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Find the Missing Millions: World Hepatitis Day

In June 2018, as many as 4,000 people were exposed to hepatitis A in Charlotte, NC.  These people were not engaging in the risky behaviors that many associate with a hepatitis infection, like drug use, shared needles, unprotected sex, or back alley tattoo artistry.  The risky behavior these North Carolinians engaged in?  Eating lunch at a fast food restaurant.

Our liver does some important work -- it filters out toxins, processes nutrients for us, and helps us to fight infection.  The literal definition of hepatitis is "inflammation of the liver".  The liver's main functions are impaired when the liver is inflamed, making us less healthy overall.  Heavy alcohol use, some medications, and toxin exposure can cause hepatitis but it is most frequently caused by a virus. While there are many strains of Hepatitis, in the United States, the most common strains of viral hepatitis are Hepatitis A, Hepatitis B, and Hepatitis C.

Hepatitis A is usually considered acute -- it develops suddenly and lasts a relatively short period of time.  It's transmitted when people ingest fecal matter, commonly through food prepared by a person with poor hand-washing hygiene.   While there are outbreaks in the United States, it is far more common in countries without modern sanitation.  Symptoms include fatigue, sudden nausea, abdominal pain, intense itching, and low-grade fever.

Hepatitis B can be either acute or chronic (long-developing and long-lasting).  It is spread through contact with the blood or other body fluids of an infected person. Sharing toothbrushes, sharing needles, and having unprotected sex are all ways of spreading Hepatitis B.   About 21,000 new cases of Hepatitis B are diagnosed in the United States each year.  Symptoms include jaundice -- a yellowing of the eyes or skin, fever, and long-lasting fatigue.

Hepatitis C is spread through blood-to-blood contact, and can present as either acute or chronic.  Sharing needles, inadequate sterilization of medical equipment and, before 1992, blood transfusions are common transmission methods.  In the U.S., there are around 41,000 new infections each year.   Symptoms of acute Hepatitis C include jaundice, fever, fatigue, and nausea; chronic Hepatitis C can be asymptomatic until liver failure occurs.  Most people who get infected develop chronic Hepatitis C.

With the basic facts above, consider the following statistics:

  • While there is no treatment for Hepatitis A, there is a vaccine.
  • 2 in 3 people with Hepatitis B are not aware that they are infected.
  • Hepatitis B is a leading cause of liver cancer.
  • Treatment can slow the replication of the Hepatitis B virus.
  • There is a vaccine for Hepatitis B.
  • At least 50% of people with Hepatitis C do not know they are infected.
  • 3.5 million people have been diagnosed in the U.S.
  • The population with the highest rates of Hepatitis C were born between 1945 and 1965
  • There is no vaccine, but there is treatment that can lead to a cure.

July 28 is World Hepatitis Day and 2018's slogan is "Find the Missing Millions".  According to the World Hepatitis Alliance, out of the 235 million people who are living with viral hepatitis globally more than 90% are not aware that they are infected.  That is 290 million humans sharing hepatitis. 

Public health professionals are urged to increase screening, diagnoses, and linkage to care.

Everyone is urged to get tested -- we can eliminate hepatitis.

Conduent's Maven Electronic Disease Surveillance and Outbreak Management System makes managing any kind of viral outbreak a simpler task for your public health department.  Providing real-time event triage and case management capabilities, as well as contact tracing and electronic reporting, Maven provides public health agencies the ability to detect outbreaks and prevent them from spreading.

Contact Conduent Public Health Solutions today to see a demonstration of Maven in action.

About the Author

Pamela Knight-Schwartz, MPH is the Director of Public Health Consulting at Conduent Public Health Solutions. She has more than 15 years of experience in public health informatics, working in immunization information systems, disease surveillance systems, and prescription drug monitoring programs in corporate and government environments.

Profile Photo of Pamela Knight-Schwartz, MPH