hepatitis C

Viral Hepatitis Information from the CDC

Viral hepatitis information
World Hepatitis Day is July 28

The Center for Disease Control and Prevention Division of Viral Hepatitis posts valuable  viral hepatitis information. Following is its post commemorating World Hepatitis Day. Visit the CDC’s viral hepatitis webpage for more viral hepatitis information.

 

Know Hepatitis. Act Now. For World Hepatitis Day, learn more about the different types of viral hepatitis that impact millions worldwide, and what you can do.

Viral hepatitis – a group of infectious diseases known as hepatitis A, B, C, D, and E- affects almost 400 million people worldwide, causing both acute (short-term) and chronic (long-term) liver disease and killing  more than 1.4 million people every year. In 2013, viral hepatitis was the seventh leading cause of death worldwide, compared with the tenth in 1990, and caused more deaths than AIDS, tuberculosis, and even road injuries. World Hepatitis Day is July 28th and is an opportunity to highlight the global burden of this disease, CDC’s efforts to combat viral hepatitis around the world, and what actions individuals can take.

What is CDC doing to help combat hepatitis globally?

The vision of CDC is to eliminate viral hepatitis in the United States and worldwide. CDC’s recently released five-year strategic plan[PDF – 17 pages] is organized around four key elements, one of which is “Act globally to prevent, detect, and control viral hepatitis.”

CDC has been re-designated as a Pan American Health Organization/World Health Organization (PAHO/WHO) Collaborating Center for Reference and Research on Viral Hepatitis. These WHO Collaborating Centers work to implement WHO’s Global Hepatitis Strategy priority activities, serving as a reference laboratory, and providing technical assistance for the development of viral hepatitis guidelines and policies.

CDC also assists countries experiencing a high burden of viral hepatitis. In recent years, these countries have included China, Egypt, Georgia, India, Pakistan, and Vietnam. Our international work is helping to reduce the disease burden for travelers and people migrating to the United States, while identifying best practices that may serve as models for other countries, including the United States.

What are the different types of hepatitis viruses occurring around the world?

The five hepatitis viruses – A, B, C, D and E – are distinct; they can have different modes of transmission, affect different populations, and result in different health outcomes. While hepatitis B and hepatitis C cause the greatest global burden of disease, hepatitis A, hepatitis D, and hepatitis E are also global health concerns.

  • Hepatitis A is primarily spread when someone who has never been infected with hepatitis A and is not vaccinated, ingests food or water that is contaminated with the feces of an infected person or has direct contact with someone who is infected. Hepatitis A does not cause chronic liver disease and is rarely fatal, but it can cause serious symptoms. Hepatitis A can be prevented through improved sanitation, food safety, and vaccination.
  • Hepatitis B is spread through contact with blood or other body fluids of an infected person, including at birth from a mother to her baby and through sexual contact. The hepatitis B virus can cause both acute and chronic infection, ranging in severity from a mild illness lasting a few weeks to a serious, chronic illness. People who are chronically infected can develop liver cirrhosis or even liver cancer. Hepatitis B is most common in sub-Saharan Africa and east Asia, where between 5–10% of the adult population is chronically infected. Rates of chronic hepatitis B are also high in the Amazon region of South America, the southern parts of eastern and central Europe, the Middle East and the Indian subcontinent. Many people with chronic hepatitis B were infected at birth or during early childhood. Getting the hepatitis B vaccine is the most effective way to prevent hepatitis B virus infection. WHO recommends that all infants receive the hepatitis B vaccine as soon as possible after birth. In many parts of the world, widespread infant vaccination programs have led to dramatic declines of new hepatitis B cases.
  • Hepatitis C is spread through contact with blood of an infected person. Hepatitis C is common in many countries in the world; in much of Asia and Africa, most infections are caused by unsafe medical injections and other medical procedures. Hepatitis C related to injecting drug use occurs throughout the world; an estimated 67% of people who inject drugs having been infected with the hepatitis C virus. Mother-to-child transmission of hepatitis C is also possible. Hepatitis C, like hepatitis B, can also cause both acute and chronic infections, but most people who get infected develop a chronic infection. A significant number of those who are chronically infected will develop liver cirrhosis or liver cancer. Antiviral medicines can cure approximately 90% of people with hepatitis C, thereby reducing the risk of death from liver cancer and cirrhosis, but access to diagnosis and treatment is low. There is currently no vaccine for hepatitis C but research in this area is ongoing.
  • Hepatitis D is passed through contact with infected blood. It only occurs in people who are already infected with the hepatitis B virus. People who are not already infected with hepatitis B can prevent hepatitis D by getting vaccinated against hepatitis B.
  • Hepatitis E is spread mainly through contaminated drinking water. Hepatitis E usually clears in 4-6 weeks so there is no specific treatment. However, pregnant women infected with hepatitis E are at considerable risk of mortality from this infection.  Hepatitis E is found worldwide, but the number of infections is highest in East and South Asia. Improved sanitation and food safety can help prevent new cases of hepatitis E. A vaccine to prevent hepatitis E has been developed and is licensed in China, but is not yet available elsewhere.

