Hepatitis B Foundation

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左医生讨论型肝炎

感觉良好不能保证健康良好

美国有成千上万的亚裔人士可能均患有一种能够致死的疾病。华人尤其可能在不知情的情况下,将这一疾病传染给自己的子女,因为他们并未感觉不适。乙型肝炎对个人、家庭和社区都有可能造成严重的风险和后果。

如果我们不在消灭这一可能具有毁灭性的疾病方面成为自身社区的表率, 乙型肝炎将继续造成不必要的疾病和死亡。遗憾的是,许多人不了解乙型肝炎,并将其与其它形式的肝炎如甲型或丙型肝炎混为一谈。

对不熟悉这一特定疾病的人士来说,乙型肝炎是由乙型肝炎病毒造成的一种肝病。如果不采取有效的措施,则这一危险的传染病可能会导致肝硬化和肝癌。遗憾的是,乙型肝炎在华人和东南亚民众中极为常见。在全球的所有慢性乙型肝炎病例中,亚裔人士占75%。

随着华人和其它亚裔人士移民到美国,乙型肝炎在以前的低发病区的发病率也在升高。在亚裔人士高度密集的大都会地区,如纽约市华埠、法拉盛和日落公园,高风险人口的增长速度最快。

在最近针对上述住区的100 名华人的一项问卷调查中,即使有74%的参加者听说过乙型肝炎,其中只有不到一半认为这是严重的致命疾病,而且他们不了解主要的传染途径。在以粤语和国语进行的同一项问卷调查中,只有16%即不到五分之一的参加者表示其认为自己或其直系家属有患上这一疾病的风险。

特别值得关注的是,大约有90%的幼儿和10%的成人被感染后无法清除病毒,并成为长期携带者。

乙型肝炎病毒不可能通过吃寿司或贝类等生海鲜传染。这一病毒通常是由已受到感染的母亲在婴儿出生过程中传播的。乙型肝炎亦可通过下列途径传播﹕与被感染者从事无防护性行为;针灸、穿耳洞或身体穿刺或刺青时使用未消毒器械;非法注射毒品;及与受感染者共享牙刷或剃刀等个人用品。

在全世界,亚裔人士患上乙型肝炎的途径与西方人大不相同。西方人通常在青少年时期或成年后受到感染。此时,他们的身体将乙型肝炎病毒视为异物,并能够在其发展成为慢性肝病之前将其清除。此类乙型肝炎属于急性病,这意味着其高峰期和持续期均较短。

另一方面,来自中国、东南亚和部分非洲地区的人士更有可能成为乙型肝炎病毒的长期携带者。在这些地区,儿童更多地在幼年即感染乙型肝炎病毒,该病毒来自其已受感染的母亲,或来自与受到感染的家人的密切接触。儿童的身体更容易将病毒作为其自然部分予以接受,因此不会清除这一病毒。此类早期病例经常发展成为慢性乙型肝炎,这意味着病毒停留在体内较长时间,因此传播给他人的机会也较多。

有些人认为,只要他们感觉良好,他们就健康。这不一定正确。

慢性乙型肝炎造成的问题是受到感染者不一定有任何症状。即使某些受到病毒感染者可能会有疲劳、恶心、食欲不振、体重下降或黄疸(眼睛或皮肤发黄)等现象,大多数人在疾病进入晚期之前,并没有典型的乙型肝炎症状。

即使在一些症状变得明显时,也并不总是被视为由乙型肝炎引起。由于血液筛检并不常见,很少有人知道自己可能是携带者。

有许多移民特别是我们华人社区的移民并不了解,如果不对这一疾病采取有效的措施,则其可能会造成毁灭性影响。 乙型肝炎病毒的许多携带者由于未认识到这一点,因而其疾病未受到合理治疗,从而可能在不知情的情况下,使他人暴露于病毒,或者自身的病情恶化。了解您是否受到乙型肝炎传染的最佳方式就是在医生诊所接受化验。接受化验者如未验出乙型肝炎,则可获得疫苗注射,从而获得对传染的防护。已被病毒感染者应当及时向医生咨询,请求对病情作评估并采取适当措施。他们可接受各种治疗。

我们必须在社区中同心协力,鼓励彼此特别是新移民接受化验,以阻止乙型肝炎的传播。未患乙型肝炎者应当接受疫苗注射。化验结果为阳性者应当接受适当的医疗护理。光有良好的感觉是不够的。无论年龄或背景,我们所有人都必须在有生之年保持健康。

 

Alan Tso医学博士是内科和儿科专科医生。Tso博士是华埠健康诊所副主任。本评论是乙型肝炎 教育宣传活动的一部分,该活动在纽约市由制药公司Glaxo Wellcome Inc.与华人社区组织共同赞助。承蒙左博士特许翻印。

 

 

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.