Soon after an outbreak of Hepatitis B in Modasa,Gujarat,come reports of an outbreak of Hepatitis E in Surat. Health officials claim there is no link between the two. Reports also suggest that Hepatitis D has been found amongst some Hepatitis B patients in Modasa. These three variants are separated by more than alphabets. Heres why: •What is Hepatitis? Hepatitis is an inflammation of the liver,most commonly caused by a viral infection. There are five main Hepatitis viruses,referred to as types A,B,C,D and E. According to the World Health Organisation (WHO),Hepatitis A and E are typically caused by consuming contaminated food or water. Gujarats health officials claim that the Surat outbreak is Hepatitis E,and is waterborne. Hepatitis B,C and D usually occur as a result of contact with infected body fluids (for example from blood transfusions). Hepatitis B is also transmitted by sexual contact. Symptoms of Hepatitis are similar across varients. Typical signs include jaundice,loss of appetite,an enlarged liver,abdominal pain,vomiting,and fever. •What is Hepatitis E? Hepatitis E is a waterborne disease,caused due to contaminated water or food supplies. In Surat,the outbreak was reportedly due to a drinking water pipeline getting contaminated. Unlike Hepatitis B or D,there is no evidence of its spread through sexual transmission or transfusion. Since cases of Hepatitis E are not clinically distinguishable from other types of acute viral Hepatitis,diagnosis is made by blood tests which detect higher levels of specific antibodies to Hepatitis E in the body. Unfortunately,such tests are not widely available. As far as treatment is concerned,Hepatitis E is typically a self-limiting viral infection followed by recovery. Occasionally,a fulminant form develops,but according to the WHO,this results in death only 0.5-4.0 per cent of the time. •What is Hepatitis B? Unlike Hepatitis E,Hepatitis B is transmitted through contact with infected blood or blood products. It might result in the cirrhosis of the liver and liver cancer. The WHO estimates that worldwide,two billion people have been infected with chronic Hepatitis B. A vaccine against Hepatitis B has been available since 1982,and it has proved to be 95 per cent effective in preventing the infection and its chronic consequences. So far,there have been 19 deaths and 70 cases of Hepititis B in Modasa. •How is Hepatitis D different from Hepatitis B? The Hepatitis D virus is found to occur only in the presence of the Hepatitis B virus. The delta antigen requires co-infection with the Hepatitis-B virus for its replication. Its transmission is by contact with blood similar to Hepatitis B. However,while Hepatitis B is a chronic infection,its severity increases when it mutates to Hepatitis D. It has rarely been reported in India. However,the National Institute of Communicable Diseases has confirmed the prevalence of Hepatitis D in at least one of the cases in Modasa,Unlike Hepatitis B,no vaccine exists to treat Hepititis D. In extreme situations,liver transplantation may be considered for cases of end-stage chronic Hepatitis D. Individuals who are not infected with Hepititis B,and have not immunised against it,are at risk of infection from Hepititis D.
