Latest news with #VivekanandanShanmugam
The Hindu
2 days ago
- Health
- The Hindu
Liver diseases often go undetected; doctors call for early screening and awareness
An estimated 304 million people worldwide live with chronic hepatitis B or C, according to the World Health Organization (WHO). Of these, 254 million have hepatitis B and 50 million have hepatitis C. The disease causes about 1.3 million deaths annually over 3,500 each day. India accounts for over 11.6% of the global burden, with around 29.8 million people living with hepatitis B and 5.5 million with hepatitis C. Hepatitis is inflammation of the liver, most commonly caused by viral infections, mainly hepatitis A, B, C, D, and E. Among these, hepatitis B and C can become chronic, potentially leading to cirrhosis, liver failure or cancer. Transmission can occur through unsafe injections, blood transfusions, sexual contact or from mother to child during childbirth. Despite the scale, most infections remain undiagnosed until complications arise. Doctors say this is due to vague early symptoms, inadequate screening, and widespread misconceptions. 'In the early stages, liver trouble may show up as fatigue, appetite loss or mild abdominal pain - symptoms that are easily overlooked,' said Vivekanandan Shanmugam, Lead Liver Transplant Surgeon, SIMS Hospital, Chennai . 'Even signs like dark urine or yellowing of the eyes are ignored. As a result, patients often present late.' He added that screening for hepatitis B and C is recommended for high-risk groups - those who had blood transfusions before the 1990s, dialysis patients and healthcare workers, but implementation remains patchy. 'Many people don't know they should get tested. There is stigma and poor access, especially in peripheral areas,' he said. Dr. Shanmugam also flagged the impact of over-the-counter painkillers and unregulated herbal supplements. 'The liver filters everything we consume. Long-term misuse of common drugs like paracetamol or herbal concoctions can silently damage the liver.' Radhika Venugopal, Senior Consultant - Hepatology, Liver Disease & Transplantation, Rela Hospital, Chennai, said symptoms such as nausea, fatigue, or weight loss are often ignored. 'By the time jaundice, swelling or bleeding appears, damage is usually advanced. Liver function tests and scans can help detect problems early,' she said. She noted that hepatitis testing is not well integrated into routine healthcare, particularly in rural settings. 'Pregnant women, people with HIV, and those undergoing surgery or dialysis must be screened, but enforcement is weak.' Dr. Venugopal also flagged the rise in 'lean MAFLD' (metabolic-associated fatty liver disease) in people with normal weight but underlying metabolic issues. 'Tools like FibroScan help detect this early.' Doctors recommend hepatitis B vaccination, avoiding excessive alcohol, limiting self-medication, and routine check-ups. 'The liver is silent until it's too late,' said Dr. Shanmugam.
The Hindu
14-06-2025
- Health
- The Hindu
Many private hospitals in T.N. hit by acute shortage of Hepatitis B vaccine
: Private hospitals across the State have been facing a shortage of Hepatitis B vaccine over the past few months. The fall in supplies has made it difficult for many hospitals to vaccinate adults at risk, especially those on dialysis. Hepatitis B vaccine is recommended for infants under the Universal Immunisation Programme (UIP), and for adults at risk such as healthcare providers and people with compromised immune systems. Inquiries with doctors in a number of districts, including Madurai, Tiruchi, Chennai, Erode, and Theni, revealed that there is a shortage of vaccines in many private centres. A doctor in Madurai said, 'We had reached a point where we were left with very few doses of the vaccine. We could not vaccinate newborn children, but got support from government facilities. We received a supply recently, but the quantity does not meet our demand. There has been an acute shortage of the vaccine for the last seven to eight months, and we are unsure of the reason. We have been continuously raising the issue with the manufacturer almost every week.' Multi-dose vials, which have 10 doses each, are used for healthcare workers since it is cost-effective, whereas, single dose vials are used for patients, she said. 'This is mainly recommended for patients visiting nephrology and oncology departments. Due to acute shortage for a few months, we could not vaccinate them,' she added. Doctors in Erode pointed out the difficulty in vaccinating healthcare workers and patients on dialysis due to limited stock, as well as the increase in the cost of vaccines. A year ago, the Chennai Liver Foundation wrote to the vaccine manufacturing company on the poor supply of vaccines. A little later, vaccines were supplied, prioritising the pentavalent ones meant for UIP, while those for adult usage trickled in now and then, according to Vivekanandan Shanmugam, its managing trustee. 'We wrote to the Government of India and they, in response, acknowledged the short supply. They said vaccines would be supplied prioritising the pentavalent doses, and those for the high-risk population. We are not sure when this issue will be sorted out,' he said. Survey to check availability There is a real shortage, and that is why the foundation has sent a survey form to all practitioners and gastroenterologists across India to assess the availability of the vaccine in their centres, Dr. Vivekanandan says, adding: 'This is a gross problem as vaccination is crucial to prevent liver cancers. The World Health Organisation recommends Hepatitis B testing and vaccination for all adults. But given the situation, we should try to test and vaccinate at least those at high risk such as healthcare workers, child-bearing women considering the risk of transmission from mother to child, immune-compromised persons, and those with co-infections such as HIV.' A government doctor said there was increased dependency on the government sector as private hospitals in tier-2 cities and semi-urban areas were facing the shortage of vaccines. Another government doctor added that while the vaccine was freely available for the UIP, they were using the buffer stock for vaccinating patients such as those on dialysis. T.S. Selvavinayagam, Director of Public Health and Preventive Medicine, said the government sector faced no challenges with procuring the vaccine. 'We have 6.34 lakh doses. This is mainly for healthcare workers. Considering our monthly requirement of around 81,000 doses, this stock will last seven to eight months. We also have 2.62 lakh doses of pentavalent vaccine, which is part of the UIP. The pentavalent contains Hepatitis B, and we have supplies that will last over 1.5 months,' he said. He added that if there was any issue with the availability of vaccines in the private sector, people could reach out to Primary Health Centres, where vaccination would be provided as per the UIP schedule for free.
