The less famous virus(es)

There is only one virus dominating the news this year, rightly so as it devastates the world.

However there are multiple other viruses that we do have the means to take control of. The group of viruses that cause liver inflammation (hepatitis) are particularly harmful.

Last week the World Health Organisation (WHO) marked World Hepatitis Day on the 28th July.

https://www.who.int/campaigns/world-hepatitis-day/2020

The WHO have less than ten days in the calendar they use for raising awareness so they consider Hepatitis an important global condition. This year’s theme is a “Hepatitis Free Future”. The WHO report that there are 290 million people living with viral hepatitis and don’t know it.

There is a dual approach to achieving the goal of elimination by 2030. Increasing immunisation rates will prevent people from ever getting infected and testing and treatment will reduce the number of infected individuals who can spread it to others.

There are five Hepatitis viruses named A, B, C, D and E. B and C are the most common and cause the most deaths. There are effective immunisations against Hepatitis B and in the last few years highly effective treatments for Hepatitis C have been developed. Both Hepatitis B and C can be transmitted via sexual partners and blood contaminated objects such as needles or razors. However Hepatitis B is more commonly transmitted from mother to baby which makes child immunisation an important method of prevention.

In Australia an immunisation for Hepatitis B is part of the childhood schedule and the first dose is given within 24 hours of birth (as recommended by WHO) to reduce the risk of mother to baby transmission. This is the case for many other countries as well but only 42% of children globally have access to a birth dose.

Putting into context how harmful Hepatitis B and C are they cause over a million deaths each year, while COVID-19 at the start of August 2020 was just under 700,000 deaths.

Next time you see your doctor ask whether you would benefit from Hepatitis tests and immunisations for yourself and your family.

Dr Amit Patel

Meningitis Immunisations

In this blog post I want to look at the meningitis B immunisation which is relatively new.

In the last month (Dec 2018) a few times I have had parents of young children asking me about whether they should pay for the Meningitis B immunisation for their children.

Just to recap, if you didn’t read my profile, I’m a full time family doctor/GP with experience working in Sydney and other locations along Australia’s East Coast.

Initially I stayed neutral and said I can prescribe it if they would like it and they have it in stock in the pharmacy next door but at A$125-A$150 dose it is their choice. There is coverage for four types of meningitis, ACWY but not B, in the Government funded National Immunisation Program (NIP).

I asked colleagues what they were doing when asked the same question. One took a proactive approach and said he recommended it on the basis that it’s extra protection and used the analogy of having insurance to describe having the extra immunisation to parents. The other colleague took the opposite approach and said the pharmaceutical company who manufactures the immunisation is just trying to scare parents into spending more money through it’s website and its TV ad campaign. The link to the official website for the recent campaign is: http://www.knowmeningococcal.com.au.

After hearing both these views I decided to adopt some of the first colleague’s approach and describe extra protection and recommend having the immunisation. To support this I have started showing them the Department of Health data on the number and types of meningitis cases if they want to see it from:

http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-meningococcal-W.htm

Like all statistics they can be viewed in different ways. One view is that the overall number of cases of Meningitis B per quarter is small and spread across the country but the consequences if affected by the disease can be severe and life threatening.

The Department of Health also have an information for the public page at:

http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-meningococcal-W-info-public.htm

Obviously it would be much easier if the various levels of Government involved in the NIP decided to fund it nationally, however the last official statement was that it was under consideration. South Australia Health have decided not to wait and their publicly funded Meningitis B initiative began in July 2018.

In conclusion I would agree with what the TV campaign says, speak to a doctor who knows your family best and have a discussion about how to proceed.

Declaration and disclaimer: I have no association with any pharmaceutical companies. This blog post is not a substitute for medical advice. See your own doctor to discuss your particular situation and needs.

Dr Amit Patel