Sharing clothes, razors, combs, bedsheets can also transmit the virus. ”Basically, anything that rubs against the skin, which could include contact sports as well, could lead to transmission,” cautions Arora.
Body secretions, which contain the virus, are left behind on articles of personal use. These could then enter another person through microscopic cuts or bruises on the skin, he explains.
hepatitis B virus is spread in much the same manner as HIV — through contact with body fluids and from mother to infant. However, unlike HIV, hepatitis B virus can remain alive for three to four months outside the body, at room temperature. Although it gets destroyed immediately if it comes in contact with a detergent.
Direct linkages of such transmission may not have been established within the country, but there is enough evidence from studies conducted elsewhere. In a joint paper with the Indian Council of Medical Research, researchers Arora, Lalit Kant and Prashant Mathur discuss studies in Ghana, wherein sharing of bath towels, chewing gum or partially eaten candy, dental cleaning material and biting of finger nails in conjunction with scratching the back of carriers have been identified as risk factors of transmission.
Within the country indirect evidence comes from different studies. For instance, a study conducted at an orphanage in Pune among children between five to 16 years found that the prevalence was higher amongst boys living there for more than three years as compared to those with a shorter period of stay.
Another study found that only 14 per cent of infection amongst children could be traced to infected mothers. Most of the remaining transmission would then have occurred through personal contact, says Arora.
In India, close to 40 million people are estimated to be carriers of the virus. Over a period of two to three decades, these people may develop serious liver problems which include liver cirrhosis as well as liver cancer. Most infection is said to occur during the first ten years of life. By the age of five, close to 80 percent of the carriers get infected, says Arora.
Hepatitis B, which manifests itself as acute jaundice, is a rather silent killer. Usually the disease shows only when the liver starts showing symptoms of cancer. As a result of transmission through personal belongings and close contacts, the transmission rate within family members is about 30 per cent higher. Childhood transmission by the virus is primarily due to close contact with carriers, especially in highly endemic developing countries.