Hepatitis, often known as the silent killer disease is a serious liver condition that is commonly caused by a viral infection. Hepatitis is the second major killer infectious disease after tuberculosis, and about 9 times more people are infected with hepatitis than with HIV. More than 1.4 deaths are caused worldwide, including Pakistan being the second largest country affected by the disease. Within the region, Pakistan and Egypt bear 80% of the disease burden and within Pakistan, more than 12 million people are suffering from hepatitis. The disease is growing at an alarming rate will almost 150,000 new cases being brought in the hospitals every year in Pakistan, with the rest remaining unreported.

In simple terms, Hepatitis refers to an inflammatory condition of the liver, with various causes including but not limited to unhygienic places, viral infections, contact with contaminated food or water, interaction with infected bodily fluids, and from use of certain medications and drugs. There are over 5 types of hepatitis viruses- A, B, C, D& E- with hepatitis B and C being the deadliest. A different type of virus is responsible for every type of disease and treatment differs from virus to virus. Hepatitis A is an acute, short term disease while Hepatitis C and D are ongoing and chronic. Hepatitis E is the least talked about since its usually acute but can be dangerous in certain cases. Hepatitis B & C cause long term permeant liver damage leading to liver cancer and death. In Pakistan, 20 million people are living with hepatitis B & C, without being aware of it. This silent disease remains dormant in the body for many years before symptoms start to appear, but if it remains untreated as it does in Pakistan, it can lead to death. Unfortunately, in Pakistan, all five types of hepatitis viruses have spread to a great extent.

Pakistan is a breeding ground for hepatitis primarily because of sanitation problems in the region. The existence of unhygienic food and contaminated water is a very common problem in Pakistan. This is the prime reason for hepatitis A and E in rural areas of Sindh and Punjab. Hepatitis B, C, and D usually occur as a result of parental contact with infected body fluids. Patients are exposed to this type of hepatitis usually in hospitals and dental clinics since modes of transmission for these viruses include receipt of contaminated blood products, invasive medical procedures using contaminated equipment. Hepatitis B is usually transmitted from mother to baby at birth or through sexual contact.

Another reason for Pakistan being the second-largest spreader for hepatitis is the lifestyle that Pakistanis tend to follow. Treatment options and precautionary cautions are determined by which type of hepatitis a person has, and whether it’s acute or chronic. In the Pakistani context, practicing good hygiene is a key to avoid Hepatitis A and E. Basic precautions include, boiling drinking water before consuming it, washing raw vegetables and fruits before eating, and cooking seafood to an optimal level to kill the possible virus. These are precautionary measures at the consumption level for Hepatitis A and E. However, for hepatitis B, C, and D additional preventions need to be taken. These include not sharing drug needles, razors, someone’s toothbrush, and avoiding spilled blood. Hospital staff should be properly trained and equipped to keep the following in check.

Another cause for these alarming rates in Pakistan is the inadequate supply of vaccinations in rural areas, along with negligence by the parents. As of now, vaccinations are available to prevent the development of hepatitis A and B, while experts are working on vaccines against hepatitis C. Vaccines for hepatitis E only exists in limited countries since it is still not taken seriously. The health authorities

should expand their vaccination programs in regions that are currently deprived of such facilities. In Pakistan, parents belonging to certain strata often have misconceptions about the side effects of vaccinations. Therefore, educating the masses regarding these serious issues is a necessity rather than an option anymore.

To prevent hepatitis from spreading, let alone end it completely, it is vital that we work not only on a national level but also on a personal level. Early-stage diagnosis of hepatitis helps in treating the disease with maximum success rate. However, if it is discovered at a later stage the chances of complete recovery are limited. Therefore, the primary solution is to spread awareness about the symptoms of the virus. Awareness campaigns should be arranged to target the masses that are at risk. Along with the campaigning, free testing and screening of blood should be organized by health institutes. Precautionary measures are always better than expensive cures, therefore every individual should take necessary precautions and spread awareness. It is the responsibility of educated individuals to pass on the information, and help eradicate this disease from Pakistan.