Hepatitis B : Lurking in HIV's Shadow

The story of the hepatitis B outbreak in Gujarat has not received the attention it deserves. More so because Hepatitis B is not the typical jaundice that comes around in the monsoon season every year and then trails off as the rains dry up. This variety of Hepatitis is chronic in nature; has no cure and is potentially more dangerous than HIV and AIDS, the mode of transmission for both being the same.

At last count thirty four people had been felled by the virus and this piece of news need not be the last word on the subject as The Gujarat health department says that this death toll could raise, as about 50 persons are still being treated in different hospitals. It has now been established that unsafe syringes and injection needles has caused the spread of hepatitis B in the Gujarat town, what is now being seen as one of the biggest hepatitis B outbreaks in the country.

Following the inevitable knee jerk reaction, the government has clamped down on many doctors and chemists claiming medical negligence. Doctors have apparently been using unsterilized and used recyclable syringes meant for single use but it is quite likely to be a case of too little action and too late. Although the cases of hepatitis B have thus far been found in Modasa taluka of the Sabarkantha district, it is quirt possible that the virus may be spreading in neighbouring districts also as the use of unboiled syringes and disposable syringes being recycled is not likely to be confined to just one location. The hepatitis B virus is transmitted through contact with the bodily fluids of an infected person. The virus can be transmitted via unprotected sex or sharing of contaminated needles. Pregnant mothers also tend to pass it on to their babies.

Chronic carriers have an increased risk of developing liver disease such as cirrhosis or liver cancer, because the hepatitis B virus steadily attacks the liver. Considering that these are exactly the methods by which HIV spreads, Hepatitis-B virus (HBV) remains a major public health problem with an estimated 350 million carriers worldwide, out of which 40 million are in India. HBV is more infectious than Hepatitis-C or the Human Immunodeficiency Virus (HIV) and chronically infected individuals readily infect unvaccinated members and sexual partners. Hepatitis B is a disease more lethal than AIDS, claiming more lives in a day than the latter does in a year.

The whole episode highlights at least three things. Firstly, the depths to which the medical profession continues to sink: doctors, let alone contribute to any cure or healing are now actively contributing to patient deaths, breaching the sine qua non of the medical profession of doing no harm. Secondly, the need for blood safety and prevention of transfusion associated infections in the country has come to the fore and though because of the spotlight has been there for long on the blood banks to screen blood, not just to rule out Hepatitis B but also HIV, a lot still remains to be done.

Thirdly Hepatitis B is an expensive disease to treat and the results are not usually so encouraging, with an efficacy of only 30-40 percent. However, a relatively affordable vaccine is available to prevent it and Hepatitis-B vaccination has now become the part of the primary immunization of infants in many countries and is being administered in many parts of India in the National Immunization Program. But this is not generally known and widely administered in India, which is why the people in Sabarkantha fell victim to it in the first place. May be the deaths occurring in Gujarat and the international attention it is drawing, will make a difference in the numbers of people queuing up for the vaccine and the government making it available at far more cheaper rates than presently available.