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Thursday, May 13, 2010

Fighting to eliminate hepatitis

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By: Mike Aldax | May 13, 2010

Face of the fight: It took nearly 20 years after Assemblywoman Fiona Ma discovered she had hepatitis B before she took action. (Examiner file photo)

Fiona Ma doesn’t mind being the poster child for a campaign against an infectious disease — if it means saving lives, and even if it means making Asian communities in The City slightly uncomfortable.

Ma, a San Francisco Democratic assemblywoman, learned she had hepatitis B at age 22 while trying to donate blood. She began speaking out against the disease several years ago and is now backing an edgy new advertising campaign that has raised eyebrows in the Asian community.

One advertisement released this month by the nonprofit San Francisco Hep B Free features an image of 10 beauty queens lined up side-by-side, with the aggressive question at the bottom: “Which one deserves to die?”

The tone of the ad – part of the second phase of a campaign that began three years ago to eradicate the virus – is a far cry from the group’s previous slogan, "B a Hero."

The time for softball pitches is over, Ma said.

"Nobody wants to talk about illness or depression or problem gambling," said Ma of the Chinese community. "Once you talk about it, it brings pity and shame."

Ignoring that hepatitis B has become a rampant public health hazard in The City is not going to make the killer disease go away, she said.

The virus, which attacks the liver, has made San Francisco the liver cancer capital of the United States. The Asian Liver Center at Stanford University estimates that 1 in 10 residents of Asian or Pacific Islander descent has the disease.

One in four people will die prematurely due to liver failure or cancer if they are not monitored and treated. The disease is a silent killer, often posing no symptoms until it is too late, and it can be transmitted from mother-to-child, from wound-to-wound contact or by sharing needles, razors or toothbrushes, experts said.

"It is seven times more contagious than HIV," said Dr. Lisa Tang, a Kaiser Permanente practitioner. "But the disease can be prevented and can be treated."

In fact, a hepatitis B vaccine has been available since 1982. The vaccine — a three-shot series given over six months — is "so effective at preventing" the disease that it is called "the first anti-cancer vaccine by the World Health Organization," the Asian Liver Center said.

"We could have wiped out 80 percent of liver cancer 30 years ago," said Ted Fang, co-founder of San Francisco Hep B Free.

Also, those who catch the virus early can live regular lives, he said.

"We have the nexus of drugs to treat this," Fang said.

That’s why there’s no reason not to break down the walls of cultural sensitivity on the topic of hepatitis B and get people tested, Ma said.

The assemblywoman, who inherited the virus from her mother, said she has no symptoms and pays regular visits to the doctor.

She said her 70-year-old mother had a piece of her liver removed last year due to the disease. Her brother, who is two years younger, is also a hepatitis B carrier. And her sister, who is 28 years old, is not a carrier because she was vaccinated at an early age, Ma said.

Ma said she can relate to Asian community members who neglect to get tested. She said it took her nearly 20 years after learning that she had hepatitis B before she did anything about it.

"I didn’t know [about the dangers]," she said. "I'd say, 'I'm just a carrier. I’m fine.’"

At a news conference several years ago, a top Stanford physician warned Ma that her condition was chronic.

"That’s where the panic started," Ma said.

That’s when Ma decided to become active about her disease — and active about informing others.

"I thought, 'If I didn’t know, I’m sure others don’t know,' so that’s when I started on the campaign to be kind of the poster child," Ma said. "it’s worked. A lot of people have stopped me on the street and thanked me because they got it checked."

Campaign gets edgy to spread message

A provocative advertising campaign launched by the nonprofit San Francisco Hep B Free irked some in the Asian community before it was even released.

DAE Advertising, a San Francisco Asian-American advertising agency, came up with the slogan, "Which one deserves to die?" that began appearing in ads this month to promote awareness about hepatitis B.

DAE said it recruited nonpaid members from the community to appear in the ads. One ad includes 10 beauty queens, another 10 members of a basketball team and yet another 10 members of a family.

Health officials estimate 1 in 10 residents of Asian or Pacific Islander descent are infected with the potentially deadly hepatitis B, which can destroy the liver.

The goal of the ads is to convince members of the Asian community — who aren’t fond of discussing illness openly — to get tested for the disease.

Some volunteers scheduled to appear in the ads pulled out of the project due to the provocative campaign slogan, including a few beauty queens, said Sunny Teo, DAE’s executive creative director.

"It certainly wasn’t easy to get volunteers," Teo said.

But the campaign wasn’t just about shocking the Asian community into getting tested for hepatitis B, though Teo admits, "We are competing with all these other diseases out there."

The idea had to create awareness about a silent killer that can creep up on perfectly healthy people, while still promoting the positive aspects of a beautiful community, he said.

"When you really read into it, the message is very positive," said Vicky Wong, president and CEO of DAE. "What it’s saying is, ‘Nobody deserves to die.’"

— Mike Aldax

Hepatitis A, B and C

Hepatitis refers to any disease resulting in inflammation of the liver, regardless of how that disease is contracted.

Hepatitis A is an acute infection transmitted through contaminated food and water. Infection can be prevented by receiving the hepatitis A vaccine. Death rate: Up to five deaths per 1,000 cases

Hepatitis B can be both an acute (short-term) and chronic (long-term) infection. It is transmitted through contaminated blood. Infection can be prevented by receiving the hepatitis B vaccine.

Hepatitis C can be both an acute and chronic infection. It is transmitted through contaminated blood. No effective vaccine is available at this time.

Hepatitis B

How it can be transmitted:

* Mother to child
* Wound-to-wound contact
* Sharing razors or toothbrushes
* Reusing needles for tattoos, piercings or injecting drugs
* Reusing medical needles or syringes
* Unprotected sex with an infected person

How it is not transmitted:

* Sharing food or water
* Sharing eating utensils or drinking glasses
* Casual contact
* Coughing or sneezing
* Hugging or kissing
* Breastfeeding

Source: San Francisco Hep B Free and San Francisco Department of Public Health

Hepatitis B numbers

1.25 million Americans who are chronically infected

60,000 Americans who become infected annually

3,000 to 5,000 People who die annually due to cirrhosis or liver cancer caused by hepatitis B

1 in 10 Asian and Pacific Islanders living with chronic (lifelong) hepatitis B

1 in 4 People with chronic hepatitis B who will die from liver cancer or liver failure without appropriate monitoring or treatment

2 in 3 Sufferers who don’t know they are infected because there are no symptoms

Source: San Francisco Hep B Free and San Francisco Department of Public Health

Read more at the San Francisco Examiner.

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