itis, disease or inflammation of an organ. Hence, hepatitis is inflammation of the liver.

Hepatitis dates back at least 2,000 years in the time of Hippocrates. There have been major epidemics in Europe (over 200 years ago), and in the United States (100 years ago). Only in the last 40 years have significant advances been made in understanding the cause, transmission and control of hepatitis.

Hepatitis can be caused by drugs, medication, absorption of toxic substances and any of a variety of organisms, including hepatitis A and B viruses, cytomegalovirus (CMV), Epstein-Barr virus (EBV), and other as yet inidentified organisms.

Jaundice can be a sign of hepatitis. The word jaundice originates from the French word jaunisse meaning yellowness and is a condition characterised by the yellowing of the eyes and skin. This is caused by the bile pigment getting into the circulatory system. There can be many causes for jaundice, for example, obstruction of the bile duct, a reaction to drugs and medication, or organisms causing inflammation of the liver. It must be remembered that jaundice is not a disease, it is a symptom or condition.

There are a few hepatitis viruses. A common one is Hepatitis A. This virus is usually spread by contaminated water or food and by personal contract. It is most common in countries without a controlled water supply or adequate sewage system. Infection is often the result of poor personal hygiene. The virus is shed in the faeces (bowel movements) of an infected person. So it follows that the washing of hands plays an essential part in the control of this infection.

Some of the signs and symptoms are abrupt onset of fewer, malaise, anorexia, nausea and abdominal discomfort, followed within a few days by jaundice.

Hepatitis A can be asymptomatic, or mild and without jaundice. The incubation period is from 15 to 20 days with an average of 28 to 30 days. This disease has no lasting effects and is rarely fatal.

Non-A, Non-B hepatitis, is caused by agents as yet unidentified, but is diagnosed by testing for and excluding the Hepatitis A and B viruses and other likely causes. The signs and symptoms can be similar as in other types of hepatitis and recovery will depend on the amount of damage done to the liver.

Hepatitis B is primarily a blood-borne virus, but is present in all body fluids such as semen, vaginal secretions, saliva etc. The virus gains entry to the body via breaks in the skin or mucous membranes, by sexual transmission and even via the eyes. Biting has been known to transmit the virus. There have been cases of persons receiving infected blood through blood transfusions. IV drug users are also at risk of contracting Hepatitis B. This virus is far more contagious than the AIDS virus and the other hepatitis viruses. The hepatitis B virus can exist outside of the body for up to 7 days. The incubation period is variable. It can be as short as 4 weeks or as long as 6 months. The symptoms, some or all of which may be present, are flu-like illness, rash, joint pains, dark urine, pale faeces and jaundice. Correct diagnosis can only be made by blood tests. Some people may be admitted to the hospital and the symptoms can last as long as six months and full recovery can take a further six months. During the recovery period, depression can be common. In some rare cases, liver failure can occur as well as death. Approximately six to 10 percent of people infected with the Hepatitis B virus can become carriers. All blood donors and all pregnant women are tested for Hepatitis B.

Immunizations are available from the Hamilton Health Centre for both Hepatitis A and B. For persons travelling to countries such as Africa, Asia the Middle East and South America, prophylactic doses of gamma globulin are given for Hepatitis A. This shot is only effective for six weeks.

Immunization for Hepatitis B is recommended for all health care workers, dentists and dental hygienists, Police and prison officers, firemen, morticians and frequent international travellers to the above mentioned countries.

For more information, please contact the Immunization Clinic at the Hamilton Health Centre. The number is 236-0224 ext. 240.

RHONDA DANIELS Nurse Epidemiologist.