World Hepatitis Day

July 28th is World Hepatitis Awareness Day. There are an estimated 3.2 million Americans living with either Hepatitis B or C infections, making the number of Americans with these infections greater than the population of Chicago. Over half of all people with hepatitis don’t know they are infected because there are no initial symptoms associated with a new hepatitis infection.

This enables the infection to spread to others and can result in severe and sometimes life-threatening liver disease. Testing, vaccination (when applicable), and prevention are key in the effort to reduce the impact of hepatitis.

Types of Hepatitis

There are three main types of viral hepatitis: hepatitis A, B, and C. 

• Hepatitis A is a vaccine-preventable, acute liver infection that can be spread through person-to-person contact or contaminated food or drink.
• Hepatitis B is a vaccine-preventable, mild-to-severe liver infection that can be acute or chronic and is usually spread through infected body fluids, such as blood or semen.
• Hepatitis C is a liver infection usually spread through exposure to infected blood and can lead to chronic infection in more than half of those who become infected. There is no vaccine for Hepatitis C.

Symptoms

Some people with acute hepatitis infections do not have symptoms or only have mild symptoms. Others may become severely ill. Depending on the type of hepatitis, symptoms may appear anytime from 2 weeks to 5 months after infection. Symptoms of chronic infection take longer to appear, decades in some cases. 

Symptoms include:

• Dark urine
• Stomach pain
• Yellow skin or eye whites, called jaundice
• Pale or clay-colored stool
• Low-grade fever
• Loss of appetite
• Fatigue
• Feeling sick to your stomach
• Aching joints

How It Spreads

According to the US Department of Health and Human Services, 2018 marked a decades-long increase in new hepatitis C infections among young adults. Rates of acute hepatitis B are creeping up as well, especially in the southern Appalachian states. Injection drug use, specifically the sharing of injection equipment, linked to the opioid & heroin epidemics was the primary route of these infections. 

Since 2016, large outbreaks of hepatitis A linked to person-to-person spread have occurred in many US states, including NC. These hepatitis A outbreaks have disproportionately involved people who use drugs, people experiencing homelessness, men who have sex with men, people who have been recently or are currently incarcerated, and people with chronic liver disease. 

Dr. Jennifer Mullendore, Buncombe County Medical Director, emphasizes the critical importance of vaccination and harm reduction services in reducing these disturbing trends. “Hepatitis A and B infection are preventable thanks to highly effective, safe vaccines. Condoms and clean injection supplies significantly reduce the spread of viral hepatitis. We encourage at-risk individuals and agencies who serve them to spread the word and utilize these infection prevention and life-saving measures.” 

Prevention

There are many ways to reduce your chances of getting hepatitis:

• Get vaccinated for hepatitis A and hepatitis B.
  • The Buncombe County Immunization Clinic provides these vaccinations free of charge to qualifying individuals. Call (828) 250-5096 to make an appointment or click here to learn more.
• Use a condom during sex.
  • Regardless of condom use, it is important to talk about your sexual history before having sex. Some questions to ask are:
    • When was the last time you slept with someone else and did you use protection?
    • When was the last time you got tested and what were your results?
• Don't share needles to take drugs.
  • Buncombe County Syringe Services, located on the bottom level of 40 Coxe Avenue, includes a syringe exchange program. Our staff is dedicated to improving the health of our community by exchanging used syringes for new ones. Click here for more information. 
• Practice good personal hygiene such as thorough hand-washing with soap and water.
• Don't use an infected person's personal items (razors, toothbrushes, etc.)
• Take precautions when getting any tattoos or body piercings.

If you have risk factors for hepatitis B or C infection, get tested.

If you are infected, treatments are available and there are steps you can take to avoid spreading your infection to others.

Additional Resources:

Buncombe County Health Clinic

Cleveland Clinic

NC DHHS

US DHHS

CDC