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What Is Hepatitis?
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Hepatitis is the name for several different illnesses which all cause an inflamed (swollen or painful) liver. Because the liver is a vital part of the body, if it does not function properly, it can cause serious illness, on going health problems and sometimes death.
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Causes Of Hepitis
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Drinking alcohol in large quantities or taking drugs or medication can cause hepatitis. It can also be caused by certain viruses and different hepatitis viruses are known by different letters – A, B, C, D and E . This is why the different strains of hepatitis infections are called ‘hepatitis A’, ‘hepatitis B’ and so on. Very often the name is shortened to ‘hep A’, ‘hep B’ and so on.
These viruses are spread in different ways, so the ways to prevent people catching the disease are different and there will be more information on hepatitis prevention later in the article.
Symptoms of hepatitis B
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Some people who are infected with hepatitis B do not become very ill and some do not become sick at all. Children are less likely to show symptoms than adults.
In more severe cases, hepatitis B can cause:
- Loss of appetite
- Nausea and vomiting
- Pain in the liver (under the right rib cage)
- Fever
- Pain in the joints
- Jaundice (when the eyes and skin become yellow).
Normally these symptoms disappear after a few weeks but even when the person is symptom free they may still be infected with the hepatitis B virus and remain infectious. Care is needed so that the infected, but symptomless hepatitis B patient does not unwittingly spread the disease.
The Good and Bad News About Hepatitis B
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Most adults who catch hepatitis B recover completely and do not get the disease again.
The Good News Bit
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About 95 per cent of adults who become infected with hepatitis B will clear the infection by themselves and require no ongoing treatment.
The Bad News Bit
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Unfortunately a few people become very ill and some people do die from this infection. Babies and children who are infected with hepatitis B are more likely than adults to develop chronic hepatitis B.
Sadly childhood infection with hepatitis B occurs more commonly in some population groups because they have higher rates of chronic hepatitis B carriers. These population groups include people from Asia including but not only China, South East Asia, the Pacific Islands, sub-Saharan Africa and Aboriginal and Torres Strait Islanders.
Chronic Hepatitis B
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People who become infected with the hepatitis B virus may develop a long-term hepatitis B infection where the virus stays in their body for their entire life. To have chronic infection means a long term, often low level infection and of course hepatitis B is not the only illness that may develop into a chronic state.
People with chronic hepatitis B often have no symptoms but may eventually develop chronic liver disease or even liver cancer. Of course while they may seem at first to be in good health they can still infect other people.
How is hepatitis B spread?
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Hepatitis B is a blood-borne virus, which can be sexually transmitted.
In people with hepatitis B, the virus can be found in the blood (or serum) and to a lesser degree in their body fluids such as semen or vaginal secretions.
Hepatitis B can be spread following exposure of non-intact skin (open cuts) or mucous membranes (such as the genital tract) to infected blood or, less efficiently, after exposure to infected body fluids.
Blood
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The hepatitis B virus is present in the blood of an infected person. If infected blood enters another person’s blood stream, that person may become infected.
The disease can be spread by:
- Sharing equipment used for injecting drugs.
- Piercing the skin with equipment which is not properly cleaned and sterilised.
- Sharing razor blades or toothbrushes.
- One person’s blood coming into contact with open cuts on another person.
People who receive blood transfusions in Australia have a very low risk of getting hepatitis B. The Australian Red Cross Blood Service currently estimates this risk as approximately 1 in 739,000 (see transfusion.com.au for further information). This is also the situation in most western countries. If you have to get a blood transfusion overseas check the blood has been screened and if you are doubtful but desperately need the blood I suggest you have a test when you get home.
Sex
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The hepatitis B virus can be spread if people have unprotected sexual intercourse, especially if there is blood present.
Mother to Baby
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Mothers who have chronic hepatitis B sometimes pass the virus to their children. Some babies are infected during birth or shortly after birth. In Australia and some other countries newborn babies are quickly immunised to protect them from infection.
