Eulalee ThompsonThe World Health Organisation (WHO) recommends that the vaccine against hepatitis B virus or HBV, that causes a chronic liver inflammation, be included in the routine immunisation schedule for children. However, Dr. Yitades Gebre, Director of the National HIV/AIDS/STI Programme says Jamaican babies are not routinely given this vaccine because it is too expensive.
In the private sector, the vaccine costs about $1,000 per course and usually, three courses are required to give full protection against HBV. This virus should be of public health concern because of its long term consequences; the slow, progressive liver damage which it causes and its link to the development of liver cancer.
The hepatitis B virus is one of the group of viruses (including A, B, C, D and E) that accounts for the majority of viral hepatitis. Infection with HBV causes the incurable hepatitis B, which is spread here mainly through unprotected sexual contact. It can also spread through blood transfusion, sharing injection needles and prenatal, mother-to-child transmission. Dr. Gebre said it is also established that in households, infected persons can transmit the virus by sharing toothbrushes or razor blades.
For every 1,000 Jamaicans, five of them will have a history of exposure to HBV. A study conducted by Dr. Peter Figueroa, chief medical officer, indicates that healthcare workers had higher risk of infections when compared to the general population because of their exposure to infected persons and sharp implements that might have come into contact with infected blood. Other high-risk groups which Dr. Gebre identified, include persons working with developmentally-disabled children, mentally-ill persons, correctional services, emergency services, funeral home employees and persons with multiple sexual partners.
Hepatitis B is a serious disease that kills about 30 Jamaicans every year and about one million people worldwide. It is also estimated that about 190 new cases of HBV are reported each year to the Health Ministry's Epidemiology Unit.
Persons infected with HBV have the virus circulating in their blood much like the human immunodeficiency virus (HIV). Within a few months, Dr. Gebre said some infected individuals will recover or they will remain chronically infected and infectious throughout their lives.
The main signs and symptoms of hepatitis B infection are jaundice, fatigue, abdominal pain, loss of appetite, intermittent nausea and vomiting. Often skin rashes, a mild degree of fever and joint pains have been observed.
"About one-third to one-half of adults infected with HBV may show yellow jaundice or discolouration of the "white of the eye". Over 90 per cent of infected children do not show any symptoms. Although most people do not show symptoms at the time of infection, a special blood test can accurately identify persons with the infection," he said.
Since there is no cure for HBV, prevention is the recommended approach either by taking the course of vaccines or by practising safe sex. Dr. Gebre said that infected persons can be treated with antiretroviral drugs such as Lamivudine (Epivir) or interferon but this treatment helps less than 40 per cent of patients. To help patients survive end-stage liver disease, high medical costs are incurred for liver transplants (if a donor can be found). The failed liver, Dr. Gebre said, is unable to produce blood clotting factors, cannot store sugar, will not digest food and is unable to remove waste from the body. Some patients will at this stage experience bleeding from their skin and internal organs and the accumulation of body waste often leads to a coma.
