Virus in the Liver

Doctors used to think they could relax about hepatitis after the end of a major war. "Infectious jaundice" (as it was commonly called from its most obvious symptom) was regarded as a disease of wartime camps with poor sanitation; peacetime outbreaks were relatively few and usually limited to overcrowded institutions such as orphanages, mental hospitals and prisons. Today, inflammation of the liver as a result of invasion by a virus is becoming a major health problem in the workaday, peacetime U.S.

No less than 33,382 cases were reported to the Public Health Service in 1953 (and reported cases are believed to be only a fraction of the actual total). The latest P.H.S. figures, for the third week in January, show 1,214 cases, or almost double the 1953 rate, though much of the apparent increase is due to better reporting.

Equal Misery. Syracuse, N.Y. recorded 46 cases within a month, and the whole town was talking about it. Two aspirants for public office were victims last year, and local politicians were kidding possible candidates with the question, "Have you now or have you ever had infectious hepatitis?" New Jersey was sifting the data on more than 150 cases in a single school. California reported 30 cases in a housing project where water from washing machines had backed up into the drinking supply.

Physicians make a sharp distinction between infectious hepatitis, usually spread by fecal matter, and serum hepatitis, or "needle jaundice," because the latter is carried only by blood.* That, and the fact that the serum type takes two or more months to develop (three times as long as the infectious variety), are the most obvious differences. Both kinds of hepatitis make the patient equally miserable, causing headache, fever, nausea and loss of appetite. In most cases, jaundice appears. Though hepatitis is rarely fatal, it may cause severe liver damage.

And many patients feel fine after a few weeks and go back to school or work, only to be laid low again, perhaps repeatedly.

Scrupulous Sanitation. There is no curative treatment. Gamma globulin, given while the infectious form of the disease is incubating, may greatly lessen the severity of the attack or actually prevent it. But once the infection is full-blown, doctors can do nothing more than put their patients to bed, and feed them a highprotein, high-carbohydrate diet with plenty of vitamins.

The viruses (evidently close kin) that cause the two types of hepatitis have never been isolated. They defy attacks by chemicals, heat, cold and ultraviolet rays.

And no vaccine can yet be prepared, since they perversely refuse to infect any animal but man. The P.H.S. has found many volunteer human guinea pigs in federal prisons, will soon report on its findings. The Army has some 60 investigators working on hepatitis. So far, the best protection seems to be scrupulous sanitation, and the only prophylactic, immunization with gamma globulin.

* And is, therefore, contracted from transfusions or from improperly sterilized needles used in taking blood samples. One famed exceptional outbreak: 33,000 cases in the Army in 1942 from a yellow-fever vaccine containing human serum.

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