Is there a test for hepatitis B?
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Yes, there are different blood tests that can be performed to determine if you are or have been infected with hepatitis B.
It is important to remember that there is a period of time when a person may be infected with hepatitis B but the usual testing does not detect it. It can take up to six months for the blood tests to confirm infection and follow-up testing may be required.
There are also other tests that can assess liver damage or the likelihood of future liver damage from hepatitis B. The interpretation of these tests can be complicated and specialist advice is needed so consult your doctor.
What should I do if I already have hepatitis B?
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About 95 per cent of adults who become infected with hepatitis B will clear the infection by themselves and require no ongoing treatment.
If you have long-term hepatitis B you should:
- Consult your doctor who will monitor your condition and, if necessary, refer you to a specialist.
- Ensure your partner and close contacts are immunised against hepatitis B.
- Completely cover any cut or wound with a waterproof dressing.
- Practice safe sex.
- Only drink in alcohol in moderation and eat a well-balanced, low fat diet.
If you have hepatitis B you should not:
- Share injecting equipment.
- Donate blood or body organs.
- Share personal items such as toothbrushes or razors.
Although there is no legal obligation to do so, you may wish to discuss your condition with your health care provider, for example, doctor, dentist, allied health or complementary health providers.
How can I avoid becoming infected with hepatitis B?
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Everyone can take simple steps to protect themselves.
- Get vaccinated against hepatitis B.
- Use condoms every time you have casual vaginal or anal sex.
- Oral sex is normally unlikely to spread hepatitis B, but it is best to avoid oral sex if you or your partner have herpes, ulcers or bleeding gums.
If you inject drugs, never share needles and syringes or other equipment such as spoons, swabs and water. Always use sterile needles and syringes. These are available from needle and syringe programs and some chemists. To find out where you can obtain needles and syringes or, if necessary, how to clean them, contact the local or Government run needle swap service. Always wash your hands before and after injecting.
Wear single-use gloves if you give someone first aid or clean up blood or body fluids.
Can I be immunised against hepatitis B?
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Yes. There is a good vaccine available, and immunisation is the most effective way to protect against hepatitis B infection.
For adults to obtain maximum protection you must receive three doses of the vaccine. The second dose is given one month after the first dose, and the third dose is given five months after that.
Remember the hepatitis B vaccine only protects against hepatitis B – it does not protect people from other hepatitis viruses.
Who should be immunised?
- Immunisation recommended for everyone and especially if you:
- Inject drugs.
- Have a sexual partner who has hepatitis B
- Are a man who has sex with men.
- Have many sexual partners.
- Live in a house where someone has hepatitis B.
- Are a health care or emergency worker, or if you come into contact with blood during your work.
- Are a prisoner.
- Are a kidney dialysis patient.
- Have a blood clotting disorder and are treated with blood products.
- Already have a liver disease such as hepatitis C.
- Are a resident or staff member at a facility for people with intellectual disabilities.
- Intend staying for a long time in high risk areas overseas.
- Adopt children from overseas. These children should be tested for hepatitis B and if they have the virus, members of the adoptive family should be vaccinated.
Immunisation is also recommended and is often free for:
- Many students
- Babies and children up to ten years old who live in a household with someone who has hepatitis B.
- All babies
To be immunised, contact your doctor, or local council, any appropriate public health organisation or if in doubt where to go phone a helpline.
Does the vaccine have side effects?
Reactions to the vaccine are uncommon, but some people do suffer side effects soon after immunisation. These include fever, soreness where the injection was given, nausea, and joint pain.
How effective is the vaccine?
The adult course of three doses gives protection to about 95 per cent of adults.
Being immunised against hepatitis B does not protect you against HIV, hepatitis C or other diseases spread through blood or body fluids. It is important that you take precautions to ensure that you are not exposed to these.
