The occurrence of jaundice has been known for centuries. But it is only in this century that the various causes of jaundice have been described. The commonest cause is viral hepatitis (inflammation of the liver caused by a virus).

Hepatitis is usually a silent illness. However, untreated hepatitis may lead to coma due to liver failure.

There are 6 viruses that cause hepatitis: A, B, C, D, E & G. They differ in their behaviour, long term complications and effect on the liver.

Hepatitis-B is an infection of the liver which is regarded as one of the world's leading infectious killer. Threat to the community posed by hepatitis-B is much more in comparison to HIV (AIDS virus). In fact, hepatitis-B is 100 times more infectious than AIDS and kills more people in a day than AIDS kills in a year.

More than 400 million people worldwide are known to be chronic carriers of hepatitis-B. In India alone there are about 50 million carriers - one in every 20 persons!

Modes of Transmission

There are 4 major routes of transmission:

1. Parenteral: during blood transfusion and through infected needles. Unsterile needles used during ear piercing and tattooing can also transmit the infection.

2. Horizontal: from person to person. In the rough and tumble days of play, scratches and cuts increase the chances of a child getting exposed to hepatitis-B virus from playmates, who are apparently healthy carriers.

3. Vertical: from mother to child at birth.

4. Sexual: between sexual partners.

Consequences of Infection

90% of children develop a low-grade and inapparent infection which persists for many years, at times throughout life. Such persons, even though apparently healthy, are at a high risk of developing liver inflammation and liver cancer, both serious diseases. These problems occur in the prime of youth. These children can transmit the hepatitis-B virus to other healthy children on contact.

Prevention

There is no known effective treatment for hepatitis-B. Only vaccination can prevent this infection. The WHO has recommended that all new borns should be vaccinated against hepatitis-B at birth. If a child was not vaccinated at birth, this vaccine can be administered at any age, at the earliest. The vaccine needs to be given in 3 doses at definite intervals of 0, 1 and 6 months.

Dr. Subhash Rao Child Specialist Laksh-Deep Hospital