Alan Tso醫學博士是內科和兒科專科醫生。Tso博士是華埠健康診所副主任。本評論是B型肝炎 教育宣傳活動的一部分，該活動在紐約市由製藥公司Glaxo Wellcome Inc.與華人社區組織共同贊助。承蒙左博士特許翻印。
Dr. Tso Talks About Hepatitis B
Feeling Good is No Guarantee of Good Health
Thousands of Asians in America of all ages may be victims of a potentially deadly disease. Chinese, in particular, may be passing this disease on to their children and not even realize it simply because they don’t feel ill. There may be serious risks and consequences to hepatitis B for individuals, families and communities.
If we do not shine a light within our own community on this potentially devastating disease, hepatitis B will continue to cause unnecessary illness and death. Unfortunately, many people do not understand hepatitis B and confuse it for other forms of hepatitis, like A and C.
For those unfamiliar with this particular disease, hepatitis B is a disease of the liver caused by the hepatitis B virus. If not successfully managed, this dangerous infection may lead to cirrhosis (scarring of the liver) and liver cancer. Unfortunately, hepatitis B is very common among Chinese and Southeast Asian populations. Worldwide, 75 percent of all chronic hepatitis B cases are persons of Asian origin.
As Chinese and other Asians immigrate to the United States, the incidence of hepatitis B is increasing where it was previously less common. And in metropolitan areas where large concentrations of Asians tend to live, like Chinatown, Flushing, and Sunset Park here in New York City, the high-risk population is growing the fastest.
In a recent survey among 100 Chinese living in these neighborhoods, although 74 percent of participants were aware of hepatitis B, less than half viewed it as the serious, life-threatening disease that it is nor were they aware of the major modes of transmission. In the same survey that was conducted in Cantonese and Mandarin, fewer than one out of five, only 16 percent, of participants stated that they believed themselves or their immediate family members to be at risk for contracting the disease.
What is a special cause for concern is that approximately 90 percent of young children and 10 percent of adults who contract hepatitis B remain infected for life and become long-term carriers of the virus.
The hepatitis B virus cannot be caught by eating raw seafood like sashimi or shell fish. It is spread by infected mother to child usually during a baby’s birth. Hepatitis B can also be spread by unprotected sexual contact with an infected person; unsterile instruments that may be used in acupuncture, ear and body piercing, or tattooing; illicit injection drug use; and by sharing personal items like toothbrushes or shaving razors with an infected person.
Around the world, hepatitis B is contracted very differently by Asians than by Westerners. Westerners more typically contract the disease during adolescence or as adults. At that stage, their bodies recognize the hepatitis B virus as something foreign and they are able to eliminate it before it develops into a long-lasting infection. This type of hepatitis B is acute, meaning that it peaks and lasts a short amount of time.
On the other hand, people from such areas of the world as China, Southeast Asia and parts of Africa are more likely to become long-term carriers of hepatitis B. In these regions, children more typically acquire the hepatitis B virus very early in life either from their infected mothers at birth or in early childhood from close contact with infected family members. Children’s bodies accept the virus more readily as a natural part of their system and therefore will not fight the virus. These early cases often develop into chronic hepatitis B, which means the virus remains present in the body for a longer time and therefore, there is a longer opportunity for it to be spread to others.
Some people believe that if they feel good they are in good health. This is not necessarily true.
The problem with chronic hepatitis B is that a person who is infected may not have any symptoms. And although some people infected with the virus may experience fatigue, nausea, poor appetite, weight loss or jaundice (yellowing of the eyes or skin), most people do not have symptoms clearly recognizable as signs of hepatitis B until the disease becomes advanced.
Even when typical symptoms do become apparent, they are not always recognized as being caused by the hepatitis B virus. Few people know that they may be carriers since being tested for the disease through a blood screening is not common.
Many immigrants, particularly in our Chinese community, do not fully understand the devastating effects this disease may have if it is not successfully managed. Therefore, many persons who are carriers of the hepatitis B virus do not realize it and do not receive medical attention for their disease. Accordingly, they may unknowingly expose others to the virus or experience a worsening of their condition.The best way to know whether or not you are infected with the hepatitis B virus is to get tested at a physician’s office. Persons who are tested and are found not to have hepatitis B can get a vaccination and become protected against infection. Persons who are infected with the virus should promptly consult a physician for evaluation and proper management of their condition. Treatments are available.
We must stop the spread of hepatitis B by working together in our community to help encourage one another, and particularly newer immigrants, to get tested. People who do not have hepatitis B should get vaccinated. People who do test positive should receive proper medical care. It is not enough to feel good. We must all, regardless of our age or background, be in good health for as long as we live.
Alan Tso, M.D., is an Internal Medicine and Pediatrics Specialist. Dr. Tso is associate medical director of the Chinatown Health Clinic. This commentary is part of the hepatitis B education and outreach campaign sponsored in New York City by pharmaceutical company, Glaxo Wellcome Inc., in association with Chinese community-based organizations. Reprinted with permission by Dr. Tso.