Safe water has a direct connection to good health - Here is why

In India, the problem of unsafe water is a huge public health concern. Apart from illnesses such as Diarrhea, Jaundice etc., unsafe water also contributes to Hepatitis A & E. Both these diseases are associated with inadequate and unsafe water supplies, poor sanitation & hygiene, leading to infection and inflammation of the Liver.

What is Hepatitis A and E? — Hepatitis A & E viruses are RNA virus which primarily infect the Liver, causing inflammation of the Liver (Acute Hepatitis). Infection with Hepatitis A & E is usually self-limiting

How is the infection acquired? — Hepatitis A or E is spread primarily through food or water contaminated by feces from an infected person (Feco-oral route). It enters the Liver from our gut and is then excreted again by our gut into stool, thus completing the cycle of infection

Who are at risk for Hhepatitis A or E? — Not everyone who's infected will have any evidence of this disease, as it may go unnoticed (asymptomatic disease). But still, these people can excrete viruses in their stool and continue to infect others (carriers)

Asymptomatic disease — Us being a developing nation with poor sanitation conditions, more than 95% of children below 5yrs of age are usually infected with these viruses, with an asymptomatic course. Thus, in India, antibody to Hepatitis A virus is nearly universally detectable by adolescence, and antibody to HEV increases during young adulthood to reach about 40% in adults

How does it spread? — Hepatitis A is usually spreads person-to-person through food or water contamination. An infected person's hands can become the source of infection after using the bathroom and the virus then spreads by direct contact or by food, beverages or other objects that were handled by the infected person. An infected individual can transmit the virus to others as early as two weeks before the symptoms begin to appear

Symptomatic disease — International travelers to India, children from high-income families are at risk of developing Hepatitis A or E infection because they do not eat much from the streets and so have not developed the required antibodies resulting in fever, stomach-ache and Jaundice

What are the symptoms of Hepatitis A or E?—

• Fever
• Tiredness
• Stomach upset
• Loss of appetite
• Dark yellow urine
• Diarrhea
• Yellowish eye & skin called jaundice

Why is it dangerous? — Unlike Hepatitis B & C, Hepatitis A does not cause Chronic Liver Disease and is rarely fatal. But it can cause debilitating symptoms and Fulminant Hepatitis (Acute Liver Failure), which is often fatal. Fulminant Hepatic Failure leading to death is seen in 1.8 % adults, and 10% in pregnant ladies.

Most people with Hepatitis E get better within a few months. Usually, it doesn't lead to long-term illness or Liver damage like some other forms of Hepatitis do. But Hepatitis E can be dangerous for pregnant women or anyone with weak immune systems, including the elderly or people who are ill.

How to prevent it? The best approach is to take all precautions to avoid Hepatitis and ensure safe drinking water for all. Make certain that your water source is clean and well maintained. Apart from this, follow this:

• Hand sanitation: Frequent handwashes before meals and after using the washroom
• Avoid eating outside, especially if you are pregnant
• Hepatitis A vaccine: Vaccinate your children who are below 6yrs (consult a Paediatrician about this)

If you identify any of the above symptoms, kindly meet your Gastroenterologist as timely treatment and care to resolve the infection with expected full recovery.