HEALTHWATCH : Fighting the silent epidemic

By Dr Cory Couilard

The ‘silent epidemic’ of viral hepatitis continues to significantly affect many unknowing victims. A major obstacle to overcome is many people remain symptom free for decades until they develop chronic liver disease.

Chronic liver disease is a major cause of cirrhosis, cancer and devastating medical bills.

Hepatitis is an inflammation of the liver. There are five main hepatitis viruses, referred to as types A, B, C, D and E. These types are of greatest concern because of the burden of illness, death and the potential for outbreaks and epidemic spread.

Hepatitis A is found in the faeces of infected persons and is most often transmitted through contaminated water or food. The virus attacks the liver and cause mild to severe illness. Hepatitis A is closely associated with inadequate sanitation and poor personal hygiene. Certain sex practices can also spread the virus. It is one of the most common vaccine-preventable illnesses in residents and travellers.
Hepatitis B is a serious disease spread through infected blood and other bodily fluids such as semen and vaginal secretions. It is spread in a very similar way that HIV is spread but hepatitis B is approximately 100 times more infectious. Hepatitis B can also be transmitted from infected mothers to infants at birth or from family members to infants in early childhood.

The majority of hepatitis B sufferers fully recover but a percentage become carriers. Carriers can transmit the virus unknowingly to others even when they are not experiencing symptoms themselves. This group can go on and develop chronic hepatitis and experience scar tissue or hardening of the liver.
Hepatitis C is often a silent condition that is most commonly transmitted through exposure to infected blood as well. Most people go on to develop chronic hepatitis C without even knowing. Chronic hepatitis C suffers often experience fatigue, a diminished appetite, joint and muscle pain as well as yellowing of the skin and eyes, urine of a dark yellow colour and an increased tendency to bleed or bruise.
It’s important to note hepatitis C can be treated using antiviral medicines. Hepatitis C is not spread through breast milk, food and water or by casual contact such as hugging, kissing and sharing food or drinks with an infected person. Sexual transmission is also possible, but is much less common. The risk is higher if one has many sexual partners.
Most people with hepatitis B or C are unaware that they carry the infectious virus. This results in unknowingly transmitting the virus to other people. Approximately one million people die each year from causes related to viral hepatitis.
Hepatitis D infections occur only in those who are infected with hepatitis B. The dual infection of hepatitis D and B can result in a more serious disease and worse outcomes. However, chronic hepatitis D is seen in less than 5 per cent of co-infected patients.
Hepatitis E, like hepatitis A, is typically transmitted through the consumption of contaminated water or food. This form of hepatitis is common in any country with a hot climate. Hepatitis E is most commonly seen in teens and adults between the ages of 15 and 40. Safe and effective vaccines to prevent hepatitis E have been developed but are not widely available.
It’s important to practice good hygiene with any form of hepatitis. Thoroughly wash your hands after using the toilet, changing a baby’s diaper and before preparing food. Avoid sharing eating utensils, toothbrushes and other intimate personal objects.
Dr Cory Couillard is an international healthcare speaker and columnist for He works in collaboration with the World Health Organization's goals of disease prevention and global healthcare education. Views do not necessarily reflect endorsement.