China is a large country with hepatitis B. Moreover, chronic hepatitis is still difficult to cure and has the risk of progressing to cirrhosis and liver cancer. Therefore, the public is afraid of “hepatitis” and often discriminates against hepatitis patients and hepatitis virus carriers. Fear and discrimination arise because the public has little knowledge or misconceptions about hepatitis.
In this article, we will summarize the common misconceptions of the public about the infectiousness of hepatitis in the hope that we can truly understand and appreciate hepatitis.
Misconception 1: All hepatitis is contagious
Among the common causes of hepatitis, in addition to viral hepatitis, there are many kinds of non-infectious hepatitis, such as alcoholic hepatitis, simple fatty liver, drug-related liver injury, and autoimmune liver disease.
Alcoholic hepatitis: caused by long-term heavy alcohol consumption.
Simple fatty liver: due to excessive deposition of fat in the liver cells.
pharmacological liver injury: mainly due to irrational use of drugs.
Autoimmune liver disease: belongs to the same category of connective tissue diseases as lupus erythematosus and rheumatoid arthritis.
These above-mentioned liver diseases are not contagious.
In addition, because various types of hepatitis often lead to abnormal liver function (most commonly elevated transaminases and/or bilirubin), the public often feels that “abnormal liver function” or “jaundice” is itself infectious. In fact, these symptoms are only the result of hepatitis and are not contagious.
Misconception 2: Hepatitis patients need to be isolated
Among the common viral hepatitis, hepatitis A and E are infectious diseases of the digestive tract and require isolation such as meal sharing and fecal disinfection.
The hepatitis A virus is excreted in the feces of patients and can cause sporadic epidemics or pandemics by contaminating water, food, and utensils.
In 1988, the consumption of arks contaminated with hepatitis A virus by the people of Shanghai caused the largest epidemic of hepatitis A since the founding of the country, with 310,000 cases occurring within four months.
Contamination of food during production is also a cause of hepatitis A transmission. Contamination of foods such as sandwiches, orange juice, salads and finished meat products with the hepatitis A virus is a major cause of hepatitis A epidemics in developed countries.
There have also been pandemics of hepatitis E caused by contaminated water sources, but currently it is more common to see disseminated cases due to food contamination.
To prevent these two types of GI-transmitted hepatitis, care should be taken to
wash hands regularly
Children living in groups in kindergartens and schools are at high risk of contact transmission of hepatitis A. They should be educated to develop good hygiene habits of washing hands after defecation.
Pay attention to meal hygiene
For foods that can easily carry pathogenic bacteria, such as snails, shells, crabs, etc., be sure to cook and steam them thoroughly, and eliminate bad eating habits such as eating them raw, semi-raw, or directly after pickling, so as to pay attention to dietary hygiene and prevent illness from entering through the mouth.
Misconception 3: Daily contact can transmit hepatitis B and C
Daily contact does not transmit hepatitis B or C.
Contact without blood exposure, such as shaking hands, hugging, sharing office supplies, living in the same dormitory, eating in the same restaurant and sharing toilets, will generally not transmit hepatitis B or C. Epidemiological and experimental studies have not found that either type of hepatitis can be transmitted by blood-sucking insects (mosquitoes, bedbugs, etc.).
Both types of hepatitis are transmitted primarily through blood, vertical mother-to-child transmission, and sexual contact.
Due to strict screening of blood donors for hepatitis B and C viruses, hepatitis B and C infections caused by blood transfusions or blood products are less common. Transmission through broken skin and mucous membranes is mainly due to the use of medical devices that are not strictly sterilized, invasive diagnostic and surgical operations, unsafe injections, especially drug injections. Other infections such as pedicures, tattoos, ear piercing, sharing razors and toothbrushes, and accidental exposure of medical personnel at work can also be transmitted.
Mother-to-child transmission of hepatitis B occurs mainly during the perinatal period, mostly through contact with the mother’s blood and body fluids during delivery. With the use of hepatitis B vaccine combined with hepatitis B immunoglobulin, mother-to-child transmission has been greatly reduced. Mothers infected with hepatitis C can also transmit it to their newborns during delivery, and it is recommended that women with hepatitis C should have children after they are cured.
Unprotected sexual contact with a person who is a carrier of hepatitis B or C virus may result in infection. The risk of being infected is higher if accompanied by other sexually transmitted diseases, especially AIDS.
Misconception 4: Hepatitis B must develop into chronic
If the hepatitis B virus has not been cleared after 6 months of infection, it is called chronic hepatitis B infection.
Age at the time of infection is the most important factor affecting chronicity. The risk of chronicity is as high as 90% for those infected in the perinatal period, while the rate drops to 50% in infancy (0-5 years) and only 5%-10% of adults who become infected develop chronic infection.
Therefore, chronic hepatitis B can be controlled by proper interruption of mother-to-child transmission of hepatitis B virus and proper hepatitis B vaccination for infants and children. Since the inclusion of hepatitis B vaccine in the free immunization program in 2000, the infection rate among infants and children has dropped significantly. 2014 National Hepatitis B Epidemiological Survey shows that the chronic hepatitis B surface antigen carriage rate among children under 5 years old in China has dropped to 0.32%.
Myth 5: Hepatitis B is inherited from mothers to their children
Hepatitis B has a family aggregation phenomenon, often manifested by the presence of hepatitis B virus infection between the mother and her child or siblings at the same time. Therefore, many hepatitis B patients mistakenly believe that it is a hereditary disease and even dare not marry and have children.
A genetic disease is a disease caused by a change in the genetic material. An infectious disease, on the other hand, is a disease caused by an otherwise healthy individual who is infected by an infectious agent. Obviously, hepatitis B is not caused by an error in the patient’s genetic material, but by an infection with the hepatitis B virus.
Newborns are exposed to large amounts of maternal blood during delivery, which is the cause of mother-to-child transmission of hepatitis B. Also intrauterine infection may occur during pregnancy when there is a break in the blood vessels on the surface of the mother’s uterus, as in the case of placental abruption, which allows leakage of maternal blood into the fetal blood circulation.
It can be seen that mother-to-child transmission, regardless of the cause, is actually the transmission of the hepatitis B virus from the mother to the next generation through the internal route. Therefore, hepatitis B is an infectious disease, not a genetic disease, and can be blocked by hepatitis B vaccination and hepatitis B immunoglobulin.
Hepatitis is not scary, what is scary is the ignorance and fear of the disease. As long as we take effective protective measures, we can completely and effectively control the spread of hepatitis.