Hepatitis A and E viruses are both RNA viruses. The sources of infection are acute patients and invisible infected persons. Fecal-oral infection is the main route of transmission of hepatitis A and E. The incubation period of hepatitis A is 2-6 weeks, with an average of 4 weeks, and that of hepatitis E is 2-9 weeks, with an average of 6 weeks. Contamination of drinking water, food, toys, and especially undercooked vegetables or shellfish with virus-bearing feces can cause epidemics. In 1988, the consumption of fecal contaminated uncooked arks from Zhejiang caused the largest hepatitis A epidemic in Shanghai since the founding of the country, with 310,000 cases within 4 months. 707 cases.
Hepatitis A and E viruses are mainly recessive infections with no clinical symptoms. Hepatitis A is prevalent in children, hepatitis E is predominant in young and middle-aged people, and older patients (>60 years old) account for 18.9%. The acute jaundice type is predominant, accompanied by fever, malaise, anorexia, epigastric discomfort, and deepening of urine color. Hepatomegaly is less common in hepatitis E than in hepatitis A, and bruising, skin itching, and grayish white stools are more common than in hepatitis A. Subacute heavy and acute bruising are more common than in hepatitis A. Pregnant women have a high incidence of the disease, and the death rate in late pregnancy is as high as 20.96%.
Hepatitis A and E are mostly self-limiting. Hepatitis A is persistently immune. Hepatitis E has no lifelong immunity.
Reduce eating out, do not drink raw water, wash raw vegetables and fruits, cook meat and shellfish thoroughly, do not eat half-cooked lamb skewers and other barbecued foods, do not eat at unhygienic stalls; promote the use of common chopsticks and spoons when dining together, and preferably implement a meal sharing system; separate tools and containers for processing cold and hot dishes, and disinfect them in a timely manner; wash hands before and after meals, and disinfect eating utensils, tea utensils and household utensils frequently. This is the key to prevention.
Eliminate insect vectors that can transmit hepatitis A and E, such as flies and cockroaches. Once a suspected case is found, isolate and disinfect it immediately, and report the epidemic in a timely manner. Pay attention to physical exercise to enhance resistance to disease. If you have symptoms such as fever of unknown origin and pain in the liver area, go to the hospital for examination.
The most effective preventive measure is vaccination. For those who are anti-HAVIgG negative, vaccination against hepatitis A is mainly used for young children, children and other high-risk groups; infants under 6 months of age do not need to be vaccinated because they carry antibodies from their mothers. The immunization period is at least 5 years after vaccination. For susceptible persons and children in close contact with the patient, injections of 16% human blood gammaglobulin or placental globulin are given.
Understanding Hepatitis B
There are five requirements for general knowledge. First, we need to understand hepatitis B virus carriers, hepatitis B surface antigen carriers and “major three yang” and “minor three yang”. Hepatitis B virus carrier refers to the absence of symptoms and signs, hepatitis B virus DNA (HBVDNA) quantitative greater than 500copy/ml, “big three positive” and a small number of “small three positive” belong to this category, indicating that there is infectious. Surface antigen carriage refers to the absence of symptoms and signs, HBVDNA quantification is less than 500copy/ml, including most “small triplets” and other types of “two and a half” combination, indicating no or less infectious. “Major triple-positive” means positive for hepatitis B surface antigen, e antigen and core antibody, and is a carrier of the virus and is infectious. The “small three positive” refers to hepatitis B surface antigen, e antibodies, core antibody positive, according to the quantitative determination of hepatitis B virus is a virus carrier or surface antigen carrier, there is no infectious depending on this. Secondly, we should recognize that the transmission of hepatitis B is through blood, body fluids, mother-to-child transmission, and other routes are rare, therefore, daily life will not spread “hepatitis B”. Thirdly, we should be “strategically contemptuous and tactically important” to hepatitis B carriers. Strategic contempt is that the majority of carriers of hepatitis B should know that the majority of carriers can live peacefully with hepatitis B “for life” and firmly believe that I am a member of the majority, which is necessary to maintain a good attitude; tactical importance is to know that a small number of carriers will develop into hepatitis, liver failure (previously often referred to as heavy liver, subhepatitis), cirrhosis of the liver It is important to monitor the situation. Fourth, we must know that hepatitis B does not have lifelong immunity and must be vaccinated regularly, usually once every 3 to 5 years; low levels of hepatitis B antibodies do not have the ability to resist hepatitis B. Families of hepatitis B virus carriers are routinely checked for hepatitis B markers and vaccinated against hepatitis B as required. Five to understand that Chinese medicine is “effective but not magical” in the prevention and treatment of hepatitis B. Chinese medicine has played an important role in protecting human health and is no exception for hepatitis B. However, Chinese medicine is by no means a “miracle drug” and it is not possible that only Chinese medicine can “dig the root” as some propaganda suggests. The “root” must be used under the guidance of a physician, do not believe in prescriptions, secret recipes.
Standardize the monitoring of the “five populations”. First, hepatitis B-related patients, once a month hospital follow-up. The second is the hepatitis B virus carriers, such as urine yellow, weakness, poor and other symptoms to go to a regular hospital in a timely manner, asymptomatic people, every 3 to 6 months to check liver function, HBVDNA once, once a year to check the liver, gallbladder and spleen ultrasound. Third, for hepatitis B surface antigen carriers, liver function, HBVDNA and liver, gallbladder and spleen ultrasound should be checked once a year. Fourth, hepatitis B virus carriers with a family history of cirrhosis or liver cancer should have their liver function, HBVDNA, liver, gallbladder and spleen ultrasound, and alpha-fetoprotein checked once every three months, and if necessary, CT or MRI of the upper abdomen. fifth, soon-to-be-married people and pregnant women. Mother-to-child transmission is the main transmission route in the country, and sexual transmission has an important place in hepatitis B transmission. For both parties who are going to get married, hepatitis B two-and-a-half and liver function tests, HBVDNA tests if necessary, and timely and standardized supplemental hepatitis B vaccination can prevent part of the sexual transmission and mother-to-child transmission. Hepatitis B carriage is not a contraindication to pregnancy; abnormal liver function is a contraindication to pregnancy. It is extremely important to test HBVDNA and liver function before pregnancy. Mother-to-child transmission can be almost completely prevented by implementing mother-to-child blocking techniques for mothers and infants with hepatitis B.