Do you need to be vaccinated and/or tested for hepatitis?

CDC and DVH are continuing to lay the foundation for the elimination of viral hepatitis as a public health threat, both domestically and abroad. Hepatitis A, hepatitis B, and hepatitis C are the most common types of viral hepatitis in the United States. To see if you need to be tested and/or vaccinated for hepatitis A, B, or C, take CDC’s online Hepatitis Risk Assessment, which is based on U.S. recommendations.

More Information

Make Smart Injection Choices

 

Smart Injection Choices
World Hepatitis Day is July 28

The World Health Organization reminds us that we need to make smart injection choices. Following are the questions that the WHO suggests we ask our healthcare provider before we receive an injection to help us make smart injection choices. Unsafe injections spread diseases such as viral hepatitis. When we communicate with our healthcare providers we make good decisions and healthcare improves.

Make smart injection choices
Make smart injection choices

Another plea for a national healthcare registry

Lauren Lollini is a patient safety advocate who has been integral in changing laws to keep patients safe as well as a member of the Drug Diversion Prevention Committee.
Lauren Lollini is a patient safety advocate who has been integral in changing laws to keep patients safe as well as a member of the Drug Diversion Prevention Committee.

News broke a few weeks ago about a possible drug diversion event in Colorado. The more we here about the details of this incident, the more we understand just why a national registry for healthcare workers is so important. Even with the current registry the state of Colorado has for surgical technologists, we see that we have still fallen short in regard to gaps in the system.

It appears the surgical tech who was caught with a syringe in an operating room where he was not scheduled has lost every previous hospital job due to drug violations. At least one other job he was caught stealing a syringe and in still another he tested positive for fetanyl. It appears 4 states are now involved in an ongoing investigation. Read more

Real fear in South Korea Hepatitis C outbreak

Lauren Lollini is a patient safety advocate who has been integral in changing laws to keep patients safe as well as a member of the Drug Diversion Prevention Committee.
Lauren Lollini is a patient safety advocate who has been integral in changing laws to keep patients safe as well as a member of the Drug Diversion Prevention Committee.

Prior to my 2009 Hep C infection I paid little, if any, attention to issues of safe injection practices, drug diversion or outbreaks. In my ordinary life, I had no concern for such things. In fact, I am not even sure I could adequately define any of those terms prior to the chaos of 2009 and the outbreak in Colorado.
But since, I have kept myself in the know, paying attention to trends, outbreaks and legislation to protect patients. My email inbox and social media accounts are littered with stories, mostly bad, about errors in patient care. I truly hope that some of the initiatives I have become a part of will put a stop to most of these incidents. However, in preparing for every situation in an attempt to prevent these events you will find a tale so far fetched you want to read the facts 2 or 3 times just to insure what you initially thought you heard was correct. Read more

Renewed Call to Action on Worldwide Injection Safety

Advocates from all over the world met in Glasgow, Scotland to participate in the World Hepatitis Summit
Advocates from all over the world met in Glasgow, Scotland to participate in the World Hepatitis Summit

Steve Langan, director of HONOReform recently attended the World Hepatitis Summit, hosted by the World Hepatitis Alliance. Following is his report.

