Hepatitis A

Experts argue that Hepatitis A, now a leading cause of acute liver failure in India, deserves priority inclusion in the Universal Immunisation Programme (UIP).

What is Hepatitis?

• Hepatitis refers to inflammation of the liver, most commonly caused by viral infections.
• The major viral types are Hepatitis A, B, C, D, and E, each differing in mode of transmission, severity, prevention, and long-term complications.
• While Hepatitis B and C often lead to chronic liver disease, Hepatitis A and E generally cause acute, short-term infections, but can still lead to severe outcomes in vulnerable groups.

About Hepatitis A

• Hepatitis A is a viral liver infection caused by the Hepatitis A virus (HAV).
• Transmission: It is typically transmitted through the fecal-oral route, meaning that the virus spreads through contaminated food, water, or contact with an infected person’s stool.
• Symptoms: Patients commonly experience fever, fatigue, nausea, vomiting, abdominal pain, jaundice (yellowing of skin and eyes), pale stools, and dark urine.
• Prevention: Vaccination remains the most effective preventive tool. Improved sanitation, safe water supply, and strict food hygiene also significantly reduce transmission.
  • Types of Vaccines: Two vaccine types are available,  live attenuated and inactivated. Both provide 90–95% protection, and immunity lasts 15–20 years or even lifelong.
• Risk Factors: 
  • lack of access to safe water
  • Travel to regions with poor sanitation
  • Consumption of contaminated food or water
  • Close household or school contact with infected individuals
  • Children in overcrowded living conditions

Why Hepatitis A Needs Priority Attention

• Historically, Hepatitis A infected most Indians in early childhood, causing mild illness and conferring lifelong immunity.
• With improved sanitation, fewer children are exposed early, leaving adolescents and adults susceptible  groups in whom Hepatitis A causes severe disease.
• Recent outbreaks in Kerala, Maharashtra, Uttar Pradesh, and Delhi have seen clusters of Acute liver failure, Hospitalisation and even deaths

Government Initiatives to tackle Hepatitis

• National Viral Hepatitis Control Programme (NVHCP):
• • Launched to eliminate viral hepatitis as a public health threat by 2030.
  • Focuses on awareness, testing, vaccination, surveillance, and treatment for Hepatitis A, B, C, D, and E.
• India’s Universal Immunization Programme (UIP): Hepatitis B is included under India’s UIP which provides free of cost vaccination. 
  • Private vaccination for Hepatitis A exists but is not universally accessible due to cost barriers.
• Indigenous Vaccine Development: India has developed its own Hepatitis A vaccine (Biological E’s Biovac-A), a live-attenuated vaccine, improving affordability and availability.

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About Universal Immunisation Programme (UIP)

• Origin: 
• • Launched as the Expanded Programme on Immunization (EPI) in 1978.
  • Renamed as the Universal Immunization Programme (UIP) in 1985.
• Aim: To provide free vaccination against preventable diseases to all children and pregnant women.
• Implementation: Vaccines are administered through government health facilities, private hospitals, and fixed immunisation sessions at Anganwadi centres and outreach sites.
• Administered by: Ministry of Health & Family Welfare
• Coverage: 12 vaccines are currently covered (including Measles, Polio, Pentavalent, HPV in selected states).