Hepatitis in India: A preventable disease still claiming lives
Before diving into India's unique challenges, it's important to understand that hepatitis is not one disease, but a family of five viruses - A, B, C, D, and E. Each one affects the liver but in different ways:Hepatitis A and E: Spread through contaminated food and water, these forms usually cause acute infections, and are more common in areas with poor sanitation. Hepatitis E is particularly dangerous in pregnant women.Hepatitis B and C: Transmitted through blood and bodily fluids, these can lead to chronic liver disease, cirrhosis, and liver cancer if left untreated.Hepatitis D: Occurs only in people already infected with hepatitis B, adding another layer of complexity.While hepatitis A and E are short-term illnesses that don't become chronic, hepatitis B and C are long-haul infections that can stealthily damage the liver over decades, often going undetected until it's too late.A LOW-PREVALENCE COUNTRY WITH A HIGH BURDENAccording to the 2023 HIV Sentinel Surveillance Plus report, the national seroprevalence for hepatitis B is around 0.85% and for hepatitis C is 0.29%. That technically puts India in the 'low prevalence' category (less than 2%) as per World Health Organisation (WHO) standards.But these small percentages translate into millions of infected individuals, many of whom are completely unaware of their status.As Dr. Kapil Sharma, Director of Gastroenterology at Sarvodaya Hospital, Faridabad, puts it, 'Many people do not know they are infected until they begin to experience complications like liver damage or cancer. That's far too late.'THE SPIKE THAT RETURNS EVERY MONSOONMonsoon in India is not just a season, it's a public health alarm. Hospitals report a surge in acute viral hepatitis cases, especially hepatitis A and E, linked to stagnant water, flooded drains, and contaminated food.This year, Dr. Abhideep Chaudhary, President-Elect of the Liver Transplantation Society of India (LTSI) and Vice Chairman, HPB and Liver Transplantation at BLK-Max Hospital, Delhi, said that there's been a 40% rise in acute viral hepatitis cases in the past three weeks alone.'Many patients are unaware of the need for hepatitis vaccination, especially those moving from rural to urban settlements," said Dr. Chaudhary.advertisementEven children are affected. Hepatitis A is highly prevalent among kids under 15, while hepatitis E is a leading cause of waterborne hepatitis, particularly deadly for pregnant women.THE REAL COST OF DELAYSymptoms of hepatitis often start subtly: fatigue, mild jaundice, loss of appetite.But as Dr. Sanjiv Saigal, President of LTSI, warns, 'We are witnessing a seasonal epidemic that repeats every year, and yet we are caught off guard every time.' In some cases, acute hepatitis A or E can lead to liver failure, requiring urgent transplant.'There's a dangerous myth that jaundice is self-limiting,' adds Dr. Chaudhary. 'Delayed diagnosis can lead to life-threatening complications. Despite being a public health challenge, these infections remain underreported and poorly understood.'One of the biggest reasons hepatitis still thrives is the gaping void in early detection. Dr. Sharma explains that in India:Routine screening is rare, especially in rural and semi-urban areas.Stigma surrounding liver disease discourages people from seeking timely care.Medical infrastructure is stretched, with a lack of trained personnel to detect early symptoms.Treatment costs, especially for hepatitis C, can be prohibitive for many families.Even though vaccines exist, coverage is patchy. Many people don't complete the full course or are unaware that they're at risk in the first place.advertisementUNSAFE MEDICAL PRACTICES FUEL THE FIREUnsafe injections, unsterilised dental equipment, and informal clinics using dubious methods are major transmission routes for hepatitis B and C.'A lot of infections occur due to unsafe blood transfusions and contaminated medical equipment in smaller healthcare setups,' Dr. Sharma says. While urban hospitals are more likely to follow safety protocols, rural clinics often operate with minimal oversight.For hepatitis A and E, it's the basics - safe drinking water and hygiene - that remain elusive in many parts of the country. Kerala, for example, faces annual outbreaks of hepatitis A.According to Dr. E. Sreekumar, Director of the Institute of Advanced Virology, floods and erratic rainfall have worsened clean water access in recent years.CHALLENGES IN PUBLIC AWARENESS AND WHAT MUST CHANGEDespite recurring outbreaks, public understanding of hepatitis remains shockingly low.'Most people can't differentiate between types of hepatitis or recognise the symptoms,' says Dr. Sharma. This lack of awareness is especially pronounced in slum areas and among migrant workers, where clean water and healthcare access are already limited.According to experts, several steps can help stem the tide of hepatitis in India:advertisementIntegrate the Hepatitis B vaccine into all birth and school immunisation programs.Launch mass screening campaigns for high-risk groups, especially pregnant women, healthcare workers, and injection drug users.Ensure all blood banks and hospitals follow strict infection control protocols.Subsidise hepatitis treatments, particularly for hepatitis C, to make them more affordable.Use community health workers, schools, and religious centres to drive public education.Train primary healthcare workers to recognise early signs of hepatitis.Dr. Monika Jain, Director of Liver Diseases at Sri Balaji Action Medical Institute, puts a spotlight on everyday hygiene: 'We tell everyone to eat properly cooked food, avoid street vendors during the rains, and wash hands thoroughly.'As Dr. Saigal notes, 'We must shift focus from treating hepatitis to preventing it. That's the only way we'll stop this disease from quietly wreaking havoc, one monsoon at a time.'Because hepatitis may be an old enemy, but it's one we already know how to defeat. Now, we just have to act like it.- EndsTrending Reel
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