I am grateful for the opportunity to represent HONOReform and our advocates and stakeholders at the inaugural World Hepatitis Summit earlier this month in Glasgow. I commend the leadership and staff of the World Hepatitis Alliance—Charles Gore, Raquel Peck, Su Wang, just to name a few—who put together a thoughtful and comprehensive meeting.

About 700 of us attended, representing 90 countries. It was a thrilling meeting. I reconnected with old friends and allies and met a lot of people from all over the world who share the desire to prevent and treat viral hepatitis.

According to the WHA, 400 million people are affected with viral hepatitis. Almost a million and a half people throughout the world die every year as a result of being affected by viral hepatitis. It’s the seventh leading killer in the world. Still, it seems that many people remain nonchalant not only about the disease itself but by its most common form of transmission in developing countries—through the medical injection process.

Earlier this year, Evelyn McKnight and I attended the Safe Injection Global Network meeting at the World Health Organization. Evelyn shared her powerful story. The WHO made a commitment to focus on encouraging developing countries—India, Egypt and Uganda, as a starting place—to only use single-use injection devices and to put these one-time-use devices in to play by 2020.

This one fact alone is, to us, a sufficient call to action: Up to 70 percent of the infections of viral hepatitis in India are transmitted through healthcare.

This call to action makes me think of the men and women in the villages west of Delhi. We had the opportunity last year to visit India and meet patients and their family members who were infected with viral hepatitis during healthcare. Watching Evelyn McKnight talk with these patients—mediated by a translator, but the emotions were universal—is one of the most memorable moments of my career.

For them, and for the many other patients throughout the world who go to the doctor and come out with an injection of viral hepatitis, we encourage the WHO and its many partners—governments and industry, in particular—to renew the commitment to injection safety in developing countries.

We have said it before but we will say it again: No person should go in to a medical facility for treatment and leave with an infection of viral hepatitis. Not in 2015. Not with all of the resources and materials that can easily, and affordably, be put in to play.

World Hepatitis Summit 2015

Antonio Oñate of the Fundacion Hepatos Aion of Mexico shares his thoughts about the recent World Hepatitis Summit and the global impact of viral hepatitis
Antonio Oñate of the
Fundacion Hepatos Aion of Mexico shares his thoughts about the recent World Hepatitis Summit and the global impact of viral hepatitis

The World Hepatitis Alliance Summit has ended; countries with different cultures face the same opponent. People around the world are working according to their particular circumstance – some, under a clear strategy, others day by day – but all familiar with the challenges and difficulties of others, because they have lived it and therefore recognized in the other his equal.

For those involved in this problem it is not only a full-time job, it’s a personal matter that is constrained by the pervasive lack of resources and political commitment of many decision makers to prevent prompt and effective medical care. A recurring theme is the voracious appetite for profits of pharmaceutical companies.

But camaraderie is a link between the participants and shows that not all storm clouds darken the sky; there are rays of hope. People who work at government level show their commitment as human beings who seek to help others, their names very rarely recognized in the media but through them their governments have decided to take action:

Brazil is a case closer to us in American continent but Egypt, Georgia, Scotland among others,  have made successful negotiations with manufacturers of drugs for hepatitis C that will provide access to an important treatment of their populations affected by the “silent enemy”.

Special mention is that of Egypt. It not only achieved a fair price but also has a clear strategy: to treat its 10 million people infected with hepatitis C by 2025. From October 2014 to August 2015 they gave 130,000 treatments and have been getting the cure for 85%. Next year it aims to provide 350,000 treatments.

Another case is Scotland. They recognized early in this century the serious public health threat from hepatitis and established a strategy to be developed in several phases, which began in 2006 and continues today. They have a strategic vision, which demonstrates the importance of planning ahead with short and medium term goals. They showed to other governments of the world that the time of analysis and planning should have been 10 years ago, not now that the bomb has exploded and urgent action is needed.

The remaining countries continue to do the best they can despite the Olympic sized lack of commitment by their decision makers.

The battle under such circumstances is unmatched, to say it politely. Governments remain entrenched despite seeing such a large segment of its population annihilated under the pretext of not having enough resources.

Talking about the discrimination, stigmatization and loss of jobs that patients and their families face should exert enough pressure on our governments to act promptly to stop the spread of the disease and reduce the number of deaths from this war without quarter.

