CAIRO: In the late 1990s, Egypt became infamous in the world of public health as one of the most hepatitis C-infected countries in the world. This unhappy distinction was gained through a public health campaign gone awry. From the 1950s through the 1980s, the government led a massive effort to eradicate the gastrointestinal bacterial infection bilharzia. The program backfired badly. Doctors involved in the effort recycled the same needles through a large number of patients, rarely sterilizing them beforehand. If one patient was infected, the needle sharing virtually ensured that many in his village would soon be as well. The highly contagious hepatitis C virus spread rapidly throughout the rural population and, today, according to British medical journal The Lancet, between 15 and 20 percent of the population has been exposed to the potentially lethal disease. Public health in Egypt is also threatened by the less famous, but still very dangerous, hepatitis B virus (HBV), but it is a challenge that can be overcome. HBV can be treated and the spread of the disease can be stopped. That was the warning issued by physicians Dr. Ali Monis and Dr. Serag Zakaria at last week's meeting of the International Association for the Study of the Liver (IASL), held in Nasr City on Sept. 8. If Egyptians work together to put an emphasis on prevention and education, they say, Egypt can avoid further public health catastrophes like the hepatitis C problem. "We need to do more to make our citizens aware of this disease, says Monis, a professor of Gastroenterology and Hepatology at Ain Shams University. "The hepatitis B virus is 100 times more infectious than HIV, and it can easily be passed from pregnant mothers to their newborn children or from infected family members to the rest of the family. We owe it to the future of Egypt to help fight the spread of the virus in our country. The top ways to do this are awareness, vaccination, testing and treatment. Just one small step - such as ensuring that pregnant mothers are tested for hepatitis B - would make a big difference in curbing the rate of infection. Studies by the Egyptian Ministry of Health indicate that there are around 2.5 million Egyptians living with chronic HBV, a condition which is usually asymptomatic. Because of this, most infected people do not realize that they have the disease. Monis claims that there are an estimated 75 million people in the Middle East and Africa living with chronic HBV, although only four percent are expected to seek diagnosis or treatment. That figure is alarming because, when symptoms do arise, they can be serious. Symptoms can include muscle and joint pain as well as chronic fatigue. But left unchecked, the disease can also lead to life-threatening ailments like cirrhosis of the liver or liver cancer. Zakaria, chairman of Tropical Medicine and professor of Hepatogastroenterology at Cairo University, pointed out that Egypt has seen a sharp decline in the number of chronic HBV cases in young children, a highly vulnerable group. He attributed this to the Egyptian government's aggressive efforts to fight the disease in the young, in particular the decision to make vaccination of newborns mandatory in 1992. While this has been good news for Egypt's children, Zakaria warns that there is still much more that can be done. The key to further fighting the spread of the disease is education, especially among at-risk populations. "The medical community and everyday citizens need to be aware of simple steps that they can take to avoid or minimize the chances of infection, he explains. He emphasized the important role that doctors and nurses have in educating their communities. "That includes educating patients, as well as ensuring that all medical professionals are taught the proper safety and hygiene practices required to reduce infection, and keeping doctors aware of new methods for testing and treatment. Zakaria outlined some specific steps that can be taken to prevent the spread of the disease. The most important way to fight HBV, he said, was to raise awareness of the risk of HBV in Egypt. "We should raise the awareness of families of the importance of vaccinating newborns; and raise awareness among families and doctors of the importance of testing pregnant women to curb the spread to their children. We should launch an awareness campaign amongst Egyptian society and medical community on sound and hygienic habits to curb the spread of HBV, and also work on treating HBV patients to prevent the progression of the infection. Both Zakaria and Monis insist that with a strong effort, Egypt can accomplish these goals. More than that, the country must overcome the threat of hepatitis B to ensure a better future. Zakaria closed his talk by urging the audience, "Let's work together for a brighter future for our children.
