Learn the ABCs of hepatitis before you leave on holiday
Hepatitis, in its many forms, is a serious threat to health. What all forms have in common is the inflammation they cause in the liver. In the long term, the most common viral forms – hepatitis B and C – can cause serious health problems such as liver cancer, cirrhosis of the liver and liver failure resulting in death. In the short-term, hepatitis A often manifests as foodborne illness, accompanied by vomiting, fever and diarrhoea.
World Hepatitis Day falls on 28 July each year, just as many people in the WHO European Region take a holiday and much-needed break from work and the daily routine. While hepatitis poses a threat at any time of the year, certain activities associated with summer holidays can carry a particular risk of infection. Fortunately, there are ways to protect yourself against hepatitis infection, both through vaccination and by taking action to limit your risk of exposure.
Avoid hepatitis A by being careful with food and drink
Many people are aware that hepatitis A strikes when there is poor sanitation or unsafe water. Fewer know that simply touching a piece of fruit in a market could leave hepatitis A on your hands, where it waits to enter your body through your mouth. Washing your hands frequently with soap and water is always important, but even more so when travelling in parts of the world where hepatitis A outbreaks commonly occur.
To avoid infection with hepatitis A and other food/waterborne illnesses:
- check if the water is safe – if not, drink bottled water or boiled tap water and also use it for brushing your teeth;
- peel and wash all fresh fruits and vegetables;
- do not eat raw or undercooked meat and fish;
- avoid drinks with ice or that are made with unsafe water; and
- wash your hands often.
Many cases of hepatitis A pass with no need for treatment. But a bad case can easily ruin the holiday experience. There is a vaccine for hepatitis A – 2 doses at least 6 months apart should protect for at least 20 years.
The virus can also be transmitted through close physical or sexual contact with an infected person, or through dirty hands.
Beware of hepatitis B and C
Hepatitis B is transmitted through contact with the blood or other bodily fluids of an infected person. Unsafe sex could put you at risk, as could getting a tattoo, piercing or manicure/pedicure in places with inadequate hygienic standards. If you cannot be sure that a nail salon is following suitable guidelines to avoid hepatitis transmission, consider supplying your own utensils such as clippers and scissors.
Hepatitis C is passed on through blood-to-blood contact only. It can also be transmitted through unsafe sex, unhygienic tattoos, piercings and nail salon treatments, although this happens less frequently than with hepatitis B. The highest risk of infection is associated with unsafe blood transfusions, blood products, and medical or dental procedures.
Hepatitis B and C are so-called silent diseases because many people do not experience symptoms. In addition, for many years there was poor awareness of hepatitis, so many people did not know they had it. Testing is an important part of a public health strategy, as long-term infection with hepatitis B or C can lead to liver damage, including cancer. If you think you may have been exposed to hepatitis B or C, discuss testing with your doctor or nurse.
The vaccine against hepatitis B is the best protection, and is included in routine childhood vaccinations in many countries. The vaccine became widely available after the year 2000, so the adults of today may not have been vaccinated as children. The vaccine is extremely effective, and 3 doses give immunity for at least 20 years.
Curing hepatitis C is now possible – but prevention is still key
There is, as yet, no vaccine for hepatitis C. People who inject drugs are at highest risk, but anything that could lead to infected blood entering your bloodstream carries a risk and should be avoided if possible.
According to Samantha May, Head of Support Services at the Hepatitis C Trust, every year holidays bring their own set of hepatitis worries. The Hepatitis C Trust is a charity in the United Kingdom that raises awareness about hepatitis C and also runs a confidential, patient-led, national telephone helpline. Over the past 16 years, the helpline team has answered more than 45 000 phone calls.
“When someone is concerned about becoming infected because of a tattoo, I ask them to remember if the ink and needles were sealed and were opened in front of them. This is the kind of hygienic practice we would hope to see,” she explains.
“We also get calls from people who have gone abroad for cosmetic or dental surgery and who are concerned. There are risks in these circumstances, depending on the setting in which they are carried out, but they are likely to be much smaller risks than if someone has shared equipment for injecting drugs or if they had a blood transfusion before the 1990s. In the end, the only way to be sure is to be tested. Thankfully, when someone is diagnosed the treatment available to them now is quicker and more effective than ever before.”