The death of a child aged five in Flacq Hospital Intensive Care Unit, from hepatitis following neo-natal jaundice, last week, revived the debate around this little-known disease. It coincided with the press conference held by HEP Support, the Mauritian non-governmental organization that aims at assisting patients and sensitizing the public as well as the authorities.

Dr Zouberr Joomaye, president of HEP Support, asserts that hepatitis is rampant in Mauritius and that some 35,000 Mauritians have been infected with the virus, which he refers to as a silent killer. The control of its outbreak is a cause of great concern in most countries and it is said that in Asian countries, some 1.5 million clinical cases of hepatitis occurring each year. Studies have shown that one of the main reasons for this growing condition is due to ignorance towards prevention of the disease. Hepatitis is a disease of the liver caused by several types of hepatitis virus. This virus causes destruction of the liver tissue and may lead to cirrhosis and carcinoma of the liver. It is the second-most important cancer-causing agent next to tobacco. There are three types of hepatitis: A, B and C, the last two being the most serious and infectious ones that cause death (see Inset). ?Symptoms range from malaise, to jaundice and may include fever and diarrhea but, in some cases, no symptom appears for this disease which is hard to fight. People infected may not even know that they are carrying the disease?, says Dr. Joomaye.

?Trust me, those injections have cost me Rs 9,000 each. And a drink, taken even socially now, is not worth it!?

?Government needs to set up a strategy to help those infected and increase prevention immediately,? adds the physician. HEP Support is holding a series of events this week to inform and sensitize the local population about hepatitis B and C. Dr Joomaye revealed at his press conference that, despite his efforts, the ministry of Health has made no move to sensitize the population against hepatitis. ?They have no strategy as such to halt contamination or to help and treat those already infected.?

Rejected by the hospital

For Sanjay Bhowany, a member of HEP Support, ?Where there is a will, there is a way.? This dynamic man of 40 discovered he had hepatitis C by accident when he was tested prior to a blood donation in 2000. He openly talks about his experience and utter confusion when he learnt the news. ?You will not be able to donate blood, you can go home.? This is what the nurse told Sanjay who says he had never heard of the deadly hepatitis virus before this blood donation.

Sanjay was not ready to die and he started an uphill battle with the help of friends and relatives. However, at the hospital, he was told by a doctor: ?It?s not something serious, you will need to live with it as we do not have any treatment for it. You just have to control the amount of alcoholic drinks you take.? Dr Joomaye insists that the hospital hould have provided treatment to Sanjay. He adds that such treatment should have been available in public hospitals since the 90s. It has not and is still not the case.

Sanjay had recourse to a private practitioner in 2000 who told him that such a treatment would cost him at least half a million rupees. Quite a big sum of money for someone not well off. What Sanjay did is what people suffering from hepatitis are still doing nowadays. Saving money, getting financial help from friends and securing a loan to meet the required amount took Sanjay almost six long years. It?s only last year that Sanjay started his treatment, which took him 48 weeks. He had weekly injections and smiling ruefully he adds, ?Trust me, those injections have cost me Rs 9,000 each. And a drink, taken even socially now, is not worth it!?

The critical treatment of 24-48 weeks over, Sanjay has 16 more weeks of treatment to undergo. He still has blood tests to verify if his blood has any trace of the virus. He has been one of the lucky ones to get out of this treatment completely cured. Many others started but have had to stop due to lack of finance.

No looking back for Sanjay now. He is one of the active members in the HEP Support and advises: ?If anyone thinks that they have this virus, please open up and come talk to us. Whichever illness you have, it?s only by talking and sharing that you will find solutions. We are here to fight.?

Anushka MOOTIA

USEFUL FACTS

How contagious and serious?

■ Hepatitis A, hepatitis B, and hepatitis C are all contagious.

The Hepatitis A virus is most common in children and has no treatment as it goes on its own in 2-6 weeks. This virus does not cause chronic liver disease. The virus can be spread in contaminated food or water, as well as in unsanitary conditions in child-care facilities or schools.

The Hepatitis B virus can lead from general malaise to chronic liver disease, but 85% to 90% of patients recover without long-term complications within 6 months. The virus can be found in virtually all body fluids, though its main routes of infection are through sexual contact, contaminated blood transfusions, and shared needles for drug injections.

The hepatitis C virus is the most dangerous one as it leads to chronic liver disease. 75% to 85% of those infected do not recover completely will suffer from liver cancer or cirrhosis. The virus can be spread through shared drug needles, contaminated blood products, and, less commonly, through sexual contact. Hepatitis C can be spread from a mother to her foetus during pregnancy. As tattoos and acupuncture have become more popular, the risk of developing hepatitis from improperly sterilized equipment used in these procedures has increased.

HOW TO PREVENT?

■ Immunization is possible against Hepatitis A and B. There are vaccination centers around the island. Dawood Samtally from Port-Louis Vaccination Center agreed to quote the prices for these two vaccines.

• People who live with or care for someone with hepatitis should wash their hands after contact with the infected person. A hepatitis A vaccine is available and recommended for those who travel abroad, have other forms of liver disease, have many sexual partners, are in high-risk occupations, such as health-care and child-care personnel. The price of hepatitis A vaccine ranges from Rs 800 to Rs 1 000.

• Household contact with adults with hepatitis B can put people at risk for contracting hepatitis. But frequent hand washing and good hygiene practices can reduce this risk. A hepatitis B vaccine exists and should be given to both children and adults as part of routine immunization. The price hepatitis B vaccine ranges from Rs 500 to Rs 800.

• Unfortunately, there's no vaccine for hepatitis C - animal studies indicate that it may not be possible because the virus doesn't cause the kind of response that would be needed for a vaccine to be successful. Only preventive measures can help: Good hygiene and healthy living conditions ; encouraging drug awareness in families and communities as contaminated needles are a major source of hepatitis infection.