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India Today
11 minutes ago
- India Today
Hepatitis in India: A preventable disease still claiming lives
After its first unwelcome debut in India in the 1950s, hepatitis has remained one of the most persistent illnesses, refusing to leave quietly. Back then, it spread mostly through contaminated water and poor sanitation, giving rise to periodic outbreaks of hepatitis A and later, while we've gained vaccines, better hygiene practices, and public health campaigns, hepatitis continues to claim thousands of lives annually in India. The villains may have evolved but the problem remains fundamentally the same: silent spread, poor awareness, and late FIVE FACES OF HEPATITIS Before diving into India's unique challenges, it's important to understand that hepatitis is not one disease, but a family of five viruses - A, B, C, D, and E. Each one affects the liver but in different ways:Hepatitis A and E: Spread through contaminated food and water, these forms usually cause acute infections, and are more common in areas with poor sanitation. Hepatitis E is particularly dangerous in pregnant B and C: Transmitted through blood and bodily fluids, these can lead to chronic liver disease, cirrhosis, and liver cancer if left D: Occurs only in people already infected with hepatitis B, adding another layer of hepatitis A and E are short-term illnesses that don't become chronic, hepatitis B and C are long-haul infections that can stealthily damage the liver over decades, often going undetected until it's too late.A LOW-PREVALENCE COUNTRY WITH A HIGH BURDENAccording to the 2023 HIV Sentinel Surveillance Plus report, the national seroprevalence for hepatitis B is around 0.85% and for hepatitis C is 0.29%. That technically puts India in the 'low prevalence' category (less than 2%) as per World Health Organisation (WHO) these small percentages translate into millions of infected individuals, many of whom are completely unaware of their Dr. Kapil Sharma, Director of Gastroenterology at Sarvodaya Hospital, Faridabad, puts it, 'Many people do not know they are infected until they begin to experience complications like liver damage or cancer. That's far too late.'THE SPIKE THAT RETURNS EVERY MONSOONMonsoon in India is not just a season, it's a public health alarm. Hospitals report a surge in acute viral hepatitis cases, especially hepatitis A and E, linked to stagnant water, flooded drains, and contaminated year, Dr. Abhideep Chaudhary, President-Elect of the Liver Transplantation Society of India (LTSI) and Vice Chairman, HPB and Liver Transplantation at BLK-Max Hospital, Delhi, said that there's been a 40% rise in acute viral hepatitis cases in the past three weeks alone.'Many patients are unaware of the need for hepatitis vaccination, especially those moving from rural to urban settlements," said Dr. children are affected. Hepatitis A is highly prevalent among kids under 15, while hepatitis E is a leading cause of waterborne hepatitis, particularly deadly for pregnant REAL COST OF DELAYSymptoms of hepatitis often start subtly: fatigue, mild jaundice, loss of as Dr. Sanjiv Saigal, President of LTSI, warns, 'We are witnessing a seasonal epidemic that repeats every year, and yet we are caught off guard every time.' In some cases, acute hepatitis A or E can lead to liver failure, requiring urgent transplant.'There's a dangerous myth that jaundice is self-limiting,' adds Dr. Chaudhary. 'Delayed diagnosis can lead to life-threatening complications. Despite being a public health challenge, these infections remain underreported and poorly understood.'One of the biggest reasons hepatitis still thrives is the gaping void in early detection. Dr. Sharma explains that in India:Routine screening is rare, especially in rural and semi-urban surrounding liver disease discourages people from seeking timely infrastructure is stretched, with a lack of trained personnel to detect early costs, especially for hepatitis C, can be prohibitive for many though vaccines exist, coverage is patchy. Many people don't complete the full course or are unaware that they're at risk in the first MEDICAL PRACTICES FUEL THE FIREUnsafe injections, unsterilised dental equipment, and informal clinics using dubious methods are major transmission routes for hepatitis B and C.'A lot of infections occur due to unsafe blood transfusions and contaminated medical equipment in smaller healthcare setups,' Dr. Sharma says. While urban hospitals are more likely to follow safety protocols, rural clinics often operate with minimal hepatitis A and E, it's the basics - safe drinking water and hygiene - that remain elusive in many parts of the country. Kerala, for example, faces annual outbreaks of hepatitis to Dr. E. Sreekumar, Director of the Institute of Advanced Virology, floods and erratic rainfall have worsened clean water access in recent IN PUBLIC AWARENESS AND WHAT MUST CHANGEDespite recurring outbreaks, public understanding of hepatitis remains shockingly low.'Most people can't differentiate between types of hepatitis or recognise the symptoms,' says Dr. Sharma. This lack of awareness is especially pronounced in slum areas and among migrant workers, where clean water and healthcare access are already to experts, several steps can help stem the tide of hepatitis in India:advertisementIntegrate the Hepatitis B vaccine into all birth and school immunisation mass screening campaigns for high-risk groups, especially pregnant women, healthcare workers, and injection drug all blood banks and hospitals follow strict infection control hepatitis treatments, particularly for hepatitis C, to make them more community health workers, schools, and religious centres to drive public primary healthcare workers to recognise early signs of Monika Jain, Director of Liver Diseases at Sri Balaji Action Medical Institute, puts a spotlight on everyday hygiene: 'We tell everyone to eat properly cooked food, avoid street vendors during the rains, and wash hands thoroughly.'As Dr. Saigal notes, 'We must shift focus from treating hepatitis to preventing it. That's the only way we'll stop this disease from quietly wreaking havoc, one monsoon at a time.'Because hepatitis may be an old enemy, but it's one we already know how to defeat. Now, we just have to act like it.- EndsTrending Reel
