Hepatitis, an avoidable risk

Philip J. Goscienski, M.D.

November 2009

An outbreak of hepatitis shut down one of my favorite restaurants about a half-century ago. Since then my medical colleagues have found ways to nearly shut down the disease as well. Actually there are two major forms of hepatitis, type A and type B, with other variants (types C, D and E) lurking in the background but fortunately much less common.

The average person has little to fear from type B hepatitis. The disease is a problem mainly among drug users. It is transmitted through contaminated blood or blood products. The incidence of transfusion-associated hepatitis B began to drop dramatically when blood banking procedures eliminated it from blood and its derivatives.

Hepatitis A is more likely to attack innocent victims. Poor hygiene and inadequate sanitation contribute to its spread. Extensive epidemics have occurred in day care centers. Young children usually have such mild disease that their illness is not recognized until one of their adult diaper-changers wakes up some morning with yellow eyeballs after a feeling poorly for several days. Although jaundice, the yellowing of the skin and the whites of the eyes, looks ghastly the disease is usually mild in adults as well.

The worst complications are usually economic and social. Victims lose time from work until their color returns to normal and their fellow employees are generally reluctant to shake hands or make other close contact for some time after the illness. Their fears are unjustified. By the time jaundice appears most victims are no longer contagious.

Exposure to hepatitis is one of the hazards of water-related recreation. If chlorine levels in a swimming pool fall because of poor maintenance or crowding, the virus that causes hepatitis may survive to spread disease. One would expect the vast size of the ocean to dilute the virus but sewage spills containing lots of virus are not uncommon in beach areas. Water samples from one coastal community yielded hepatitis A virus in 80 percent of the samples during one recent year.

Overseas journeys are exciting and travel to exotic lands even more so. What makes them exotic is their primitive nature and that includes their sewage systems. Seasoned travelers occasionally get careless, forgetting that germs like the hepatitis virus can settle on fruits and vegetables and not just in the water supply.

Most hepatitis victims have mild symptoms; it is rarely fatal. Nausea, fatigue, abdominal pain, headache, joint and muscle aches and cold-like symptoms resemble other viral illnesses. In some persons food becomes unappetizing and smokers may develop a sudden distaste for cigarettes.

Very effective hepatitis vaccines are available, some of which protect against both the A and B forms of the disease. If you're traveling, plan ahead. The interval between the two necessary doses is 6 months. Side effects are so rare that travelers and water sports enthusiasts owe it to themselves to receive the vaccine. Waking up with yellow eyeballs can spoil your whole day!

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.