ASK THE DOCTOR:
The ABCs of hepatitis
By DR JIM MITTERANDOQ - My brother has chronic hepatitis. How is this different than the recent hepatitis outbreaks at local restaurants?
A - Hepatitis - inflammation of the liver - is most often caused by viral infections such as Hepatitis A, B or C. Symptoms of acute hepatitis include jaundice (yellow skin), dark urine, fever, feeling very ill with flu-like symptoms - nausea, vomiting and headaches.
Hepatitis A
Hepatitis A is spread by infected food handled by someone with hepatitis A and rarely by contaminated shellfish. It is not common but is quite contagious. It is rarely fatal but people can be very ill for several weeks. Hepatitis A does not cause a chronic infection. There is no treatment for hepatitis A infection but there is a vaccine for its prevention. Food handlers, sewage/septic workers, people with chronic hepatitis B or C, and travelers to third world countries should receive the hepatitis A vaccine. People who have been exposed to someone with hepatitis A can receive a gamma globulin shot that contains antibodies to prevent an infection.
Hepatitis C
Your brother probably has hepatitis C illness that causes a chronic infection in most affected people. Hepatitis C is transmitted by blood products (occupational exposures, IV drug abuse or blood transfusions before 1992) and rarely by sexual contact. One percent of Americans have chronic hepatitis C. Contracting hepatitis from blood transfusions these days is extremely rare since donated blood is screened for hepatitis. Hepatitis C cannot be spread by sharing food or kissing. Some people with chronic hepatitis C develop cirrhosis (liver failure) or liver cancer. There is no vaccine against hepatitis C. People with chronic hepatitis C should receive vaccines against hepatitis A and B.
The anti-viral drugs, interferon and ribavirin, can eradicate chronic hepatitis C viral infection 50 percent of the time. These drugs can cause severe side effects and are used in people with liver damage hoping to prevent further scarring of the liver. People with chronic hepatitis need to avoid alcohol and over-use of Tylenol (acetaminophen).
Hepatitis B
Hepatitis B is a sexually transmitted disease that can also spread by contact with blood. Pregnant women are screened for hepatitis B since it can be passed to the developing fetus. A small percentage of people with hepatitis B can develop a chronic infection and cirrhosis.
Hepatitis B is common in Asia. Fortunately, it is declining in the United States since routine childhood vaccination began about 15 years ago. In Massachusetts, most people under the age of 25 have been vaccinated. Sexually active adults and health care workers should also receive hepatitis B vaccine.
More information about hepatitis is available at the Centers for Disease Control web site: www.cdc.gov.
Dr. Jim Mitterando is a family doctor at Cohasset Family Practice and a staff member at South Shore Hospital in Weymouth.
Readers should send questions to: Ask the Doctor, The Patriot Ledger, P.O. Box 699159, Quincy, MA 02269-9159, or by E-mail to his attention at features@ledger.com.
Questions of general interest will be answered in this column. The information in this column is not intended to diagnose individual conditions, and individual replies are not possible. Readers should see their own doctors about specific problems.
Copyright 2004 The Patriot Ledger
Transmitted Tuesday, August 03, 2004