"There's a myth that anyone who has a liver problem has brought it on themselves" This quote is from a Crohn's disease patient living with a blocked portal vein hoping for a liver transplant (Independent 31st Oct 2010)

Wednesday, 27 June 2012

Am I serious?

To my earlier post on the source of the infection, anonymous asks "Are you serious?".  

Well yes.  Apart from having no idea how you check a mosquito to see if it is Hep B positive!  But if we can identify malaria in mosquitoes, I guess we have the technology.
Do a general 'google' search and you will find lots of articles with valid reasons why its not possible to spread via mosquitoes - to do with saliva not being a transmission route, the likely survival time of the virus in the mosquito, etc. 
But if Hepatitis B viral DNA can be detected in bed bugs up to six weeks after they feed on infectious blood, it makes you wonder, doesnt it?
Here's some research that was published in 1973 on HBV in mosquitoes:
Mosquitoes were fed on or inoculated with blood or serum positive for hepatitis-B antigen (HBAg) or allowed to feed on the arm of an HBAg carrier. Pools of mosquitoes were tested by radioimmunoassay at intervals up to 45 days after exposure to HBAg. HBAg was detected long after the blood itself would have been digested. The findings suggest persistence (but not necessarily replication) of HBAg in mosquitoes.
The Lancet, Volume 302, Issue 7832, Pages 758 - 760, 6 October 1973

I've had 30 years to go over and over the different possibilites for how I was infected.
Here are the most common transmission routes:
Mother to baby:  Possible, but unlikely.  If my mother had Hep B (she too spent time in Kenya, but in the 1950s) I will never know, as she died in 1981.  If I had been infected by maternal transmission, then my brother most likely would have.  And he hasnt (as far as I know, sorry bro!)
Intravenous drug use:  I'm always asked about this.  Its a 'no'.
Unprotected sex with a Hep B+ partner: Again, no
Sharing razor/toothbrush with a Hep B+ partner.  No
Blood transfusion before screening was introduced in the UK:  No
Dental work in a country where equipment isnt sterilised:  No (unless my white middle class dentist in the UK in the 60's is a possible)
Tattoo: No
Piercings: Possible, if a white middle class hairdressing salon in the UK with piercing gun was high risk.

Where have I been where Hep B is much more prevalent than white middle class England.  
How many of the Kenyan population there are infected with Hep B: Hundreds of thousands.
And with my genotype?: 88%
Are travellers recommended to get the Hep B vaccination before travelling there: Yes.
Why? Are they all going to share needles with Kenyan drug users and have unprotected sex? I think not, so there must be other transmission routes that put travellers at risk.
Did I have a Hep B vaccination before travelling?:  No, it wasnt available in the early 1970s.
How many of the population there are bitten by mosquitoes:  Hundreds of thousands.
When a mosquito bites a human, it injects saliva and anti-coagulants. Could these carry Hep B?  Seems possible to me.

Anonymous said "I had no idea that mosquitos could spread hepatitis so easily".  Whoa, steady on.  If you 'google' the question, the answer will come back either its not possible or its not documented in medical literature that Hep B is transmitted that way.  But how many other viruses and infections apart from malaria do mosquitoes transmit?: Yellow fever, dengue fever, encephalitis, polyarthritis, Rift Valley fever, Ross River fever, West Nile virus.  So why not viral hepatitis, seems possible to me.  Hep B is highly infectious, 100x more infectious than HIV.  Doesnt take a lot of blood to transmit it.

Anonymous said "That is an extremely scary thought... since it is next to impossible to entirely avoid exposure to mosquitos"  But you can protect yourself 100% by choosing to have the Hep B vaccination.  Have it done now and you banish scary thoughts!

"I hope they automatically screen for hepatitis whenever they draw blood"  In the UK, the Blood Transfusion service have screened blood donors for many years now, for hepatitis, HIV etc.  That's how I was diagnosed - it was picked up when my donor blood was screened.
What they dont do is screen your blood when the doctor does a blood draw for a health reason.  Say, for example, you were having a blood draw for your thyroid, or diabetes, no they would not routinely screen that blood for hepatitis.  It would be an invasion of your privacy to do that, unless you specifically asked or gave permission.  The only time they DO routinely screen for Hep B (and HIV) is when you are pregnant.


  1. Fiona,
    It sounds like one of the smartest things a person can do is donate blood. You end up with a free screening of your blood and any warning signs that might show up from them.
    PS We are off on vacation as a family for the first time since Steve was diagnosed...will be out of touch for a short while. Take care...

  2. Hi Carla. Yes in the UK your blood donation gets screened for HIV, Hep B, Hep C, syphilis. One thing that isnt regularly screened (but might be in some circumstance) is Cytomegalovirus (CMV) which has a sneaky way of popping up in post transplant patients with weakened immune systems, if their donor had the virus.
    Have a wonderful vacation, I thought you went cruising to Alaska a while back? Hope all well with Steve.