Communicable Diseases and Health Analysis
Action needed to improve prevention, surveillance, diagnosis and treatment
Washington, D.C., 28 July 2011 (PAHO/WHO) — As many as 2 billion people worldwide are infected with hepatitis B—one of five types of hepatitis virus—and more than 350 million suffer a chronic form of the disease. Yet public awareness is low, and much more public health action is needed to prevent and control viral hepatitis, said experts today at the Pan American Health Organization/World Health Organization (PAHO/WHO) in observance of World Hepatitis Day.
The hepatitis group of viruses—types A, B, C, D and E—cause acute and chronic infection and inflammation of the liver, and are a major public health problem globally. An estimated 500,000 to 700,000 people die annually as a result of hepatitis B virus infection. Some 130–170 million people are chronically infected with hepatitis C virus, and some 35,000 people die from related liver diseases each year. An estimated 57 percent of cases of liver cirrhosis and 78 percent of cases of primary liver cancer result from infection with hepatitis B or C virus.
In the Americas, more than 380,000 potential blood donors were deferred from donating due to the presence of risks for hepatitis B, C or HIV in 2009. Yet despite this initial screening, more than 75,000 blood donor donations were found to be infected with hepatitis B or C viruses. According to available data, between 7 million and 9 million people may be infected with hepatitis C in Latin America alone.
The World Health Assembly in 2010 designated World Hepatitis Day as an official WHO health day to call attention to the growing threat of this disease and called on countries to improve awareness, surveillance, prevention, diagnosis and treatment of viral hepatitis.
“Today, on World Hepatitis Day, we join WHO and the World Hepatitis Alliance in calling attention to the enormous toll of viral hepatitis,” said Dr Roses, PAHO’s Director. “We hope that together we can stir a sense of urgency and commitment across all levels of society, from the health system to the communities they serve.”
Viral hepatitis can be prevented through the use of vaccines, and PAHO/WHO recommends the inclusion of hepatitis B vaccine in all immunization schedules, as well as routine use of hepatitis B vaccine among health workers. Hepatitis B vaccine was introduced by nearly all PAHO/WHO Member countries at the end of the 1990s. Currently, all the countries and territories of the Americas, with the exception of Haiti, have hepatitis B vaccine in their national immunization programs, with levels of coverage of over 90 percent.
In observing World Hepatitis Day, PAHO and WHO are calling on countries to: develop, enhance or improve their surveillance systems for viral hepatitis; strengthen laboratory capacity; support public policies and integrated interventions; implement strategies and tools to strengthen their health care systems; guarantee early diagnosis and treatment, protection and immunization for healthcare workers; implement universal hepatitis B immunization for newborns and children; and promote safe blood donation and injection safety.
A working group, launched by PAHO/WHO today, will try to integrate the existing efforts of all entities that have been collaborating with PAHO/WHO member countries to prevent and control viral hepatitis.
In May 2010, the 63rd World Health Assembly decided to designate each July 28 as World Hepatitis Day, as an opportunity to focus attention on the global health threat of viral hepatitis and to promote actions to confront it. The theme for this year’s campaign is “Don’t let hepatitis tear your life apart … Know it. Confront it. Hepatitis affects everyone, everywhere.”
For more information visit: World Hepatitis Day 2011 -http://www.who.int/mediacentre/events/annual/world_hepatitis_day/en/
Hepatitis: Key Facts
Hepatitis is an inflammation of the liver, most commonly caused by a viral infection. There are five main hepatitis viruses, referred to as types A, B, C, D and E. These five types are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of people and together are the most common cause of liver cirrhosis and cancer.
- Hepatitis A virus (HAV) is present in the feces of infected persons and is most often transmitted through consumption of contaminated water or food. Certain sex practices can also spread HAV. Adequate supplies of safe-drinking water and proper disposal of sewage within communities, combined with personal hygiene practices, such as regular hand-washing, reduce the spread of HAV. Safe and effective vaccines are available to prevent HAV.
- Hepatitis B virus (HBV) is transmitted through exposure to infective blood, semen, and other body fluids. HBV can be transmitted from infected mothers to infants at the time of birth or from family member to infant in early childhood. Transmission may also occur through transfusions of HBV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. HBV also poses a risk to healthcare workers who sustain accidental needle stick injuries while caring for infected-HBV patients. A safe and effective vaccine is available to prevent HBV.
- Hepatitis C virus (HCV) is mostly also transmitted through exposure to infective blood. This may happen through transfusions of HCV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. Sexual transmission is also possible, but is much less common. There is no vaccine for HCV.
- Hepatitis D virus (HDV) infections occur only in those who are infected with HBV. The dual infection of HDV and HBV can result in a more serious disease and worse outcome. Safe and effective hepatitis B vaccines provide protection from HDV infection.
- Hepatitis E virus (HEV), like HAV, is transmitted through consumption of contaminated water or food. HEV is a common cause of hepatitis outbreaks in developing parts of the world and is increasingly recognized as an important cause of disease in developed countries. Safe and effective vaccines to prevent HEV infection have been developed but are not widely available.
Early diagnosis provides the best opportunity for effective medical support. It also allows those infected to take steps to prevent transmission of the disease to others, for example, by adopting safe sex practices. It also facilitates lifestyle precautions—such as eliminating alcohol and certain drugs--to protect the liver from additional harm.
Viral hepatitis can be prevented through the use of vaccines. Screening blood used for transfusion can prevent transmission of HBV and HCV. Sterile injection equipment protects against HBV and HCV transmission. Safer sex practices, including minimizing the number of partners and using barrier (condom) protective measures, have been shown to protect against HBV and HCV transmission. Harm reduction for injection drug users prevents HBV and HCV transmission, and safe food and water provide the best protections against HAV and HEV.