies should be vaccinated against hepatitis B within 24 hours of birth, followed by at least 2 more doses under the routine immunization programme.
To prevent hepatitis C transmission, hospitals have to enforce infection prevention and control practices by ensuring safe injection practices and eliminating unnecessary and unsafe injections. Globally, the most common cause of hepatitis C is sharing drug injecting equipment.
The good news is that hepatitis is preventable and treatable. The World Health Assembly in May 2016 adopted the first-ever elimination strategy for viral hepatitis. This is seen as the pivotal year for viral hepatitis and the global theme for this year’s campaign is elimination.
For hepatitis endemic to countries in Asia, this is an uphill task and that is why the WHO has called on policy makers, local authorities, development partners, civil society, media and the general public to raise awareness and encourage people to learn about hepatitis and act now.
The message is that we can begin by protecting ourselves and our family members, with simple behavioural change practices. The community needs to practise good hygiene by washing their hands regularly with soap and water after using the toilet and before preparing food and this can prevent many diseases.
WHO will support countries in implementing the global hepatitis goals under the Sustainable Development Goals Agenda 2030 by focusing on raising awareness, promoting partnerships and mobilizing resources, and also increase awareness of the public understanding of viral hepatitis.
In Laos, hepatitis and acute jaundice syndrome are one of the notifiable diseases monitored by the national surveillance system.
Long-term political support and multi-sectoral collaboration from development partners, local authorities, civil society and communities is needed to achieve the elimination goal. The work extends beyond the scope of the Ministry of Health and all sectors have to work together if we want to eliminate the disease.