Hepatitis in the United States
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[Dr. John Ward] Viral hepatitis kills about 12 to 15,000 Americans each year, a number similar to or even slightly greater than the number of deaths from HIV/AIDS, a disease more people know about and have concerns about.
Four-and-a-half to five million persons are living with viral hepatitis. Those individuals are at risk for progressing towards end-stage liver disease, known as liver cirrhosis, and liver cancer. Viral hepatitis is the major cause of both of those conditions in the United States.
The term viral hepatitis just signifies viral infections that cause the liver to become inflamed. In our country there are three major viruses that cause viral hepatitis: Hepatitis A, which is actually quite common and fairly easily transmitted through contaminated water and food and through direct contact with infected individuals, including through sexual contact;
Hepatitis A is vaccine preventable. All children, beginning at the age of one, are recommended to receive Hepatitis A vaccine as are adults who may be at risk for it, including travelers to other countries where Hepatitis A is more common than in the United States.
Hepatitis B, which is a very common infection worldwide, is vaccine preventable but is transmitted in a variety of different ways: from mother to child, from within families, through incidental blood contact in the health care setting, both to patients and as well as posing a risk for health care workers, and through sexual contact ...
About one-and-a-half million persons in this country are infected with Hepatitis B. We have a vaccine that’s been made available; most infants receive this vaccine and the vaccine has translated into large declines in the number of people being infected in this country, which is great news. However, here, 30 years after it has been made available to our nation, we still have about 50,000 persons getting infected.
Some of those are newborns infected at the time of birth because their mother was infected. If given promptly, the vaccine can protect almost all of those infants. But about a thousand of those infants every year become infected, and about one out of every four of those will go on to die prematurely of liver disease, including liver cancer.
Our challenge for Hepatitis B is that vaccine coverage is very low still for adults with Hepatitis B relative to children. And this is hampering our efforts to eliminate Hepatitis B transmission in the United States.
Hepatitis C is the most common blood borne infection in the United States. It is transmitted almost exclusively by blood contact, again, either in the health care setting or among injections drug users, for example, and through a lesser extent through sexual contact, and even rarer still from mother to child transmission.
Hepatitis C does not have a vaccine. The virus changes its spots, so to speak, quite frequently once in the body and so the body really can’t get a bead on it to develop a consistent anti-body that we can use to manufacture a vaccine. …
… So we have to look at other strategies such as screening the blood supply so we don’t transmit it at the time of blood transfusion. Intervene with injection drug users to either help them stop injecting drugs or, if injection continues, to give them information so that they can do that as safely as possible so they don’t transmit Hepatitis C to others if they are infected or that they become infected if they are susceptible.
There are other forms of viral hepatitis that are more common in other parts of the world …. CDC is a global health agency and we also respond to requests for assistance when these other forms of viral hepatitis are issues elsewhere.
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