Safe water prevents diseases

While we all should aim to save water, an important source of life, we must also focus on improving water supplies and hygiene. Worldwide, 2.2 billion people lack access to safely managed drinking water, and 4.2 billion people lack safe sanitation. Unsafe hygiene practices are widespread, compounding the effects on people’s health. The impact on child mortality rates is devastating with more than 2,97,000 children under five who die annually from diarrhoeal diseases due to poor sanitation, poor hygiene, or unsafe drinking water.

In India, the problem of unsafe water is a huge public health concern. Apart from causing illnesses such as diarrhoea, jaundice etc, unsafe water also contributes to Hepatitis A amd E. Both these diseases are associated with inadequate and unsafe water supplies, poor sanitation and hygiene, leading to infection and inflammation of the liver.

What is Hepatitis A and E?

Hepatitis A and E viruses are RNA virus which primarily infect the liver, causing inflammation of the liver (Acute Hepatitis). Infection with Hepatitis A & E is usually self-limiting. Hepatitis A or E is spread primarily through food or water contaminated by feces from an infected person (Feco-oral route). It enters the liver from our gut and is then excreted again by our gut into stool, thus completing the cycle of infection

Who is at risk for Hepatitis A or E?

Not everyone who’s infected will show symptoms of the disease, as it may go unnoticed (asymptomatic disease). However, these people can spread the virus by excreting it in their stool and continue to infect others (carriers).

Asymptomatic disease

As a developing nation with poor sanitation conditions, more than 95% of children below five years of age are usually infected with these viruses, with an asymptomatic course. Thus, in India, antibody to Hepatitis A virus is nearly universally detectable by adolescence, and antibody to HEV increases during young adulthood to reach about 40% in adults

Hepatitis A usually spreads person-to-person through food or water contamination. An infected person’s hands can become the source of infection after using the bathroom and the virus then spreads by direct contact or by food, beverages or other objects that were handled by the infected person. An infected individual can transmit the virus to others as early as two weeks before the symptoms begin to appear

International travellers to India, children from high-income families are at risk of developing Hepatitis A or E infection because they do not eat much from the streets and so have not developed the required antibodies resulting in fever, stomach-ache and jaundice

Symptoms:

- Fever

- Tiredness

- Stomach upset

- Loss of appetite

- Dark yellow urine

- Diarrhoea

- Yellowish eye & skin called jaundice

Unlike Hepatitis B & C, Hepatitis A does not cause Chronic Liver Disease and is rarely fatal. But it can cause debilitating symptoms and Fulminant Hepatitis (Acute Liver Failure), which is often fatal. Fulminant Hepatic Failure leading to death is seen in 1.8 % of adults, and 10% in pregnant ladies.

Most people with Hepatitis E get better within a few months. Usually, it doesn’t lead to long-term illness or liver damage like some other forms of Hepatitis do. But Hepatitis E can be dangerous for pregnant women or anyone with weak immune systems, including the elderly or people who are ill.

The best approach is to take all precautions to avoid Hepatitis and ensure safe drinking water for all. Make certain that your water source is clean and well maintained. Apart from this, follow this:

Hand sanitation: Frequent handwashes before meals and after using the washroom

Avoid eating outside, especially if you are pregnant

Hepatitis A vaccine: Vaccinate your children who are below 6yrs (consult a Paediatrician about this)

If you identify any of the above symptoms, kindly meet your gastroenterologist, as timely treatment and care to resolve the infection with expected full recovery.

(The writer is Consultant, Gastroenterology, at a network of hospitals in Maharashtra)