左醫生討論乙型肝炎

感覺良好不能保證健康良好

美國有成千上萬的亞裔人士可能均患有一種能够致死的疾病。華人尤其可能在不知情的情况下，將這一疾病傳染給自己的子女，因爲他們幷未感覺不適。乙型肝炎對個人、家庭和社區都有可能造成嚴重的風險和後果。

如果我們不在消滅這一可能具有毀滅性的疾病方面成爲自身社區的表率， 乙型肝炎將繼續造成不必要的疾病和死亡。遺憾的是，許多人不瞭解乙型肝炎，幷將其與其它形式的肝炎如甲型或丙型肝炎混爲一談。

對不熟悉這一特定疾病的人士來說，乙型肝炎是由乙型肝炎病毒造成的一種肝病。如果不采取有效的措施，則這一危險的傳染病可能會導致肝硬化和肝癌。遺憾的是，乙型肝炎在華人和東南亞民衆中極爲常見。在全球的所有慢性乙型肝炎病例中，亞裔人士占75%。

隨著華人和其它亞裔人士移民到美國，乙型肝炎在以前的低發病區的發病率也在升高。在亞裔人士高度密集的大都會地區，如紐約市華埠、法拉盛和日落公園，高風險人口的增長速度最快。

在最近針對上述住區的100 名華人的一項問卷調查中，即使有74%的參加者聽說過乙型肝炎，其中只有不到一半認爲這是嚴重的致命疾病，而且他們不瞭解主要的傳染途徑。在以粵語和國語進行的同一項問卷調查中，只有16%即不到五分之一的參加者表示其認爲自己或其直系家屬有患上這一疾病的風險。

特別值得關注的是，大約有90%的幼兒和10%的成人被感染後無法清除病毒，幷成爲長期携帶者。

乙型肝炎病毒不可能通過吃壽司或貝類等生海鮮傳染。這一病毒通常是由已受到感染的母親在嬰兒出生過程中傳播的。乙型肝炎亦可通過下列途徑傳播﹕與被感染者從事無防護性行爲；針灸、穿耳洞或身體穿刺或刺青時使用未消毒器械；非法注射毒品；及與受感染者共享牙刷或剃刀等個人用品。

在全世界，亞裔人士患上乙型肝炎的途徑與西方人大不相同。西方人通常在青少年時期或成年後受到感染。此時，他們的身體將乙型肝炎病毒視爲异物，幷能够在其發展成爲慢性肝病之前將其清除。此類乙型肝炎屬于急性病，這意味著其高峰期和持續期均較短。

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.