The first thing I noticed after waking up was a beeping sound above me. It seemed to be coming from a monitor which was hooked to my forearm, now deep purple and bruised with a number of pinpricks. I was scared and anxiously looked around for help. A nurse came over to check on me; my throat was parched and I asked for some water. To my great agony, I was offered my sip from a disposable 10 ml pouch, as my caregiver explained the doctor’s instructions to prohibit water till my body recuperated. I was still dazed, but remember catching the words acute liver failure and hepatitis A.
It only sunk in after I saw my father standing beside me the next day. He explained how I was admitted to Sir Ganga Ram Hospital three days ago, after slipping into second-grade hepatic encephalopathy. It is as scary as it sounds: deteriorating brain function, on account of viral hepatitis-A-induced acute liver failure.
What the experts say
The World Health Organization (WHO) estimates that every year, there are 1.4 million cases of hepatitis A worldwide. The National Centre for Disease Control (NCDC) notes that while the proportion of young adults at risk for HAV infection is very low in India, there is a recent upward shift in the average age at first HAV infection, among the socio-economically developed population.
Even so, Dr Ashok Choudhury, an assistant professor and hepatologist at the Institute of Liver & Biliary Sciences (ILBS), and the physician who was helping me recover, was surprised at my body’s reaction to the virus. Most cases of hepatitis A are mild and often pass undetected in children and teenagers. The infection carries a higher risk for older adults and those with chronic liver disease. Unlike hepatitis B and C, the A virus does not cause chronic liver disease and is rarely fatal, but it can cause debilitating symptoms and fulminant hepatitis (causing liver failure).
My parents recollect the trauma of being asked to prepare for a liver transplant as I lay in the ICU. Fortunately, my body responded to the treatment and I was discharged from the hospital after 10 days. I suffered from a prolonged jaundice over the next eight weeks, and was advised weekly Liver Function Tests and medication to help with my recovery.
What one does
A self-proclaimed street-food connoisseur and a part-time food writer, I got my thrill out of eating out — following trails recommended by other foodies, taking friends along the food track, and the ultimate kick of discovering a glorious eat not yet documented on Instagram or profiled on Zomato. Good food gave me more than pleasure; it gave me purpose and meaning. It also gave me hepatitis A.
According to WHO, the Hepatitis A virus is transmitted primarily by the faecal-oral route; that is when an uninfected person ingests food or water that has been contaminated with the faeces of an infected person. Yes, it’s as icky as it sounds.
With sanitation being an ongoing challenge in most Indian cities, contracting the virus while eating out is an inevitable risk. WHO estimates that unsafe food containing harmful bacteria, viruses or chemical substances, causes more than 200 diseases — ranging from diarrhoea and organ failure to chronic neurological disorders, even cancers.
Eating out frequently, even uncontaminated food, carries additional risks like obesity, elevated cholesterol and sodium levels, exposure to allergens and gastrointestinal disorders like acid reflux.
It has taken me three months to recover, and while I will probably not quit eating out entirely, I realise that we could all do with a few safeguards. Even celebrity chef Anthony Bourdain advises a few personal cautions when eating out in his book, Kitchen Confidential , from avoiding stale seafood on Monday, which was stocked the previous week, to mistrusting hard-to-clean mussels and pre-made hollandaise on the Sunday Brunch (a hotbed for bacteria).
