Skip to main content

Hepatitis E

It amazing how a healthy body takes a lot of things for granted. The golgappas from the road side vendor, along with the mouth watering ‘pani’ is taken for granted that they are germs free. Unfortunately, the one that I had during the weekend prior to Diwali wasn’t. The virus took a week to announce it’s presence in my body.

Jayant and his wife Vandana had invited me for dinner on the occasion of Diwali. I was served mutton. To my surprise, I didn’t get excited at the salivating prospect of having a non-vegetarian meal. On the contrary I felt nauseated. My reaction should not reflect Vandana’s cooking abilities. In fact, after having lot of meals prepared by Vandana my verdict is that she a fantastic cook. That made me realize that there was nothing wrong with the meal itself but with me. I ate very little and preferred the vegetarian items on the menu. I got up the next day with constipation and fatigue. Alarmingly, my urine had a dark yellow color to it. I still wonder why I ignored these unusual happenings and carried on for a couple of days. Then, after staying constipated for close to seventy two hours, I vomited after a meal. I threw up periodically for close to two hours. The next day I visited the doctor. He made me go through the Liver Function Test (LFT) to ascertain if I was suffering from the condition-Hepatitis (commonly called jaundice). If the result was positive, according to the doctor, I was to undergo another series of tests to find out which type of hepatitis I had.


As I later found out, by definition, Hepatitis is inflammation of the lever and is caused by viruses, medications and toxic agents. My LFT test results turned out to be positive and was subsequently prescribed by doctor to go through the type test. Result of that showed that I had contacted the Hepatitis E virus. Hepatitis E virus (in short HEV) is one of the five viruses that cause the lever to enlarge. The others are Hepatitis A (in short HAV), B, C, and D viruses.



A magnified view of Hepatitis E virus.

It so happens that the HAV and HEV are present in the stool of an infected person. So any contact of sewage water with drinking water is likely a reason for an epidemic outbreak. Moreover, lack of personal hygiene of an infected person can put people living with him/her in danger. To be absolutely safe it is advised that an infected person does no cooking for others. Logically, in order to keep one self protected from these two viruses one is advised against using water of unknown purity, anywhere, at home or away. One common habit is that we wash fruits and vegetables with tap water, the purity of which is doubtful. It’s fine as long as the washed item is cooked before consuming, because these two viruses are killed at high temperatures. But, if one intends to have the items raw, for your own safety use water of known purity for washing. Precaution is better than cure after all. Isn’t it?

Nowadays doctors avoid discussing the problem with the patients in detail. The general style is: they listen to problems, take them down on a sheet and then prescribe a lot of costly medicines and tests and then politely show you the way out. In the whole process you hardly hear them speak. This style works very well for the doctors in a commercialized set up where time management is the key. My doctor was no different. Nevertheless, from my second visit I kept questioning him persistently. For most part he ignored the questions but eventually my stubbornness made him give in. He went on to lecture me on my condition for a good 10-15 minutes. What came out from him was priceless information. It would be difficult for me to reproduce that here but I will try my best to bring out the important points.

The bad news is that there is no drug that can alter the advent of the viral attack on the lever. The good news is that HEV infection (it’s true for HAV infection as well) is self limiting. The enlarged lever needs physical and ‘biological’ rest for quicker recovery. Patients are therefore advised to take maximum rest by doctors. This gives the lever much needed rest. According to the doctor it is also important for patients to be extra careful of what they eat. Its underlying theme is to have easily digestible food. That translates to reducing fats and proteins in your meal. Also an increase in carbohydrate intake is recommended by the doctor. Increasing the percentage of fiber intake keeps the bowel movements regular. Juice of sugarcane, carrot and orange is highly recommended. But one needs to be cautious here. The juice from the road side vendor is open to infection. Especially, the ‘thelas’ offering sugarcane juice. The last thing one wants is another lever infection. It so happens that HAV can attack along side HEV and such a condition is generally fatal with lever transplant the only hope. So, allow your loved ones to prepare the juices in the safety of your home. If you are left wondering as to how you can juice the sugarcane at home you would be not alone. I will share an ingenious solution. Just have them like a healthy body has it. Munching sugarcane in the morning winter sun is one of the few fond memories I have of those days with the virus.