Indian Express
31 minutes ago
- Indian Express
World Hepatitis Day 2025: Top 10 countries account for two-thirds of the global hepatitis B and C cases, with China and India leading
Viral hepatitis — an infection that causes liver inflammation, damage and may lead to liver cancer — is a critical public health challenge of this decade globally. It is one of the leading causes of death globally—with an estimated 1.3 million people dying in 2022 from the disease, according to the World Health Organisation (WHO) report. Notably, the top ten countries in the world account for nearly two-thirds of the global burden of viral hepatitis B and C combined, according to the report. For hepatitis B, the top three countries—China, India, and Indonesia—represent 50% of the global burden in 2022; and for hepatitis C, six countries—China, India, Indonesia, Pakistan, the Russian Federation, and the United States of America—represent 50% of the global burden, the report highlighted. Since 2015, there have been certain significant advancements forward in testing and treatment for viral hepatitis, with it being more widely available. While countries worldwide have national strategies and updated clinical guidelines to facilitate people getting prevention, testing, and treatment services; however, overall global coverage lacks and remains unchanged; its implementation continues to proceed incredibly slowly, making progress critical to the global response. As a result, the world observes World Hepatitis Day on 28th July every year to promote global awareness of hepatitis prevention, early detection, and effective treatment options. Source: Global Hepatitis Report 2024, World Health Organisation India is one of the countries with the highest burden of viral hepatitis with the data revealing a significant burden of hepatitis infections with the country accounts for 29,800,000 total hepatitis B infections and 5,500,000 total hepatitis C infections across all ages. When combined, these results highlight 35,300,000 total hepatitis B and hepatitis C infections, representing 11.6% of the total combined hepatitis B and C infections across the countries, making India the second-highest contributor after China. Cherry Gupta is an Assistant Manager - Content at The Indian Express. She is responsible for crafting compelling narratives, uncovering the latest news and developments, and driving engaging content based on data and trends to boost website traffic and audience engagement. One can connect with her on LinkedIn or by mail at ... Read More
NDTV
33 minutes ago
- NDTV
Covid And Other Infections Leave Lasting Impact: Chronic Fatigue, Brain Fog
Stellenbosch: Millions of people who recover from infections like COVID-19, influenza and glandular fever are affected by long-lasting symptoms. These include chronic fatigue, brain fog, exercise intolerance, dizziness, muscle or joint pain and gut problems. And many of these symptoms worsen after exercise, a phenomenon known as post-exertional malaise. Medically the symptoms are known as myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). The World Health Organization classifies this as a post viral fatigue syndrome, and it is recognised by both the WHO and the United States Centers for Disease Control and Prevention as a brain disorder. Experiencing illness long after contracting an infection is not new, as patients have reported these symptoms for decades. But COVID-19 has amplified the problem worldwide. Nearly half of people with ongoing post-COVID symptoms - a condition known as long-COVID - now meet the criteria for ME/CFS. Since the start of the pandemic in 2020, it is estimated that more than 400 million people have developed long-COVID. To date, no widely accepted and testable mechanism has fully explained the biological processes underlying long-COVID and ME/CFS. Our work offers a new perspective that may help close this gap. Our research group studies blood and the cardiovascular system in inflammatory diseases, as well as post-viral conditions. We focus on coagulation, inflammation and endothelial cells. Endothelial cells make up the inner layer of blood vessels and serve many important functions, like regulating blood clotting, blood vessel dilation and constriction, and inflammation. Our latest review aims to explain how ME/CFS and long-COVID start and progress, and how symptoms show up in the body and its systems. By pinpointing and explaining the underlying disease mechanisms, we can pave the way for better clinical tools to diagnose and treat people living with ME/CFS and long-COVID. What is endothelial senescence? In our review, our international team proposes that certain viruses drive endothelial