Hepatitis; the Gift That Keeps on Giving

Clay suggested that with the rain and runoff that this is a teachable moment about Hepatitis.  I agree and as a  public health professional with 40 years of experience, I have some interest in providing you, the public and my friends, with some useful information about Hepatitis.

There are five types of Hepatitis; A, B, C, D and E.  As surfers, we are primarily concerned about Hep A and Hep E;  sometimes referred to as acute hepatitis.  These are the types of hepatitis that are transmitted by the fecal-oral route; that is, eating shit.  Hep B, C and D are transmitted by saliva, blood or sex.

Hepatitis is caused by a virus that attacks the liver.  Hepatitis can be a mild illness lasting 1–2 weeks to a severely disabling disease lasting several months. Getting better often takes months; a long time out of the water.  You are wiped out, have no energy, stamina or even desire to surf (or anything else that requires exertion).   It is also easily transmitted to others who in turn can give it to even more people because they are infectious way before the symptoms appear.  It's the gift that keeps on giving.

So, how does the hepatitis virus get in the water in the first place?  Understand that the sewage collection system and the storm water conveyance system are separate; storm water runoff does not go to sewage treatment plants.  Storm water runoff and all of the wonderful stuff the water picks up as it courses through streets, parking lots and and businesses dumps right into the ocean.  

Furthermore, if sewers and sewage treatment plants are overwhelmed during a storm event by the volume of runoff entering the sewage system (the sewage collection mains are not a closed system, water can enter them very easily), raw, untreated sewage becomes part of the runoff which we know flows right to the ocean.  Research conducted at SDSU has shown that the hepatitis virus remains infectious in ocean water for at least a week.  

There is a vaccine for hepatitis A.  It is given in two shots, six months apart.  Initial immunity starts 2 - 4 weeks after the first shot.  The second shot provides long term protection.  The Hepatitis A vaccine is safe. No serious side effects have resulted from the Hepatitis A vaccine.  However, you should discuss the vaccine with your doctor if you are considering it.

The surfers in Imperial Beach are especially at risk and a while back a nonprofit organization known as WildCoast (www.wildcoast.net) was sponsoring a program to provide the Hepatitis A vaccine to surfers.  I'm not sure if they are still providing that service but you can check with them to find out.   

While hepatitis is rarely fatal, it is no fun to have, keeps you out of the water for months on end, eliminates you from being able to donate blood and will make the folks you give it to extremely pissed off.  

These photos are from this morning.  The top one is at 15th Street and the bottom two are at Swami's.

Aloha

Gary