A good example for taking action is the serious problem of the use and sharing of injected drugs and the importance of an injection safety program.

Thanks to the World Hepatitis Alliance, the Ministry of Health of Scotland, the governments of Brazil, Egypt and Georgia, to the people who work in government, and the pharmaceutical companies that genuinely share our goals.

But especially you, the patient, family member, and friend that advocate to seek a better quality of life for those affected by hepatitis C . And to all the parents, brothers, children, wives, husbands who have died in this unjust war, thank you for your courage and tenacity.

Thanks and keep fighting!

Up to 1.5 million deaths, annually, caused by infections of viral hepatitis

Steve Langan, director of HONOReform, will attend the inaugeral World Hepatitis Summit
Steve Langan, director of HONOReform, will attend the inaugeral World Hepatitis Summit

We stand alongside our many colleagues throughout the world, including representatives of the WHO, one of whom, Dr. Stefan Wiktor, refers to hepatitis as the “silent epidemic.” Hepatitis is the seventh leading cause of death throughout the world Many of these cases of hepatitis, especially in developing countries, are caused by unsafe injection practices.

HONOReform is honored to be included in the inaugural World Hepatitis Summit, which will occur early next month in Glasgow. We are grateful to the World Hepatitis Alliance for including us in these meetings. HONOReform continues to seek ways to expand and provide injection safety education and awareness in developing countries. I will report back from these meetings. In the meantime, we encourage you to read about the proposed WHO-led pilot program--in India, Egypt and Uganda–to which we aim to lend the leadership of Evelyn McKnight and HONOReform’s experience, determination and voice.

Hepatitis C and preventive measures by Dr Mudasir Firdosi

We would like to thank Dr. Mudasir Firdosi for helping to highlight Hepatitis C as a truly global issue. This is re-printed from a post which appeared in mid-May.

Kashmir valley is witnessing another disaster in the form of Hepatitis C epidemic. In some villages in Kokernag area, the number of cases is around 40% of the total population. In spite of media pressure, and demand from local population, authorities are still contemplating curbing the further spread of this infection. Similar scenario exists in other districts of the valley like Shopian, Kupwara, and Srinagar.

Hepatitis C is not transmitted by routine personal contact and there needs to be an actual transfer of the virus via blood, blood products and body fluids, from one person to another. From the sociodemographic profile of the rural population, one can easily exclude intravenous drug abuse or sexual contact as the cause of the current epidemic in majority of cases.
Read more

Possible Hepatitis, HIV Exposures in Santa Barbara, CA

Lauren Lollini is a patient safety advocate who has been integral in changing laws to keep patients safe as well as a member of the Drug Diversion Prevention Committee.
Lauren Lollini is a patient safety advocate who has been integral in changing laws to keep patients safe as well as a member of the Drug Diversion Prevention Committee.

My heart skipped a few beats last week when I read about the potential outbreak resulting from a lack of safe infection control measures in a doctor’s office in Santa Barbara County. Things had been going fairly smoothly in regard to safe injection practices. In 2014, none of the investigations which took place found any disease transmissions. In fact, we had not had an investigation over the last six months and although we never stop educating and spreading awareness, we were able to breathe a small sigh of relief. Read more

A heartfelt thank you to some very hard working epidemiologists

Lauren Lollini is a patient safety advocate who has been integral in changing laws to keep patients safe as well as a member of the Drug Diversion Prevention Committee.
Lauren Lollini is a patient safety advocate who has been integral in changing laws to keep patients safe as well as a member of the Drug Diversion Prevention Committee.

A huge thank you to the wonderful epidemiologists at both the Colorado Department of Public Health and Environment (CDPHE), Division of Disease Control and at the Centers for Disease Control and Prevention (CDC), Viral Hepatitis Division for their major article published this month in the American Journal of Infection Control. Their article, “Outbreak of hepatitis C virus infection associated with narcotics diversion by an hepatitis C virus-infected surgical technician,” outlines the happenings surrounding the Hepatitis C outbreak in Colorado in 2009. Their in-depth study of this situation brilliantly highlights the need for better health surveillance in identifying such outbreaks and the diversion which causes them.
Read more

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