- (AP) - There are three main types of
hepatitis, a group of viruses that inflame the liver:
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- Hepatitis A is a relatively mild form
of the virus. It spreads primarily through food contaminated by poor sanitation,
such as raw shellfish culled from tainted water or food handlers who contaminate
salad bars. It can cause food poisoning symptoms, although most patients
require no medical care; hepatitis A clears out of the body quickly. It
is most common in developing countries, and a vaccine is recommended for
world travelers.
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- Hepatitis B is more severe, sometimes
fatal. It can cause both acute attacks of jaundice and chronic liver infection.
It does not spread through food, but primarily through blood and through
sex with infected people. The U.S. blood supply is tested against hepatitis
B so cases from transfusions today are rare. People injecting illegal drugs
commonly spread hepatitis B by sharing needles; health care workers are
at risk from needle sticks, and patients undergoing kidney dialysis may
be at risk if equipment isn't properly sterilized. A vaccination recently
became available, and it is given routinely to children, but adults who
have not been vaccinated remain at risk.
-
- Hepatitis C also is very severe and causes
long-term liver infection that damages over time. It afflicts an estimated
3.9 million people, is the leading reason for liver transplants and kills
up to 10,000 Americans a year. Most patients today are 30 to 49, and doctors
fear deaths could triple in coming years as they reach the age where complications
from chronic liver disease typically occur. Because it seldom causes early
symptoms, many patients don't know they're infected. Sharing needles to
inject drugs is the biggest risk, but thousands of Americans were infected
from transfusions before the blood supply was tested adequately in 1992.
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- There is no vaccine or cure. About 15
percent of patients overcome the virus without treatment. Others can try
injections of interferon A, starting when liver tests indicate the virus
is active. If standard treatment fails, patients can try a new therapy
approved last summer, a combination of the shots and ribavirin pills for
six months.
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By Lauran Neergaard AP Medical Writer
10-16-98
-
- (AP) -- Thousands of people will soon
open their mailboxes to find warnings that they may have caught the dangerous
liver virus hepatitis C from blood transfusions before 1992. It's the first
step in a long-awaited government attack on the epidemic.
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- Hepatitis C afflicts an estimated 3.9
million Americans, many of whom don't know they're infected because the
virus can lurk silently in their bodies.
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- But now that doctors finally have treatments
to offer -- a handful of drugs -- the government is launching a major campaign
to get people tested. First on the list are tens of thousands who received
transfusions before purity tests of the blood supply began in 1992.
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- Those people shouldn't panic, stressed
Dr. Louis Katz of the the Mississippi Valley Regional Blood Center, who
advised the government on the campaign.
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- "The message is: Ask your doctor,"
he said. Many people will just be carriers of the disease, but for those
with active hepatitis C, "we now have something to offer."
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- A few hospitals, including some in Wisconsin
and Minnesota, already have begun tracking down at-risk transfusion recipients.
But most were awaiting guidelines from the Centers for Disease Control
and Prevention, issued Thursday, so doctors would have the best advice
for worried patients.
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- "Whether you feel sick or not, you
should have a blood test for hepatitis C," says an information sheet
the American Association of Blood Banks developed to mail to at-risk patients.
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- Once the hospitals have traced everybody
they can, the CDC said Thursday it will launch an advertising campaign
next year to urge even more people to be tested.
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- Hepatitis C, which kills up to 10,000
Americans each year, is the most common blood-borne infection in the United
States and the leading reason for liver transplants.
-
- Some people overcome the virus without
medical help. But 85 percent develop a chronic, simmering infection that
they can spread to others. Most of them will suffer at least some liver
damage, especially if they also drink alcohol, and 15 percent will develop
severe damage.
-
- Sharing intravenous drug needles is the
chief source of hepatitis C, causing 60 percent of cases. The CDC recommended
testing for:
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- --Anyone who ever injected drugs -- even
once as a teenager 20 years ago.
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- --Hemophiliacs who used clotting factors
before 1987, when they became better purified.
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- --Recipients of organ transplants or
blood transfusions before 1992.
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- An estimated 300,000 Americans were infected
from transfusions before 1992, the year that accurate testing of blood
donors began.
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- Today, the risk from transfusions is
very small. But only now are doctors tracking down past transfusion recipients
to reveal the risk -- because it was only in the last year that they figured
out how best to treat hepatitis C.
-
- "These people need to be told,"
said Rep. Christopher Shays, R-Conn., who led a House subcommittee investigation
that concluded government notification should have started earlier. "The
federal response has been sluggish at best and mute at worst."
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- Responded CDC hepatitis chief Miriam
Alter: "It's only recently that we have advice to give individuals
that might help them protect their liver from further harm."
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- Under the massive notification program,
every U.S. blood bank must identify possibly tainted blood donated before
1992, and begin sending hospitals those records by March. Then hospitals
have a year to go through their own records and track down patients who
received the blood.
-
- Many may have died of other causes in
the ensuing years, or moved away so doctors can't find them. The CDC expects
62,000 people to respond to the program, 37,000 of whom statistics predict
will be infected.
-
- "It's a really huge job," said
Laurie Becker, the nurse in charge of notification at the Southeast Wisconsin
Blood Center. "It's taken me hours and hours and hours" to identify
319 units of possibly tainted blood sent to 31 hospitals.
-
- Getting a head start, she notified the
hospitals a year ago, yet so far they have traced just 45 percent of the
blood, a number Becker called disappointing. Eleven people have come in
for free hepatitis testing; five were infected and sent to doctors for
treatment.
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