The rodent problem in Hong Kong is becoming more and more serious. In addition to bringing troubles and hygiene problems to the public, it will also infect the public with deadly diseases. Since the first rat hepatitis E case was discovered in Hong Kong in 2018, the Center for Health Protection has recorded the 12th human-infected rat hepatitis E case in 2020. According to the information released by the government, the patient is a 79-year-old man with long-term illness who lives in Lam Tin Village. Today, this article will explain to you what is rat hepatitis E? How is hepatitis E transmitted? How to prevent infection?

Source: Ming Pao, "Centre for Health Protection: Hong Kong's 12th human infection with rat hepatitis E", September 19, 2020

Chen: Chen Peiran (specialist in Gastroenterology and Hepatology)

Zheng: Zheng Zhiwen (family doctor)

How many types of hepatitis are there? What is Rat Hepatitis E?

Zheng: Hepatitis refers to the inflammation of liver cells. There can be many reasons, such as viruses, bacteria, alcohol, drugs, autoimmune system disorders, gallstones, etc. For viral hepatitis alone, there are already A, B, C, D, and E types. It is difficult for doctors to distinguish clinically, and they must be classified through blood tests.

Chen: There are different types of hepatitis E, and the hosts they infect are also different. For example, some can infect humans, while others can infect camels, wild boars or rats. Generally speaking, cross-infection between different species is rare. However, last year, a research team at the University of Hong Kong discovered for the first time that humans were infected with rat hepatitis E, which previously only infected rats. The incident aroused social concern.

Yellowing of the skin and whites of the eyes means hepatitis?

Zheng: Rat hepatitis E is a hot topic recently, and many citizens are worried whether it will develop into a large-scale epidemic. Some patients found that their skin or the whites of their eyes turned yellow, and they suspected that they had hepatitis, or even hepatitis E in rats. Yellowing of the skin or the whites of the eyes may indeed be a symptom of hepatitis, but there are other diseases that can also cause these symptoms, such as cholangitis and yellow fever, which may cause jaundice due to elevated liver enzymes; other conditions such as patients with glucose Hexaphosphate dehydrogenase (G6PD) deficiency and hemolysis may cause yellowing of the skin and whites of the eyes. Therefore, if the skin or the whites of the eyes turn yellow, it is not necessarily hepatitis. The doctor must ask the symptoms in detail and do a blood test to confirm the diagnosis.

Hepatitis E in rats recovers automatically in 4 to 6 weeks?

Chen: Most hepatitis A and E are acute hepatitis. The general symptoms are nausea, diarrhea, abdominal pain, or jaundice. Some patients seem to have a bad cold, usually after 4 to 6 weeks Automatic recovery, no need to take medicine. If the doctor confirms that the patient is suffering from acute hepatitis E, and the patient is not a high-risk person such as pregnant woman, long-term patient or autoimmune system problem, the doctor will only give the patient appropriate advice and close monitoring, such as avoiding alcohol and taking health care products, so as to avoid Increase the burden on the damaged liver.

For the first case of hepatitis E infection in rats, the doctor once prescribed Ribavirin antiviral drug, but because there are not many cases and treatment experience, it is not sure its efficacy in the treatment of rat hepatitis E utility. Doctors may only consider liver transplantation unless the patient's condition worsens or liver failure develops.

How is hepatitis E transmitted?

Chen: Hepatitis can be divided into two categories. One is infection by blood or body fluids. Hepatitis B, C, and D fall into this category; Caused by food. In terms of numbers, there are about 100 cases of hepatitis E infection every year, and 5 of the cases of hepatitis E infection in rats in Hong Kong, the patients were taking drugs to suppress the immune system or had undergone organ transplantation, so suspicion and immunity worse about. Because there are only a few cases, the medical community has not yet grasped exactly why rat hepatitis E can infect humans, but it is estimated that it is related to eating food or water contaminated by rat feces.

How to prevent infection?

Chen: Hepatitis E is a "disease from the mouth" disease. Hepatitis E in rats is estimated to be caused by food being contaminated by rat feces and infecting humans. Therefore, to prevent the outbreak of Hepatitis E in rats, it is necessary to deal with both humans and rats. start. We must ensure personal hygiene and food safety, such as washing hands before eating, washing hands after going to the toilet and cleaning eating utensils, etc. In terms of food safety, raw and cooked foods should be placed separately, and meat or liver ingredients should be cooked thoroughly to kill the virus inside.

In terms of rats, the main thing is to cut off their food, housing and transportation, such as properly disposing of garbage and kitchen waste, cleaning up debris in the corners, blocking their hiding places and blocking their exit and exit channels, so as to reduce the gathering and reproduction of rats, and the diseases caused by rats can be controlled. .

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