Endemic area: vaccination for Hepatitis A recommended for all kids

Vaccination for Hepatitis A is available and is recommended for all children of two years and above, living or travelling to an endemic area. This has been advised by Dr Khalid Mumtaz, gastroenterologist, at a public health awareness programme at Aga Khan University Hospital (AKUH).
Dr Mumtaz, Assistant Professor, Section of Gastroenterology, was addressing the Hospitals Signs, Symptoms and Care programme on Hepatitis and Dyspepsia, says a AKUH statement here on Sunday.
He said that Hepatitis A and E is by far the most common form of acute viral hepatitis in Pakistan. It spreads through the ingestion of contaminated food or water, especially where unhygienic conditions allow water or food to become contaminated by human waste (the faecal-oral mode of transmission).
Hepatitis A is usually more common among school-going children particularly in first decade of life. Hepatitis E occurs more frequently in teenage, though both can occur at any age in endemic areas, he said.
Recounting the symptoms of both the infections, which include generalised weakness, nausea, vomiting, and jaundice alongwith fever, he said that fortunately, in majority of cases hepatitis A and E could recover with symptomatic treatment. Hepatitis E can be disastrous if it affects a pregnant woman with 20-25 percent chances of developing acute liver failure and mortality.
After recovery from a hepatitis A or E infection, person develops immunity to the virus, meaning he or she has very low chances of the same infection again.
Simple preventive measures include using boiled or properly filtered water for drinking, avoiding unhygienic food and food prepared in unhygienic conditions and washing hands before preparing and eating food.
Dr Rustam Khan, Department of Medicine, informed that chronic Hepatitis B and C are common health problems in developing countries like Pakistan.
Mode of transmission of these viruses is parenteral, ie by transfusion of unscreened blood and blood products, sharing needles or shaving blades, surgery and dental procedures by contaminated instruments, tattooing and ear piercing, etc. Chronic infection due to hepatitis B, C, if not treated in time may progress to Liver Cirrhosis, which is end stage liver disease. Patients with liver cirrhosis usually face complications like blood vomiting, abdominal distention due to fluid, episodes of unconsciousness and liver cancer.
Treatment in this condition is very costly, with lots of side effects and at time may be ineffective. Great emphasis should be on preventive aspects. Prevention can be achieved by increasing public awareness about avoiding high risk behaviour, proper screening of blood before transfusion, using disposable syringes for injection, vaccination for hepatitis B and early detection and treatment of patients with hepatitis B and C.
Gastroenterologist Dr Mohammad Salih defined Dyspepsia as pain or discomfort centered in the upper abdomen. Discomfort may be characterised by or associated with upper abdominal fullness, early satiety, bloating, or nausea. Dyspepsia comprises 40 percent to 70 percent of gastrointestinal (GI) complaints in general medical practice, he said. The common organic causes are acid peptic disorder, motility disorders, NSAIDs and other drugs, gall bladder disease, malabsorption and mesenteric ischemia etc.
Sometimes cardiac disorders may simulate dyspepsia. He explained that a number of diagnostic tests are available for finding out the underlying cause of dyspepsia. These include upper GI Endoscopy, Urea Breath Test, pH Monitoring, Esophageal Manometry, Drinking Tests and Endoscopic Ultrasound.
As part of its outreach programme and societal commitment to creating awareness of early diagnosis and timely treatment, AKUH has organised over 230 Signs, Symptoms and Care programmes in Karachi, Hyderabad and the UAE, benefiting more than 40,000 people, it was further pointed out.