Is there a treatment for hepatitis B?
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Treatment is available and some treatments are covered by public health schemes.
People with long-term hepatitis B may require treatment. The aim of the treatment is to suppress replication of the virus and reduce liver damage.
The current treatments available include pegylated interferon and antiviral medications. Treatment can be accessed through a hospital liver clinic. For more information on treatment, consult your doctor.
What should I do if I think I have just been exposed to hepatitis B?
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See a doctor immediately. Your doctor can give you treatment, in some instances, which will reduce the risk of you becoming infected with hepatitis B.
It is really important for your own health and that of family, friends and the community that you seek medical advice if you think you might have been infected. Even if no symptoms show it would be worth while to explain you fears to a health professional.
Ian Miller - Health Writer
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(These are not complete lists– please feel free to suggest any I’ve missed.)
Vaccine Preventable Diseases
This is a list of diseases that can be prevented by vaccines.
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List of Infectious Diseases
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The Best Way To Exercise
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This exercise gadet amuses some passers by in Sydney, Australia. Image by Catherine from Australia
Life fitness means being fit enough to enjoy life to the max. Look around, it’s surprising how many people are not fit enough to do more than easy sedentary activity. Getting to that stage is easy and many folk just slip into being overweight and inactive gradually over a number of years.
When you find walking up a small hill or a short flight of stairs hard work, when moving about outside the house with any sort of slightly vigorous activity leaves you breathless: it is time to have a rethink of your lifestyle.
Get Fit For Life
Exercise combined with a change to your eating habits is the best way for you to loose weight, improve your health and start along the road to getting fit. Anyone of any age can start right now to improve their fitness. Finding the best way for you to exercise is not difficult. Just make sure you enjoy what you are doing.
If you want to improve your health with the aim of being fitter and healthier right into old age you need to follow some pretty simple fitness routines and a keep a variety of workouts in mind that you can do regularly without getting bored with them. The key to maintaining fitness and long term positive health benefits is to keep your activity levels up as you age – just modify them to suit as the years roll by.
You may want to start with a gym membership or a personal trainer while you find the best exercise that suits your age, ability and lifestyle or you might simply go walking. You may also want to try weights or other equipment such as a treadmill, an elliptical trainer or other exercise equipment ranging from bicycles to dumbbells to increase your calorie burn and strength.
How Not To Exercise.
The best way to exercise is to work yourself as hard as you can for as long as you can until you pretty much collapse with complete exhaustion. Don’t waste time, pick yourself up and do it all again. No gain without pain. Just harden up. Right? Wrong!
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Excessive uninformed and unplanned exercise is almost totally counter productive for the following reasons:
- You won’t carry on doing it for long
- You will learn to hate exercise
- Your recovery time will be measured in days
- You will probably do yourself an injury
- Short bursts of vigorous exercise followed by rest periods achieve more
Enjoy It Or Lose Interest
Find an exercise that you will enjoy because you want to keep it going for the long term. Real health benefits will result from regular exercise and these health benefits
will last for years making it important that you get into some form of exercise that your enjoy.
To be successful exercise needs to be maintained and to be kept up over the long term, exercise needs to be enjoyable. Your exercise activity needs to have some interest factor to keep you going. If you enjoy it you’ll keep doing it.
What Sort Of Exercise Do I Recommend?
- Walking
If you are new to exercise or don’t fancy anything quite so strenuous as half an hour of exhausting burpee’s and the thought of doing a repetitive series of squats doesn’t float your boat (Read on – these are not some sort of embarrassing medical conditions.) then walking might be your thing. Walking is of great benefit to everybody,
The scenery on Cayucos Beach, Estero Bay on the Central California Coast. Brisk beach walking is one of the western worlds favorite pastimes.
particularly older people. It is an activity easily done with friends but it needs to be done as vigorously as possible with spells of brisk walking interspersed with slower walks in the manner I suggest for jogging.