If all this seems scary and you consider the precautions hard to follow then take the easy way out. And that is: get vaccinations of Hepatitis A, B, and C done immediately. It’s available at all health centers. Considering the cost of the treatment in terms of money and time, the vaccination option seems logical. Most people take the Hepatitis B vaccines, but I recommend that all should do the same for the other two viruses as well. If you are left wondering as to why I have not mentioned the D and E hepatitis as a vaccination option then you need to know that vaccination for HEV is not in the Indian market yet. And as for the D hepatitis: it attacks a human body only when the body is infected with Hepatitis B virus. So if you protect yourself from Hepatitis B you additionally protect your self from Hepatitis D as well.



P.S What I am sharing here is my experience and the knowledge I gathered on the internet and during conversations with my doctor. Understandably, my knowledge on the topic is not complete. For the ones who wish to validate and know more please check the links given in the post.

Comments

Vishwa Bandhu said…
good to see ur new blog..
good piece of information...
but i dont see the links at the end of the blog for more information abt Hep E.
eager to read more on ur blog...:-)
Utpal said…
[Vishwa] Clicking the bold words in the post will take you to the corresponding link.

As for the next post... lets see :-)

Popular posts from this blog

Indian Crab Syndrome by Shobha John

I remember watching the movie 'Ek Doctor Ki Maut' on DD many many years ago. Pankaj Kapoor plays a doctor whose seminal research is met with stiff peer opposition. The movie was inspired by the real-life story of Dr. Subhash Mukhopadhaya. Dr. Subhash's story is tragic and the movie brilliantly portrays his frustration and in effect portrays the story of all individual in India who dare to have a mind of their own, or is creative or has seminal ideas. Sadly, hierarchical structures in all aspect of human life is a truth in India and this fosters nepotism, false sense of entitlement and concentrates all power at the top. Energy is spent on fighting this structure instead of doing something constructive. A piece in the Times of India made me remember the movie and I felt like sharing that article on this blog. The article titled 'Indian Crab Syndrome' can be fond here . The article follows. Indian Crab Syndrome by Shobha John Anyone who challenges the prevailing

CWG 2010: India's Pride

"Indians defecate everywhere", commented Naipaul in his "Area of Darkness", the first book in the trilogy on India. As an outsider, this is how he viewed Indians on his first visit to India. Off course, many of us thought it to be a statement made due to ignorance of what Indianness is and we openly romanticize the idea of a 'maidan' visit early in the morning. Sanitation is a western concept and therefore we don't really think very highly of it. We do not want our feces to go to waste and would rather use it to fertilize our agricultural land. We take pride in such organic way of life. With the scarcity of space in urban environments we have been forced to defecate in our own homes. A revolting idea. We do that with a lot of shame but we do makeup by urinating in open public spaces. It satisfies our urge to be and behave Indian. The Indian government being Indian supports this idea of Indianness by not providing basic sanitary amenities and util

Mausam ki adla badli mein ...

I am not a big fan of the movie ' Black '. I think the true inspirational story of Anne Sullivan-Helen Keller was turned into a overtly dramatized average movie. I have never understood the mind of Sanjay Leela Bansali. A director of a movie is primarily a story-teller. I wonder if Bansali ever tries to tell a story. He directs his movies as if he is trying to paint a sequence of paintings. It's possible he uses the colors as metaphors. It's possible! Only I don't see it. And I wonder how many do if there are any.  Anyways, seems like, so distracted was I while viewing it that I missed one gem that was embedded in the movie. The song 'Mausam ki adla badli mein' sung by Gayatri Iyer , almost flawlessly. Now, I am not a music expert by any standard but as a listener I do consider this song as one of the best compositions of the last decade. It's crafted to near perfection, if not to perfection. The composition is haunting, the rendition mesmerizing a