I REFER to the report “Family would’ve been in dire straits if not for subsidy” (The Star, Dec 31), which quoted the person saying: “Doctors said I had eaten too much raw food while working in Singapore.”
The reason for my letter is to address the misconception about the mode of transmission of chronic hepatitis B (CHB) infection among the general public.
Based on statistics from the World Health Organization, an estimated 257 million people are infected with the hepatitis B virus (HBV). It was estimated that in 2015, 887,000 deaths were caused by complications of hepatitis B. Despite the high disease burden, only 8% with HBV infection (1.7 million people) are treated.
In Malaysia, the prevalence of CHB is between 1.5% and 9.8% in our population, with the highest disease burden coming from east Malaysia. The prevalence of disease also varies among the different races: Chinese 14.8%, Malay 7.4%, and Indian 6.0%.
Based on studies, there is a reduction in the number of cases of CHB after the introduction of the universal vaccination programme in 1989 by our Health Ministry.
How is HBV transmitted? Transmission can happen when blood or body fluid of a person infected with hepatitis B enters the body of a person who is not infected. There is no data on the commonest route of hepatitis B spread in Malaysia. However, I believe that transmission of disease during delivery is one of the important routes. It is estimated that 2.4% of pregnant women in Malaysia are infected with hepatitis B. Thus, screening for hepatitis B is important in pregnant women.
Based on the severity of the condition, some may require treatment to prevent spreading, with extra medication given to the infant on delivery.
As the disease is spread by body fluids, other routes of spread are having unprotected sex with someone who is infected, sharing needles (drug users), or using infected needles for tattooing, acupuncture or piercing. It is also advised not to share personal items such as toothbrushes and razors with an infected person.
Most importantly, I would like to stress that hepatitis B is not spread through sharing eating utensils, breastfeeding, hugging, kissing, holding hands, coughing or sneezing.
I am also concerned by the tendency of the general population to think hepatitis B is a benign condition. Some may be labelled as a “carrier” but are not concerned about this silent infection. In actual fact, 12% to 20% of hepatitis B carriers may progress to cirrhosis or irreversible liver damage. Once cirrhosis develops, 6% to 15% of patients may develop liver cancer and 20% to 23% may progress to liver failure.
In short, the hepatitis B virus is spread through infected blood or body fluid. If you or any of your family member is infected with hepatitis B, please seek proper medical advice and receive the care pertaining to your stages of infection.
ASSOCIATE PROFESSOR DR NGIU CHAI SOON
Consultant physician and gastroenterologist
UKM Medical Centre
Kuala Lumpur
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