Reporter Chen Xiaoli
July 28 is the 12th “World Hepatitis Day”. In order to call on the whole society to pay attention to viral hepatitis, and to call on everyone to overcome viral hepatitis through vaccination, early screening and standardized treatment, this issue of One Point Ask Medical has specially invited the first department of liver cirrhosis of Shandong Provincial Public Health Clinical Center. Director Zhu Yanhui will introduce the prevention and control knowledge of hepatitis E (hepatitis E for short) in detail.
“Hepatitis E is an acute viral hepatitis caused by the hepatitis E virus, which is a Class B infectious disease.” Zhu Yanhui introduced that at the same time, hepatitis E is also a seriously underestimated clinical disease. About 20 million people are infected with hepatitis E virus each year, and 56,600 people die from the disease. The number of reported cases and deaths of hepatitis E in my country has been higher than that of hepatitis A for ten consecutive years.
“Our hospital’s liver disease department was formerly known as Jinan Infectious Diseases Hospital, which often treated patients with hepatitis E, some of whom came to see a doctor with severe symptoms and abnormal liver function after acute onset, and some who had a sudden aggravation of their condition based on the original chronic liver disease. Come to see a doctor.” Zhu Yanhui introduced that a hepatitis E patient admitted this year developed ascites and hepatic encephalopathy, and was finally diagnosed with subacute hepatitis E liver failure. He was discharged after treatment for nearly two months.
Zhu Yan will explain that because the liver has no pain nerves, it is difficult to directly transmit signals to the nerve center. For ordinary injuries, the liver always suffers silently with its powerful compensatory and regeneration capabilities. This also means that mild liver damage and early-stage liver tumors have no symptoms, and when they do, they can be serious.
“The most common route of transmission of hepatitis E is gastrointestinal transmission, also known as fecal-oral transmission.” Zu Yanhui introduced that pork, beef and mutton, animal livers, seafood, polluted water sources, etc. carry hepatitis E virus. In order to chase the taste of food, many people have a relatively short processing time and cannot completely kill the hepatitis E virus.
Hepatitis E is generally manifested as fever with chills, general malaise, loss of appetite, nausea, vomiting, oil loathing, abdominal distension, discomfort in the liver area, darkening of urine that is tea-like, and yellowing of the skin and sclera. . Most of the mild patients can recover on their own, but for a small number of severe patients, it can lead to liver failure and even death. In addition to intrahepatic manifestations, hepatitis E will also have some manifestations of systemic multi-organ damage, such as the nervous system, blood system, and urinary system.
“Hepatitis E is generally susceptible to the general population and is a zoonotic disease.” According to the Zuyan Association, livestock breeders, people engaged in the catering industry, and students (group living) are all cases of hepatitis E. Liver susceptible population. In addition, women of childbearing age, patients with chronic liver disease, and the elderly are very prone to severe disease if they are infected with hepatitis E. Hepatitis E infection in pregnant women can easily lead to fetal miscarriage and even death of pregnant women and other adverse pregnancy outcomes.
Zhu Yanhui once treated a patient with hepatitis E. The patient was infected with hepatitis E on the basis of alcoholic hepatitis. The patient was very ill and developed liver failure. Later, it turned into post-necrotic cirrhosis with ascites , stabilized after a year.
Zhu Yanhui said that there is currently no specific treatment for hepatitis E virus, and generally only some liver-protecting drugs can be used, and there are no drugs that can be used for pregnant women. Therefore, it is very important to strengthen the prevention of hepatitis E.
Hepatitis E can be prevented through three aspects: management of the source of infection, strengthening the isolation of hepatitis E patients and medical observation of contacts; cutting off the route of transmission, strengthening environmental sanitation, improving water supply conditions, strengthening host animals and Manage relevant meat products, develop good personal hygiene habits; vaccinate against hepatitis E to protect susceptible groups.
Among them, hepatitis E vaccination is the most economical and effective way to prevent hepatitis E. The hepatitis E vaccine was independently developed by my country and was approved for marketing in China in 2012. It has been vaccinated for ten years, and it is safe and effective. Hepatitis E vaccine is suitable for people over 16 years old. It needs 3 injections, 1 injection each at 0, 1, and 6 months, to obtain a lasting immune effect, and no booster is needed.
As to whether the HPV vaccine and hepatitis E vaccine can be vaccinated at the same time, which many netizens are concerned about, Zu Yanhui said: “In principle, hepatitis E can be vaccinated with any vaccine at the same time, as long as there is no instruction manual for another vaccine. It’s okay to say that you can’t be vaccinated with other vaccines.” However, for women preparing for pregnancy, due to the large number of vaccines that need to be vaccinated, it is recommended to be vaccinated in advance. Combined vaccination can shorten the time for pregnancy preparation, not only for their own protection, It also allows the baby to acquire maternal antibodies against the virus after birth.