A study of middle aged woman walkers found that the walkers maintained their weight while non walkers increased their weight. Walking also strengthens leg muscles, maintains balance, improves aerobic fitness and can show quite dramatic improvements in some peoples health.
Interestingly there has also been research findings that show that regular walking can increase the size of the hippocampus, an area of the brain linked to memory. This suggests to me the regular exercise is beneficial on several layers; aerobic fitness, cardiovascular fitness, muscle building and maintenance, psychologically and as a way of keeping the grey matter tuned up.
Walking is easy and cheap to do and can be done almost anywhere without equipment.
Cons: Too easy to walk slowly and not achieve a great deal but other wise hard to beat.
- Jogging
Two English joggers tolerating traffic. Image: Kenneth Allen U.K.
I have tried jogging but I found that hard to keep interested in doing more. However as many people are very keen on jogging I suggest that if you are a jogger you keep doing it, at least for the time being. If you start have problems with hip joints try cycling instead. Joggers (and cyclists) often run in groups so it can be a very social activity.
Jogging at a steady pace will not do you the most good thou. To get the best out of it try this. Once you are warmed up sprint for a distance enough to get you puffing. This works: Try going hard out between one or two power poles then jog slowly or walk between the next two. Repeat this a few times and then revert to your normal jog.
This little modification to your routine will increase your aerobic fitness to a new level with reduced chance of heart and vascular disease, lower blood pressure, help you reduce weight and maintain it to healthy levels, increase the strength of your leg muscles (mainly thighs), reduce blood sugar levels and make depression unlikely.
Cons: Jogging can be stressful on feet and joints.
- Cycling
I prefer cycling, particularly in groups as I enjoy the company of friends. I enjoy riding country roads, the scenery and physicality of riding.
Cycling certainly improves ones aerobic health and is easy on my knees and hips and is impact free.
I like to power up hills in the tallest gear possible and then coast down the other side while I recover. This is not unlike sprinting between power poles and has similar benefits.
Cons: You need a bicycle and somewhere to ride it. Weather dependent.
- Swimming
Swimmingis great exercise and easy on the body but for me I tend to sink and don’t have easy access to a pool so don’t usually do any swimming. Once again cruising
Working out while staying in a hotel - a guest enjoys the onsite exercise. Image: Adrian Pingstone
down the lanes won’t do you the most good unless you intersperse periods of speed with rest periods. I suggest swimming in a style that suits you so that you keep doing it regularly – more than once a week if you’ve time.
Cons: Can be expensive and inconvenient to access a heated year round pool.
- Burpees
Professor Martin Gibala, of the Department of Kinesiology at McMaster University in Hamilton, Ontario suggested that ‘burpees’ were an all round exercise but were not that enjoyable so unlikely to be kept up regularly.
Burpees are an exercise movement where one stands then drops to a squat taking your weight on your hands. Then kick your legs straight out behind hind you bringing them back up to under your torso in a fast action. Then quickly leap as high as you can extending your arms straight up above your head. Repeat.
This exercise will quickly build muscle and endurance – if you can do it regularly.
Cons: Exhausting and difficult to maintain. Not very enjoyable.
Listen To This:
An interview with Dr Martine Gibala, Professor and Chair of the Department of Kinesiology at McMaster University in Hamilton, Ontario, Canada
Audio – plug in your head set or speakers to listen then click on the link below.
- Squats
Professor StuartPhillips, Ph.D., also working in the Department of Kinesiology at McMaster University, recommends squatsas a very effective exercise and it is simple to do without equipment. “Just fold your arms across your chest,”
Doing squats can become something of an obsession but for most people they are a great way to build strength - as long as you approach the exercise with a degree of realistic common sense. For a start I suggest you join a gym and get some good instruction before you start any weight training regime. Failure and injury can result from over enthuisiastic and uninformed weight training practises. Image by: Artur Andrzej
he said, “bend your knees and lower your trunk until your thighs are about parallel with the floor. Do that 25 times. It’s a very potent exercise.” Use a barbell once the body-weight squats grow easy he says.
