Hepatitis B at AP’s door?

By M H Ahssan

Reusing Syringes, Not Testing Donated Blood Are Causes

The hepatitis B infection that led to the death of 43 people in Modasa town of Gujarat’s Sabarkantha district over the last two weeks has city doctors point out some malpractice that could well lead to a similar problem in Andhra Pradesh. Doctors say that reuse of syringes particularly in rural parts and donated blood not being tested for this particular infection are two worrisome trends in the state.

According to the doctors, occurrence of this infection is more rampant in rural areas of the state because of malpractice in the health sector. They say that the reuse of needles and syringes is considerably high in villages, which is one of the main reasons for the spread of hepatitis B. “This apart, even the needles used for tattooing and the blades used for shaving in villages are reused over and over again without sterilisation. These are very common carriers of the infection,” said Dr Subhas Chandra Samal, gastroenterologist (medical) with Apollo Hospitals.

HNN has earlier reported that many hospitals in the city were allegedly reusing cannulae for surgeries.

However, doctors do not deny that there is a reasonable spread of hepatitis B even in urban areas, though for different reasons. According to gastroenterologist Dr Srinivas Rao, Yashoda Hospital, it is primarily caused due to the lack of proper tests conducted to check hepatitis B during blood transfusions or dialysis. “There is a DNA test that should be ideally done to check for hepatitis B before any such process. This test can detect the presence of the infection even in its window period, when it (the infection) is in its developing stage. However, the cost of conducting this test is very high (around Rs 3,000-Rs 4,-000) and also requires a PCR lab, which is not there in most hospitals,” he said.

The fear of blood transfusions infecting people with hepatitis B is also because of the lack of scrutiny by most blood banks in the city, feel doctors. Most city hospitals treat close to four or five hepatitis B positive patients each week, which is a good 25 per cent of the total number of hepatitis (A and E primarily) cases handled by hospitals.

Though the number of acute hepatitis B cases form only five per cent of this figure, doctors say that it is still a matter of great concern. “Almost 95 per cent of the cases that we get are completely curable. However, India’s total load of hepatitis B is five per cent and that is worrisome. According to global readings, it falls under the intermediate level, (low, intermediate and high are the three levels) and should, therefore, be taken seriously,” said Dr Samal.

Another concern of health experts in the city is the lack of awareness among people about the disease and its symptoms. Rajesh Popli, ex-secretary of the Thalassemia Society, Hyderabad believes that the care-a-hoot attitude of people leads to most cases of chronic hepatitis B in society leading to death.

However, the issue is not that simple says C K George, director, Institute of Health Systems. According to him, several hepatitis B cases show no regular symptoms and, therefore, become difficult to detect. “Many times a person has none of the regular symptoms of the disease but is still found to be a carrier of the infection. This not only causes death due to lack of treatment but also makes it difficult for experts to determine a hepatitis B outbreak at times,” he said.