Hepatitis is inflammation of the cells of the liver. It can be acute, lasting for less than six months, or chronic when it lasts for longer. At its most severe hepatitis can lead to liver failure.

See Map 47 Chronic liver disease.

Males and females are mapped separately as the geographical patterns are very different. Two thirds of deaths from hepatitis were of males. Both males and females have high SMRs in London, where nearly a quarter of all deaths from this cause occurred.

Hepatitis can be viral or non-viral. The most common forms of viral hepatitis are A, B and C.

Hepatitis A, or infectious jaundice, causes an acute form of hepatitis. It is a virus transmitted by the faecal-oral route and is often associated with ingesting contaminated food. This is the commonest form of hepatitis, but is rarely fatal, and does not cause chronic liver disease. Most infections occur in childhood and pass unnoticed.

Hepatitis B can cause both acute and chronic hepatitis. Transmission can be via blood, by needles (used for tattoos or drugs), sexual or through breast-feeding. Hepatitis B is considered an occupational hazard for healthcare workers and the emergency services.

Hepatitis C can be transmitted through blood and can cross the placenta. It can remain asymptomatic for up to 20 years and culminate in cirrhosis. There is currently no vaccine for Hepatitis C.

Hepatitis B and C are a major health threat to injecting drug users.

In the late 1970s and early 1980s in Britain some 4,800 haemophiliacs were infected with Hepatitis C due to infected blood product transfusions (see www.taintedblood.info).