B.C. to educate Asian immigrants about dangers of hep B

StephenW

B.C. to educate Asian immigrants about dangers of hep B


By Erin Ellis, Postmedia NewsApril 15, 2012




                                                                VANCOUVER - Raymond Wong never suspected he was carrying a virus that could kill him.
Slim, jovial and seemingly healthy, he was in his 50s before he found out his liver was working at about 30 per cent capacity. His wife, Liz, says she noticed the signs sooner - growing fatigue, a darkening complexion likely due to jaundice - but had no idea of the cause. None of their friends and family from Hong Kong talked about hepatitis B.
Now, at 64, Wong is recovering from the liver transplant he had in September 2011 and the complications that followed. He's one of the lucky ones: only 56 people received a liver transplant in B.C. last year.
``If they did not remove my liver early, probably once the cancer developed fully then it would spread to other parts of my body, so it's no use getting the transplant,'' said Wong, from the Vancouver suburb of Richmond, B.C.
The cost of such drastic treatments, both personally for the Wongs and financially for the health-care system, is now being addressed by the Chinese immigrant support group S.U.C.C.E.S.S. along with specialists from the University of British Columbia. They're launching a project Monday to educate Asian immigrants about the danger of undiagnosed hepatitis B and also improve its treatment.
Wong is like most people who don't know how or when they were infected with hepatitis B - and it usually doesn't matter. When someone is acutely ill with the disease, they may have dark urine, jaundice and fatigue, but it's far from deadly and 90 per cent of people beat the virus on their own. Only 10 per cent become carriers of the hepatitis B virus, meaning they can spread it through sexual contact, exchange of blood or childbirth, and up to one-quarter of those cases will develop cirrhosis of the liver or liver cancer later in life.
While those numbers sound small, they are magnified in a massive population like China's where about 50 per cent of its citizens have been exposed to the hepatitis B virus.
Hepatitis has been around for tens of thousands of years, said Dr. Mel Krajden, an expert in the disease who works at the BC Centre for Disease Control. But it's only in recent decades that medical advances made it possible to prevent its spread. B.C. has tested pregnant women since the mid-1980s, vaccinated Grade 6 students since 1992 and began an infant immunization program in 2001. All have pushed the number of virus carriers down to about one per cent of the population. Compare that to up to 15 per cent of immigrants from China and Southeast Asia, most infected at birth from their mothers.
Statistics from B.C. show the rate of chronic infection has dropped from 70 per 100,000 population in 2000 to 30 per 100,000 in 2009. Yet Vancouver and Richmond - with their high number of Asian immigrants - accounted for more than double and triple the average rates of infection.
Aboriginal People make up the next ethnic group with a higher rate of infection, but at only four cases in every 100,000.
In Asia, Taiwan led the way in introducing immunization, said Krajden. China has followed suit, beginning in the early 1990s. But vaccinations are reaching only about half of those who need it in Southeast Asia, according to the World Health Organization's 2009 statistics.
Vaccinating children near the time of birth is key because inflections are more likely to become chronic when contracted in childhood.
If immunization becomes universal, hepatitis B could be eradicated in the next few generations, but its lingering damage is causing suffering and enormous health-care costs in the meantime.
One of the main difficulties is getting people who don't feel particularly sick to seek treatment, said Dr. Raymond Kwan in his busy office at the edge of Vancouver's Chinatown.
``They say, `I'm feeling fine. Why should I go see my doctor? Why does my doctor need to see me every six months?'
The Wongs said Raymond wouldn't be alive today if they had stayed in Hong Kong and they heap praise on his doctors and nurses here. But the ordeal has been a huge stress on the family - something they urge others to avoid.
``Most important is people should check to see if they have it.''
Vancouver Sun
© Copyright (c) Postmedia News

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StephenW

[I am really surprised that they have only discvovered the problem now, so many Chinese migrated from Hong Kong to Canada in the 80's, 90's]

• Hepatitis B runs rampant in BC's large Asian community
  

                                                                                                                       
                                                                                                                                                                                                                                                                Dr. Eric Yoshida, Gastroenterologist at UBC (Erin Loxam, News1130)
  

• Dr. Eric Yoshida, UBC Gastroenterologist Hepatitis B runs rampant in BC's large Asian community
•   Doctors urge early testing to prevent cirrhosis or liver cancer                                     Erin Loxam
  

Apr 16, 2012 12:51:44 PMVANCOUVER (NEWS1130) - Hepatitis B (HBV) is proving to be a huge medical problem for the large Asian community in the Vancouver area. BC already has an estimated 60,000 patients and many others are undetected.

Many are diagnosed very late in the disease - once they already have cirrhosis or liver cancer.

Dr. Eric Yoshida, Gastroenterologist at UBC, says many people come to Canada, not even knowing they are a carrier of HBV.

"Around the world it's passed from mother to child. It is not because you scored drugs, it's not because you had affairs sexually, or things like that. You got it because you were born. End of story. There should be no stigma about Hepatitis B."

But he says there is. Trying to find someone among his patients with the disease to talk publicly about their experiences was nearly impossible.

HBV rates in Vancouver, Richmond and Surrey are approaching that of Asia and treatment is necessary to keep worse conditions at bay.

"We have these great anti-viral agents, which are only wonderful if people can actually take them. They cost a lot of money."

"If I tell my patients they need to go on these expensive drugs, I'm not telling them they need to go on these expensive drugs because I like writing prescriptions, or I'm supporting the pharmaceutical industry. I'm telling them they need these drugs because if they don't take these drugs, then I can't guarantee that something bad may not happen in the next five to 10 years," explains Dr. Yoshida.

Twenty-five per cent of people with HBV currently die from related diseases. Cirrhosis and liver cancer are huge strains on the BC healthcare system and could be avoided earlier on.

Doctors doing blood work need to order the test for HBV when looking for other problems in people in the Asian community.

Yoshida thinks things are better than they were 20 years ago, but they are still losing the battle against this deadly disease.

Yoshida and SUCCESS want more awareness and increased resources for early diagnosis, which is a simple blood test. He's also pushing for coverage for treatment from the BC Government.