Viral Hepatitis E (HEV) - Final note (Part 6)

Today I am reading a book of memoir by Lee  Kuan Yew, a glowing example of leadership (my understanding)  - the name of the book is "From Third World to First" and this thick book of almost 800 pages walks you through the Singapore's story of success from 1965 to 2000. Fortunately, I had a chance to be in Singapore on the day of his farewell march for eternity. I could see how much people of Singapore adore and respect him. From the unending line of people waiting patiently in that tropical heat was a sight that we have "so rare" a chance to witness. No doubt, he has contributed so much to bring Singapore from nothing to one of the economic power house in South East Asia. You may be wondering why I am talking about Mr, Lee and what does he have to do with theme of this series? Well, I know, it may sound way opposite but from the story of Mr. Lee what am i trying to understand is what we can do and learn from him in order to make things happen !! For this, i think, he deserves attention and we seriously contemplate on his wisdom so we also can also do the most from what we have and make the best use of time and resources. That is it !! I dedicate this final note to Mr. Lee and this is all i can do to understand his contribution in terms of learning and educating ourselves in making things happen instead of just complaining about existing adversaries.

With this, I read Chapter 49 of Plotkin's Vaccine on Hepatitis E vaccine. There are few facts i need to write for my memory and keeping facts straight before i conclude this series for next one. Here follows some facts on HEV:

• Incubation period (IP) is approximately 40 days
• most important acute viral hepatitis among adults in much of central and southeastern  Asia and the Indian Subcontinent and the second most important hepatitis in the Middle east and North Africa
• Up to 20 % clinical attack rate and an associated high incidence of fetal wastage
• In endemic countries, genotypes 1 and 2 predominate and contaminated water is the major source of infection.
• Seronegative children and adults are at general risk of disease and pregnant women are at special risk for severe or fulminant hepatitis in endemic regions
• With regards to vaccination - HEV vaccination is best suited to be included in EPI schedule rather than providing this vaccine in campaign mode. 

Finally, my intention of writing this HEV series is primarily for self understanding and share my thoughts to wider interest group who has interest to involve in this line of work. I know, this is a drop in ocean but you never know how important that a single drop can contribute in better understanding of the disease where it is so important as a public health problem. My opinion is that we need to strengthen our own capability and network and bring the necessary preventive measures to the community rather than waiting for some outside agencies. 

Action items:

1. Review paper
2. Explore partnership and make things happen with clarity in work plan

28 March 2015