cells into a half-alive, "zombie-like" state called cellular senescence. Senescent endothelial cells stop dividing, but continue to release molecules that awaken and confuse the immune system. This prompts the blood to form clots and, at the same time, prevent clot breakdown, which could lead to the constriction of blood vessels and limited blood flow. By placing "zombie" blood-vessel cells at the centre of these post-viral diseases, our hypothesis weaves together microclots, oxygen debt (the extra oxygen your body needs after strenuous exercise to restore balance), brain-fog, dizziness, gut leakiness (a digestive condition where the intestinal lining allows toxins into the bloodstream) and immune dysfunction into a single, testable narrative. From acute viral infection to 'zombie' vessels Viruses like SARS-CoV-2, Epstein-Barr virus, HHV-6, influenza A, and enteroviruses (a group of viruses that cause a number of infectious illnesses which are usually mild) can all infect endothelial cells. They enable a direct attack on the cells that line the inside of blood vessels. Some of these viruses have been shown to trigger endothelial senescence. Multiple studies show that SARS-CoV-2 (the virus which causes COVID-19 disease) has the ability to induce senescence in a variety of cell types, including endothelial cells. Viral proteins from SARS-CoV-2, for example, sabotage DNA-repair pathways and push the host cell towards a senescent state, while senescent cells in turn become even more susceptible to viral entry. This reciprocity helps explain why different pathogens can result in the same chronic illness. Influenza A, too, has shown the ability to drive endothelial cells into a senescent, zombie-like state. What we think is happening We propose that when blood-vessel cells turn into "zombies", they pump out substances that make blood thicker and prone to forming tiny clots. These clots slow down circulation, so less oxygen reaches muscles and organs. This is one reason people feel drained. During exercise, the problem worsens. Instead of the vessels relaxing to allow adequate bloodflow, they tighten further. This means that muscles are starved of oxygen and patients experience a crash the day after exercise. In the brain, the same faulty cells let blood flow drop and leak, bringing on brain fog and dizziness. In the gut, they weaken the lining, allowing bits of bacteria to slip into the bloodstream and trigger more inflammation. Because blood vessels reach every corner of the body, even scattered patches of these "zombie" cells found in the blood vessels can create the mix of symptoms seen in long-COVID and ME/CFS. Immune exhaustion locks in the damage Some parts of the immune system kill senescent cells. They are natural-killer cells, macrophages and complement proteins, which are immune molecules capable of tagging and killing pathogens. But long-COVID and ME/CFS frequently have impaired natural-killer cell function, sluggish macrophages and complement dysfunction. Senescent endothelial cells may also send out a chemical signal to repel immune attack. So the "zombie cells" actively evade the immune system. This creates a self-sustaining loop of vascular and immune dysfunction, where senescent endothelial cells persist. In a healthy person with an optimally functioning immune system, these senescent endothelial cells will normally be cleared. But there is significant immune dysfunction in ME/CFS and long-COVID, and this may enable the "zombie cells" to survive and the disease to progress. Where the research goes next There is a registered clinical trial in the US that is investigating senescence in long-COVID. Our consortium is testing new ways to spot signs of ageing in the cells that line our blood vessels. First, we expose healthy endothelial cells in the lab to blood from patients to see whether it pushes the cells into a senescent, or "zombie," state. At the same time, we are trialling non invasive imaging and fluorescent probes that could one day reveal these ageing cells inside the body. In selected cases, tissue biopsies may later confirm what the scans show. Together, these approaches aim to pinpoint how substances circulating in the blood drive cellular ageing and how that, in turn, fuels disease. Our aim is simple: find these ageing endothelial cells in real patients. Pinpointing them will inform the next round of clinical trials and open the door to therapies that target senescent cells directly, offering a route to healthier blood vessels and, ultimately, lighter disease loads. (Author: Burtram C. Fielding, Dean Faculty of Sciences and Professor in the Department of Microbiology, Stellenbosch University; Etheresia Pretorius, Distinguished Professor in Physiological Sciences, Stellenbosch University, and Massimo Nunes, Postdoctoral Research Fellow , Stellenbosch University (Disclaimer Statement: Burtram C. Fielding works for Stellenbosch University. He has received funding from the National Research Foundation, South Africa and the Technology Innovation Agency. Resia Pretorius is a Distinguished Research Professor at Stellenbosch University and receives funding from Balvi Research Foundation and Kanro Research Foundation. She is also affiliated with University of Liverpool as a Honorary Professor. Resia is a founding director of the Stellenbosch University start-up company, Biocode Technologies and has various patents related to microclot formation in Long COVID. Massimo Nunes receives funding from Kanro Research Foundation.)
