Our liver is a poor swallower. As a detoxification organ, it is the garbage dump par excellence in our body and takes care of many a sweep of fatty foods and alcohol. However, when so-called hepatitis viruses get in its way and start parasitizing on it, the liver falters.
Many liver diseases go undiagnosed
The World Health Organization estimates that there are 3.5 million liver patients in Germany. However, it says the number of unreported cases is significantly higher. Estimates assume 7.5 million. Alarmingly, only a fraction of those affected have been diagnosed. The main reasons are that it is often rather unspecific symptoms that can indicate liver disease.
Symptoms of hepatitis nonspecific
Neither affected persons nor many general practitioners think of the possibility of liver disease when they experience fatigue, lack of concentration, nausea or a feeling of pressure in the upper abdomen. If the above symptoms persist and are accompanied by frequent muscle and joint pain, clay-colored stools and beer-brown urine, loss of appetite, flatulence, yellow skin or eyes, a doctor (if possible a hepatologist) should be consulted. He or she should perform a thorough examination of the liver. If the liver values are elevated, the liver should be closely examined. Hepatitis viruses love variety. They come in different shapes, which is why physicians distinguish them by the letters A to E. All hepatitis viruses have the same shape. All hepatitis viruses have the sinister property of using the liver metabolism of humans to reproduce themselves. This does not leave the liver unscathed. The severity of the disease depends on which family of viruses has spread in the organ. Viruses A, B, C and D are of particular importance.
Hepatitis A
The travel-related disease that is most frequently imported into Germany is hepatitis A. The Robert Koch Institute registers around 4,000 cases every year. Therefore, the simple rule: Anyone traveling toward the sun needs hepatitis A vaccination protection. This applies not only to tropical and subtropical countries, but also to Eastern Europe and the Mediterranean countries. And the vaccination should also be independent of whether you are planning a backpacking vacation or pampering yourself in an expensive hotel with high hygienic standards.
Common sources of infection for hepatitis A
The fact that infections can occur even in supposedly good hotels is due to the fact that mostly locals are part of the staff. A so-called fecal-oral infection due to poor hygiene is there quickly. In addition, contaminated food or virus-contaminated drinking water can be found in the best hotels. Especially milk, water, salads or fruit are frequent sources of infection. Caviar or shellfish should also be avoided on vacation. Caviar concentrates viruses by a factor of 1000 compared to the environment, and shellfish form veritable hepatitis A cocktails. They grow particularly well in fecalized waters.
Hepatitis A: signs and consequences
Hepatitis A does put the affected person out of action for three to four weeks – fatigue, nausea, diarrhea and gastrointestinal grimness sometimes force bed rest – but in the vast majority of cases the course is benign, and the liver emerges unscathed. In a few cases, however, especially among travelers over 60, hepatitis A can be fatal. This can be avoided by getting vaccinated against the A virus about two weeks before the vacation. As a travel vaccination, it must be paid for out of pocket.
Hepatitis B
Often the usually harmless hepatitis A is lumped with the dangerous hepatitis B. However: hepatitis B viruses are many times more dangerous. They leave behind permanent liver damage in up to 10 percent of infected adults and in up to 90 percent of children. The liver is overloaded by permanent inflammation, and massive cell death occurs. The diseased liver scars and shrinks. The final stage is called cirrhosis of the liver. In the worst case, the viruses attack the liver to such an extent that liver cancer develops. Because treatment with drugs is not even effective in every second person, about 2,000 people die every year in Germany from the consequences of hepatitis B – twice as many as from AIDS.
Transmission of hepatitis B
The fact that hepatitis B viruses are transmitted to partners during sexual intercourse through seminal fluid or vaginal secretions is known to many.However, few people know that other body fluids such as blood, wound secretions, saliva and tears also pave the way for the hepatitis B virus to reach its new victim. There are many opportunities to do so, whether on a camping trip, during sports or at a barbecue in the garden. It doesn’t take long to get a graze or cut your finger, and the virus can be transmitted in the blood while you’re tending to the mishap. Even a harmless injury is enough, because a millionth of a milliliter of blood is enough to become infected. This makes hepatitis B 100 times more contagious than AIDS.
Symptoms of hepatitis B often ambiguous
In Germany, 50,000 mostly young people become infected with the hepatitis B virus every year. Only every third person notices symptoms of the disease. Thus, the virus initially makes itself felt with a whole series of non-specific symptoms such as loss of appetite, malaise, fatigue, joint complaints, and even liver inflammation with jaundice. Even though two thirds of those infected do not experience any symptoms, the disease progresses inexorably. The virus continues to multiply unnoticed, and many contacts can become infected.
Prevention through hygiene and vaccination
If you want to avoid this, you rely on prevention: And that consists of disposable gloves during first aid and vaccination against hepatitis B. Vaccination offers the best protection against the disease. The Standing Commission on Vaccination at the Robert Koch Institute in Berlin recommends that all children and adolescents up to the age of 18 receive a general hepatitis B vaccination. The costs are covered by the health insurance companies. Adults must pay for hepatitis vaccination out of their own pockets. “Actually, you could call the hepatitis B vaccination the first vaccination against cancer,” said Dr. Karl Alfred Nassauer, of the Robert Koch Institute. Those who like can also get a combined vaccination against the virus siblings A and B. Good to know: The hepatitis D virus cannot reproduce on its own; it always needs the help of the B virus. Therefore, if you are vaccinated against hepatitis B, you are also protected against hepatitis D. There is no solo vaccination only against the D variant among the liver viruses.
Hepatitis C
Despite all the therapeutic advances, the hepatitis C virus keeps physicians on their toes. Experts estimate that there are around 600,000 hepatitis C carriers in Germany. The number of unreported cases is probably much higher. The virus, which is transmitted by blood, is the main reason for liver transplants. This makes the aggressiveness of the C virus clear: it affects the liver for life in 80 percent of cases. The fatal consequences here are also liver cirrhosis and, in the final stage, cancer. These facts are all the more frightening because there is no vaccination against the C virus. There is virtually no prevention possible. As far as therapy is concerned, physicians have a better chance of getting the C virus under control than the B virus. “Today, 98 percent of an acute C infection can be eradicated with the drugs interferon-alfa and ribavirin,” Professor Dr. Claus Niederau, Chairman of the Board of Deutsche Leberhilfe, made clear. If the liver inflammation has already been present for a longer period of time, the same drugs are used for treatment, but the success rate is only around 50 percent. Problematic: “Of those diagnosed, only about 5 to 10 percent receive adequate therapy according to current knowledge.” In untreated patients, liver damage progresses unceasingly and ends with cirrhosis and/or cancer of the liver.
