Rejoinder: Avoid eating foods such as fufu in groups from one bowl to prevent spreading Hepatitis B- Prof Akosa

With reference to the publication by the Graphic on 28^th May, 2024, on the above topic, I would like to bring to your attention that Hepatitis B is not transmitted through food or water, sharing eating utensils, breastfeeding, hugging, kissing, coughing, and sneezing or by causal contact

In the said publication, Professor Agyeman Badu Akosa was reported to have said that eating soupy foods such as fufu, omo tuo or tuo zaafi together from one bowl can make people "swallow saliva" from each other thus putting them at risk of hepatitis B, . His explanation is that, people put their hands in their mouth, and dip them in the soup and by such behaviour, they can mix saliva with the soup and if they have Hepatitis B, they can spread it.

This is a sad misconception that will increase stigma and discrimination.

Hepatitis B is not spread through food or water. It is not spread by eating with family members or others with HBV. Hepatitis B is not transmitted by eating food cooked by someone with Hepatitis B.

HBV is transmitted parenterally by contaminated blood or other body fluids through blood vessels, skin or mucous membranes. Though the virus can be detected in all human body fluids, the virus concentration is highest in the blood or serous exudates, and it is relatively low in saliva, semen, vaginal fluids. Thus, there is almost no risk of transmission in the course of daily life, and the infection through fecal-oral transmission does not occur.

Hepatitis B is not easily transmitted through saliva. That means you are not likely to get it from sharing food or eating utensils or from someone coughing or sneezing on you. Spreading hepatitis B through kissing is highly unlikely; however, deep kissing that involves the exchange of large amounts of saliva might result in infection if there are cuts or abrasions in the mouth of the infected person, especially if they have a high viral load.

The spread of hepatitis B occurs when blood/bodily fluids from a hepatitis B-infected person enters the body of a person who is not infected. Sharing of infected needles, unsafe procedures in medical settings, and sex with a hepatitis B-infected person without using a condom are all risky for getting hepatitis B. However, in Ghana, where maternal hepatitis B has recently been estimated by the Ghana Health Service at 8.7%, the major mode of transmission is mother-to- child (that is, vertical transmission). Horizon transmission from child to child is also common possible though routine pentavalent vaccination has obviously reduced it significantly.

There is no scientific evidence that one can get hepatitis B through food or water or eating with someone with hepatitis B. The hepatitis B virus can survive outside the body for at least 7 days. During this time, the virus can still cause infection if it enters the body of a person who is not protected by the vaccine.

The incubation period of the hepatitis B virus ranges from 30 to 180 days. The virus may be detected within 30 to 60 days after infection and can persist when the body fails to clear it and develop into chronic hepatitis B, especially when infected in infancy or childhood. Chronic hepatitis can lead to permanent liver damage, scarring and liver cancer over time leading to liver failure and death unless one receives liver transplant.

Hepatitis B is vaccine preventable. As stated previously, routine pentavalent vaccine has reduced most childhood transmissions from child to child and mother to child transmission (not communal eating) is the major driver of the epidemic for which reason advocacy for hepatitis B birth dose introduction in Ghana must continue till all newborns start receiving it. An immune person has no risk of getting infected even when exposed to high doses of the virus from any source. The panic generated by the publication should translate into unvaccinated Ghanaians seeking to become immune if not already infected. It should also translate into parents ensuring their children are fully protected. Pregnant women should be calling for hepatitis B birth dose for their newborns. Birth dose plus three doses of the vaccines provide life -long protection and usually no boosters will be needed.

It is an unfortunate statement and we want him to retract that statement. We are not happy with the misinformation.

From: HEPATITIS FOUNDATION OF GHANA AND HEPATITIS COALITION OF GHANA

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