Good habits “four attention”. One should pay attention to exercise to enhance physical fitness, exercise to a small amount of exercise, such as tai chi, walking, qigong, etc., not strenuous exercise. Second, to prohibit alcohol and limit smoking, balanced nutrition, more vitamin-rich and trace element foods, mushrooms, yeast, eggs, whole grains, milk, soybeans, tomatoes and so on. Third, we should sleep reasonably and not stay up late. Fourth, when taking medication for other diseases, be careful to seek the advice of a hepatologist.
Scientific prevention and control “three words”. The majority of chronic hepatitis B virus carriers do not need treatment, only a very small number of hepatitis B carriers need treatment. These include symptomatic chronic hepatitis B carriers, those with dynamic liver ultrasound changes, and those with active inflammation confirmed by liver biopsy, and many patients with cirrhosis without a history of hepatitis are produced by such patients. Liver aspiration biopsy is performed in carriers with relative indications and requires treatment under the guidance of a physician. Second, there are no absolutely effective drugs for viral conversion worldwide. The indications for antiviral therapy are very strict and need to be used under the guidance of a specialist physician and must not be abused. Irregular antiviral treatment will only increase hepatitis B virus resistance, increase the economic burden, increase drug side effects, and will not increase the efficacy. The treatment of chronic hepatitis, cirrhosis and liver cancer needs to be carried out under the guidance of a specialist physician. Thirdly, do not treat liver function abnormalities in hepatitis B carriers as chronic hepatitis B. Pay attention to differentiating liver function abnormalities with fatty liver. Currently, liver function abnormalities caused by fatty liver have accounted for more than 40% of liver function abnormalities, the chances of hepatitis B carriers and fatty liver have increased dramatically, the use of antiviral treatment for such patients is not effective, while the effect of treatment for fatty liver is good.
Do not believe the lie “three common sense”. The hepatitis B carriers can identify the “lies” as long as they understand the following common sense. The first is that hepatitis B is a class B infectious disease, the transmission path is special, there will be no outbreak of epidemics, the state of hepatitis B to implement the policy of “prevention first, treatment as a supplement”, in the prevention of a lot of energy, not in the treatment of investment. Secondly, Chinese medicine is effective for hepatitis B, but there is no evidence to prove that it can “dig the root”. Thirdly, the “hepatitis B conversion” is a worldwide problem that cannot be cracked by small clinics and even less by “charlatans”.
If you know the above common sense, you can identify the false advertisements in the radio, TV, buses and flyers. The “xxxx Foundation” and “xxxx Chinese Medicine Society” are even more false.
Hepatitis B patients and hepatitis B carriers should never believe in lies such as miracle doctors, ancestral secret recipes, folk remedies, etc. Beware of soft advertisements that are disguised very stealthily and entice you to take the bait. At the same time, maintain a healthy lifestyle and work style, strive for psychological balance and mental stability, regular consultation and examination at regular hospitals, and avoid indiscriminate use of medication.
”The silent liver killer – Hepatitis C
Hepatitis C is a disease caused by hepatitis C virus (HCV) infection of the liver. Hepatitis C is usually mild or asymptomatic; when it becomes chronic, most people are asymptomatic for a long time, so hepatitis C is known as the “silent liver killer”. Hepatitis C can develop into cirrhosis in 10%-30% of cases; 1%-7% of cirrhotic patients will develop liver cancer; many hepatitis C have cirrhosis and liver cancer as the first symptoms. Hepatitis C virus is an RNA virus, and the patient is the source of infection.
This year marks the 21st anniversary of the discovery of the hepatitis C virus. 180 million people worldwide suffered from hepatitis C in 2009, four times the number of people infected with HIV. The number of deaths caused by hepatitis C-related liver disease doubles every 10 years; hepatitis C is the tenth most common infectious disease with global mortality and the fifth most common infectious disease with mortality in China. The prevalence of hepatitis C infection in China is about 3.2%, which is the second highest among infectious diseases transmitted through blood and sex, and has become a serious public health problem.
The transmission routes of hepatitis C include.
(1) Transmission by blood transfusion and blood products;
(2) Injections, needle sticks, organ transplants, hemodialysis;
(3) Close contact transmission;
(4) Sexual transmission;
(5) Mother-to-child transmission has a 10% chance of transmission.
At present, there is no vaccine to prevent hepatitis C. Personal protection and timely treatment of patients are very important. Cleanliness, staying away from drugs and careful use of blood products are the keys to prevention. Regular health checkups for high-risk groups and timely detection and treatment of hepatitis C are the keys to prevent chronicity of hepatitis C and its progression to cirrhosis and liver cancer. Hepatitis C can be cured in 60% to 70% with early and standardized medication.
Tests include.
(1) Liver function test to know if there is liver function damage;
(2) Hepatitis C antibody (anti-HCV) for initial screening of hepatitis C virus infection;
(3) Hepatitis C gene (HCV-RNA) qualitative test to confirm the diagnosis.
Due to the low level of HCV body fluid, a negative test cannot completely exclude HCV infection and should be observed dynamically.