Hepatitis A - Pakistan: (Azad
A ProMED-mail post,http://www.promedmail.org, ProMED-mail is a program of the
International Society for Infectious Diseaseshttp://www.isid.org
Date: Mon 6 Dec 2010
Source: The Express Tribune
As a result of poor hygiene
standards and the lack of awareness campaigns, hepatitis A is fast
spreading in Azad Jammu and Kashmir (AJK), doctors of the area have
said. Hepatitis A is an acute illness associated with fever,
malaise, jaundice, anorexia and nausea. The disease is spreading at
an alarming rate, especially in the earthquake affected areas of
the region, where hygiene conditions have still not improved
despite all the money that was spent on these areas to rehabilitate
the health structure.
The Health Department has still
not launched any awareness campaigns to educate the masses about
this fast spreading disease. The Khalifa Sheikh Zaid Al-Nayan
hospital in Muzaffarabad has been receiving patients from the
earthquake affected areas of the Neelum and Jhelum valley, Bagh and
Rawalakot districts infected with hepatitis A.
A recent survey conducted by Dr
Tahir Raheem Mughal, a general practitioner (GP) at the hospital in
Muzaffarabad, observed that at least 150 patients were diagnosed
with hepatitis A in last 2 months.
"Acute viral hepatitis (AVH) is one of the most common diseases in
the patients who visited hospital," Mughal said. Doctors have
observed that the reason for the spread of AVH in AJK is through
the fecal-oral route, which means that the infection travels from
one person to another when a person comes into contact with
something that is directly or indirectly contaminated by feces of
another infected person.
"Though the hygiene conditions in
the region have improved, the lack of proper sewerage lines adds to
the increasing number of AVH patients," Mughalsaid. The sewerage
system in AJK was functional, but after the October 2005
earthquake, it was destroyed and has still not been repaired 5
years on. Another big reason for the spread of this disease is the
consumption of contaminated water.
Health experts say that increasing
the awareness amongst the general population regarding preventive
measures and improving hygienic conditions are essential. Hepatitis
A vaccine can prevent the spread of the infection, but patients
predominately come to the hospital late. Two doses are needed 6-18
months apart to ensure long-term protection.
[Azad Jammu and Kashmir (AJK)
[current ISO nomenclature: Azad Kashmir (JK) - CopyEd.MSP], is the
southernmost political entity within the Pakistani-administered
part of the former princely state of Jammu and Kashmir. It borders
the present-day Indian-controlled state of Jammu and Kashmir to the
east (separated from it by the Line of Control), Khyber-Pakhtunkhwa
to the west, Gilgit-Baltistan to the north, and the Punjab Province
of Pakistan to the south. With its capital at Muzaffarabad, Azad
Kashmir covers an area of 13 297 square km (5134 sq mi) and has an
estimated population of about 4 million.
Hepatitis A is a viral liver
disease that can cause mild to severe illness. It is spread by
faecal-oral transmission when a person ingests food or drink
contaminated by an infected person's stool. The disease is closely
associated with poor sanitation and a lack of personal hygiene
habits, such as hand-washing. Epidemics can be explosive in growth,
and improved sanitation and hepatitis A vaccine are the most
effective ways to combat the disease.
The symptoms of hepatitis A range
from mild to severe, and can include fever, malaise, loss of
appetite, diarrhoea, nausea, abdominal discomfort, dark-colored
urine and jaundice (a yellowing of the skin and whites of the
eyes). Not everyone who is infected will have all of the symptoms.
Adults have signs and symptoms of illness more often than children,
and the severity of disease and mortality increases in older age
groups. Infected children under 6 years of age do not usually
experience noticeable symptoms, and only 10 percent develop
jaundice. Among older children and adults, infection usually causes
more severe symptoms, with jaundice occurring in more than 70
percent of cases. Most people recover in several weeks -- or
sometimes months -- without complications. (More detailed
information can be accessed at:http://www.who.int/mediacentre/factsheets/fs328/en/index.html
A map and further information
about Azad Jammu and Kashmir can be found athttp://www.ajk.gov.pk/index.php?option=com_content&view=article&id=62&Itemid=96.
Hepatitis, viral - Pakistan (04): (SD) prisoners 20091125.4045
Hepatitis, viral - Pakistan (03), syringe re-use 20090920.3304
Hepatitis, viral - Pakistan (02): prevalence 20090610.2141
Hepatitis, viral - Pakistan: (SD) fatal 20090609.2125
Hepatitis, viral - Pakistan 20070306.0796