Hepatitis A increases in clean nation

With hepatitis A infecting younger Koreans, fulminant hepatitis A, a more devastating complication, has claimed five lives this year, according to the country’s health authorities and major general hospitals.

Four general hospitals, including Seoul National University Hospital and Samsung Medical Center, have seen 20 patients with fulminant hepatitis A in the past five months, compared with 13 during all of 2008 and none in 2007.

Of the 20, 11 had to have liver transplants. Two are waiting for the same operation, while the other two recovered. With the exception of a patient in his 60s, patients with fulminant hepatitis A from last year until now are aged between 20 and 40, according to the Korea Centers for Disease Control and Prevention.

Fulminant hepatitis A is characterized by a rapid development of jaundice and the onset of brain swelling and nervous system deterioration. Confusion, disorientation, dementia and coma may develop within hours in some cases, and liver failure, vascular bleeding in the brain and kidney failure may ensue.

“Fulminant hepatitis A occurs in 0.1 percent of the total hepatitis A patients,” said Suh Kyung-suk, professor of surgery at Seoul National University. “How and why hepatitis A develops into a fulminant status has not been proven yet.” He recommended that people in their 20s and 30s get vaccinated against hepatitis A.

According to the Centers for Disease Control, hepatitis A infection has been on the rise in recent years in Korea - from 798 in 2005 to 2,081 in 2006 and 2,233 in 2007. As of May 15, the tally for this year reached 4,231. Last week a high school in northern Seoul saw 14 of its students diagnosed with the disease.

Ironically, some experts say the return of the epidemic has been caused by the country becoming overly hygienic. Until the 1970s, when Korea was rapidly recovering from the Korean War (1950-1953), children under 6 years old suffering from hepatitis A was considered an ordinary event due to the poor water supply and drainage system.

Most patients who catch the disease when they are young suffer symptoms similar to those of a cold. Now that the country has become highly industrialized, parents born in post-war Korea have raised their children in highly hygienic circumstances. That means many adults in their 20s and 30s are not immune to the disease.

The disease is transferred through ingestion of food or drink contaminated by the virus transmitted from the excrement of an infected person. This is why the number of patients increases in summer, when people have more chances of drinking unsanitary water or eating food that easily goes bad.

The Centers for Disease Control said it is considering a law to put hepatitis A under the class-1 legal epidemic category, which requires patients to be isolated.

By Seo Ji-eun, Ahn Hai-ri [spring@joongang.co.kr]