The squat is very good at beating muscle loss, a natural phenomena of aging. Excellent for building and maintaining leg strength and balance into old age but older people may need to hold onto something to help with balance. Squats can be done at home without any equipment.
Cons: Not much fun for most people and not that great at increasing aerobic fitness.
- Exercise Machines
I am not familiar with many exercise machines but I see that most are purchased with enthusiasm but languish unused after a short while.
A Korean woman does the twist on this exercise gadget. Image: Clementina
Rowing machines seem to be a good way to obtain a good all over workout and I use one – but not often enough.
Cons: Expensive and too many to choose from; some are probably not worth buying. Essentially working out at home with a machine can be boring and lonely. Consider joining a gym or getting friends together for twice weekly workouts so you have some company.
Remember, if you want to improve your health it is the first 30 minutes of exercise that has the most benefits. Once you have warmed up, exercise as vigorously as you can with short rest periods. From then on proceed for as long as you are comfortable.
Make your exercise as interesting and as varied as you can so you enjoy doing it and keep it up.
Ian Miller - Health Writer
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Get Fit And Enhance Your Life
Exercise can keep you fit and supple right into old age. It will improve your aerobic fitness, overall health and help you with balance and bending as you age. Image by Diana of Tampa, Florida
Age brings some problems as it creeps up on us. Unfortunately many people have physical capabilities considerably less than they should; they have the body and the health of someone much older.
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This can apply to some young people as well as older people and while we cannot stop ourselves aging we can, to a very large extent, ameliorate the most troublesome effects of encroaching age.
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We All Hope To Live Long Enough To Grow Old
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Of all the health issues that dog us as we age there are many we can usually beat very simply and thus ensure we have the best possible chance of a healthier old age. Exercise and diet play major roles in preserving our health right into old age. This not an ‘old wives tale’ or the alarmist bleatings of some health guru, it is a fact. Isn’t it better to have a healthy old age than become decrepit by the time you’re 60?
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One Very Good reason To Keep Fit
One thing that happens to us as we age is that our arteries become less pliable; the walls of the tubes that are our arteries become less able to stretch and allow an increase in blood flow at times when we need extra blood to carry more oxygen and remove more waste products from our muscles.
This demand for an increased blood flow usually occurs when we are exercising. However, as we age and especially if have been eating too much animal fat, are smokers or have simply just been leading a sedentary lifestyle, even normal blood flow can become restricted while we are at rest.
A build up of fatty plaque in arteries caused by bad diet also exacerbates this problem by reducing the internal diameter of arteries thus reducing blood flow even further.
Exercise Your Arteries
The stiffening of the artery walls alone can cause increased blood pressure and make the problems associated with plaque narrowed arteries a major contributing factor of cardiovascular disease.
Exercise will stimulate the whole cardiovascular system and in particular will keep the heart fit making it more able to pump efficiently. At the same time exercise will keep the arteries supple by keeping them alternately stretching and relaxing as exercise and rest periods increase and then reduce blood pressure.
Walking is one of the most effective ways to keep fit and active - it is also one of the most socially enjoyable pastimes many people do together. Image by Henri Bergius, Finland
It makes very good sense to eat well and exercise enough to reduce your risk of cardiovascular problems limiting your your enjoyment of life as you age. It is very possible to improve your cardiovascular health by exercise alone. Better still, improve your diet as well as get fit.
Any physical exercise is better than no exercise. Anaerobic exercise will keep the blood pressure of older people down; it’s good for diabetics, it’s good for heart health, in fact it’s good for your whole cardiovascular health and that makes it good for your overall health and well being, physical as well as mental. Staying fit most often means staying healthy.
Start now; it is never too late to improve you health.
Ian Miller - Health Writer
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