Hepatitis A

Subject: Science and Tech (UPSC Prelims)
Source: The Hindu

Context:

Public health experts are recommending that Hepatitis A vaccination be added to India’s Universal Immunisation Programme (UIP), as outbreaks are rising and natural immunity among adolescents and young adults is declining.

About Hepatitis A

What is it?

Hepatitis A is an acute viral liver infection caused by the Hepatitis A Virus (HAV).
It does not cause chronic liver disease, but adults may develop severe hepatitis or acute liver failure.

Geographical Distribution

• Common in low- and middle-income regions with poor sanitation.
• Most infections occur in childhood in high-burden areas.
• High-income countries see fewer cases but frequent outbreaks in specific groups (MSM, travellers, PWID, homeless populations).

Mode of Transmission (Faeco-oral)

• Consumption of contaminated food or water.
• Direct contact with an infected person (poor hygiene, dirty hands).
• Household spread and food handlers are major contributors.
• Waterborne outbreaks linked to sewage contamination.

Symptoms

Fever, malaise, nausea, diarrhoea, abdominal pain, dark urine, and jaundice.

Treatment

• No antiviral medicine exists.
• Supportive care is provided.
• Most patients recover fully and develop lifelong immunity.
• Hospitalisation only in severe cases.

Universal Immunisation Programme (UIP)

What it is?

India’s flagship vaccination programme, providing free immunisation to all children and pregnant women against major vaccine-preventable diseases. It is among the largest immunisation programmes in the world.

Launch Timeline

• 1978: Started as Expanded Programme on Immunization (EPI)
• 1985: Expanded into the Universal Immunisation Programme (UIP)
• 1989–90: Achieved nationwide coverage

Key Components of UIP

1. Strategy & Policy Framework

Driven by:

• National Health Policy
• National Vaccine Policy
• NTAGI recommendations

2. Cold Chain & Logistics

• ~30,000 cold chain points nationwide.
• Equipment includes ILRs, deep freezers, WIC/WIF units, vaccine vans.
• eVIN ensures real-time temperature and stock monitoring.

3. Injection Safety & Waste Disposal

• Auto-disable (AD) syringes, hub-cutters.
• Disposal as per CPCB biomedical waste guidelines.

4. AEFI Surveillance (Adverse Events Following Immunisation)

• Multi-level AEFI reporting since 1988.
• SAFEVAC portal for digital real-time reporting.

5. Training & Capacity Building

• Training modules for medical officers, ANMs, ASHAs, cold-chain technicians.
• Key centres: NCCTC Pune, NCCVMRC Delhi.