Over the years, we all have seen lots of people especially newborn babies diagnosed with jaundice, which turn out to be of great a concern for most of us. First thing that comes to mind (esp. of grandparents) that in old days jaundice was not so high among newborns, but why is it now? Are doctors over diagnosing it? Is our baby kept unnecessarily in nursery? Dr. Varghese Cherian, Head of Department of Pediatrics & Neonatology at Lourdes Hospital, Ernakulam writes about Jaundice with particular focus on Infant jaundice.
Jaundice is not actually a disease by itself; rather it is a manifestation of an underlying problem. The term jaundice is from the French word jaune, meaning yellow, which is described as yellow discolouration of the eyes, which may be accompanied by deep yellow coloured urine. Usually patients have decreased appetite.
This is due to the accumulation of a yellow pigment called bilirubin which is a by-product formed during the break down of the red blood cells. Normally, the liver processes this pigment and excretes it into the bowel through the bile duct.
Any disease affecting the liver, the bile ducts or the breakdown of red blood cells can cause an accumulation of bilirubin and can lead to jaundice. The causes for Jaundice are many and range from the serious to the not-so-serious, and from the common to the rare.
Causes of Jaundice
Hepatitis refers to an inflammatory condition of the liver and can be caused by viruses as well other causes. The most common viruses causing hepatitis are Hepatitis A, B and C. The others are Hepatitis D and E.
Although hepatitis A and hepatitis E both are highly endemic, Hepatitis E Virus infection is responsible for 30-70% of the jaundice outbreaks in India. This is usually due to sewage contamination of drinking water and happens in monsoon when rain water floods drain pipes and seeps into broken water supply lines. Hepatitis A and E are contracted from eating contaminated food or drinking contaminated water and is mainly found in areas with poor sanitation.
- The Hepatitis A virus is excreted in the faeces of an infected person and can survive for 3-4 hours outside of the body. Transmission of the virus is thus enhanced in conditions of poor hygiene and overcrowding. Generally hepatitis A is a self-limiting illness and does not persist in the bloodstream nor in the stools after the illness has resolved. Hepatitis A infection usually resolves without any drugs. Bed rest may be recommended if symptoms cause a great deal of discomfort. A vaccine against hepatitis A is available and is recommended for children between ages 12 and 18 months. Vaccination is also available for adults.
- Hepatitis B infection is transmitted through puncture wounds or contact with infectious body fluids, such as blood, saliva, or semen. Risk increases with Injection drugs, sex with multiple partners, sharing razors. It usually becomes chronic and it’s estimated that 350 million people worldwide live with this chronic disease.
- Acute hepatitis B requires only symptomatic treatment. Chronic hepatitis B needs antiviral medications and is costly because it must be followed for several months or years. The Universal immunization programme of the Government of India recommends hepatitis B vaccinations to all newborns are given free in all Public health centres. The vaccine is also recommended for all healthcare and medical personnel.
- Hepatitis C and D are also transmitted through contaminated blood and infected body fluids, typically through injection drug use and sexual contact. Hepatitis C is among the most common blood-borne viral infections in the United States. These forms of hepatitis can also be either acute or chronic. Hepatitis C infection needs antiviral drugs.
(Read the full article in the April issue of Safety Messenger Magazine 2016)