The A to E of hepatitis

Not only travellers need to get vaccinated against hepatitis

Thursday, August 14 2014

With one in 12 people across the world living with some form of the hepatitis virus, Dr Pete Vincent of Netcare Travel Clinics and Medicross Tokai Family Medical and Dental Centre, is urging South Africans to get vaccinated against the disease.

“December holidays are nearing and many South Africans are starting to plan their annual getaways to exciting destinations all over the world. Now is as good a time as ever to vaccinate yourself and your family against the most common forms of hepatitis,” asserts Dr Vincent.

However, it is not only jetsetters and globetrotters who should consider getting vaccinated. According to Dr Vincent, “the disease remains a significant yet preventable health issue in this country and all South Africans should make sure that they are taking the adequate measures to prevent themselves from getting the disease, which causes approximately 1.5 million deaths each year.”

Hepatitis is inflammation of the liver caused by a virus. If left untreated, it can lead to life threatening complications such as cirrhosis (liver scarring), liver failure and even liver cancer. The symptoms of hepatitis depend on the severity of the infection but people who have been infected with the disease will usually experience nausea and vomiting, and abdominal pain or discomfort, especially in the area of the liver on the right side beneath the lower ribs. Other symptoms include a loss of appetite, fever, dark urine, light stools, muscle pain and yellowing of the skin and eyes (jaundice).

Although there are five types of the hepatitis virus, hepatitis A, B and C are the most prevalent among the South African population. Dr Vincent briefly explains the different types of the disease and what vaccinations are available.

Hepatitis A
Hepatitis A is spread mainly through eating food or drinking water that has been contaminated by faeces of an infected person, or by exposure to sewage. “This has become known as the ‘faecal-oral’ route of the virus. Food handlers are one of the most common culprits of spreading hepatitis A, therefore it is essential that they are taught good personal hygiene habits such as washing their hands thoroughly after going to the toilet and before preparing food,” asserts Dr Vincent.

“There is an excellent vaccination available to prevent hepatitis A, which requires two doses, six months apart and provides immediate and life-long protection against hepatitis A. However you should also always wash your hands after you have used the toilet, be mindful of the food you choose to consume and avoid drinking water that has come from a potentially unsafe source,” he adds.

Hepatitis B
Hepatitis B is one of the most common of the viral infections in the world. It is highly infectious and is transmitted through contact with the blood or other bodily fluids such as saliva, semen and vaginal fluids of an infected person. It can also be transmitted from mother to child during childbirth.

According to Dr Vincent, “Hepatitis B infections can become chronic in 30 to 90% of cases when the infection is contracted in childhood, and in 5% of cases when infection occurs in an adolescent or adult. Chronic infection with the hepatitis B virus can cause liver disease including cirrhosis and liver cancer.”

“There is a series of three vaccinations to prevent hepatitis B. The first vaccine can be administered at any given time, the second, at least one month after the first dose and the third, six months after the first dose. Hepatitis B vaccinations are part of the schedule in the expanded paediatric vaccine schedule. Healthcare workers should have a booster vaccine every five years and regularly check their immunity status,” he advises.

However, because hepatitis B can also be spread by sexual activity, Dr Vincent cautions that any individual engaging in sexual activity with a partner, whose sexual history is unknown to them, should use a condom to prevent the spread of the disease. Also avoid sharing needles, toothbrushes, razors or nail scissors.

Hepatitis C
Hepatitis C is also spread through blood-to-blood contact. Hepatitis C can also cause cirrhosis of the liver, liver cancer and liver failure if left untreated.

Unfortunately there is no vaccination for this type of hepatitis. Therefore Dr Vincent asserts it is imperative that people reduce their risk of exposure by avoiding the sharing of needles, toothbrushes, razors or nail scissors and avoid getting tattoos or body piercings from unlicensed facilities.

Hepatitis D
This form of hepatitis is only found in people who are already infected with the hepatitis B virus and it is also spread through contact with infected blood. The symptoms of hepatitis B and hepatitis D are similar, and hepatitis D can also cause the symptoms of hepatitis B to worsen, or appear in those who have been infected but have not yet developed symptoms. The virus can be acute or chronic. If you have chronic hepatitis D, you are at a higher risk of developing complications from the disease.

“People not already infected with hepatitis B should get the hepatitis B vaccination to prevent also getting infected with hepatitis D,” advises Dr Vincent.

Hepatitis E
Like hepatitis A, this form of the virus is mainly transmitted through eating food or drinking water that has been contaminated by faeces of an infected person. The time between infection with hepatitis E and development of symptoms ranges between 15 to 60 days. Common symptoms of acute hepatitis E are similar to those of other types of viral hepatitis such as fever, weakness, fatigue, a loss of appetite, nausea, vomiting and jaundice. According to Dr Vincent, “Prevention is the most effective approach against hepatitis E.”

“Vaccinations against hepatitis A and hepatitis B are very effective, safe and essential for any traveller. I would also recommend that students who stay in residences, hostels and boarding houses get vaccinated against these common forms of the disease. I would also suggest that people who are involved in contact sports get the hepatitis B vaccination. These vaccinations are available in single vaccinations or in various combinations from any Netcare Travel Clinic,” concludes Dr Vincent.

Please do not hesitate to contact your nearest Netcare Travel Clinic should you have any queries or questions regarding travel-health related topics. You may also visit our website on or email

Issued by: Martina Nicholson Associates (MNA) on behalf of Netcare Travel Clinic
Contact : Martina Nicholson, Graeme Swinney, Sarah Beswick and Jillian Penaluna
Telephone: (011) 469 3016
Email:, or