THE HISTORY OF LIBRARY IN NIGERIA

Introduction

A library is a building or room containing collections of books, periodicals, ands sometimes films and recorded music for use or borrowing by the public or the member of an institutions. It is also referred to as a collection of sources of information and similar resources made accessible to a defined community for reference or borrowing. It provides physical or digital access to material and may be a physical building or room, or a virtual space, or both. The collections in library include books, periodicals, newspapers, manuscripts, films, maps, cassettes, videotapes, DVDs, Blu-rays Dics, e-books audio books, data bases, and other formats. Libraries range in size from a few shelves of books to several million items.

            The first libraries consisted of archives of the earliest form of writing the clay tablets in cunci form scripts discovered in the summer, some dating back to 2600 BC. Private or personal libraries made up of written books appeared in classical Greece in the 5^th century BC. In the 6^th Century, at the very close of the classical period, the great libraries of the meditaterranean world remind those of Constantinople and Alexandria.

            A library is organizer for use and maintained by a public, an institution, a corporation, or a private individual. Public and institutional collections and services may be intended for use by people who chose not-to- or can not afford to purchase an extensive collection themselves, who need material no individual can reasonably be expected to have, or who required professional assistance with their research. In addition to providing materials, libraries who are experts at finding and organizing information and at interpreting information needs. Libraries they also often offer common areas to facilitate group study and collaboration. They often provide public facilities for access to their electronic resources and the internet.

Abstract

            The first libraries consisted of archives of the earliest form of writing on clay tablets in cuneiform script. This was discovered in temple rooms in sumer, dating back to 2600 BC. The archives consisted mainly in the Ancient Egypt records were made on papyrus at Ugarit; besides correspondence and inventories, texts of myths may have been standardized practice-texts for teaching new scribes. There is also evidence of libraries at Nipper about 1900BC and those at Nineveh about 700BC showing a library classification system. Over 30,000 clay tablets from the library of Ashurbanipal have been discovered at Nineveh, providing modern scholars with an amazing wealth of mesopotamin library, religious and administrative work. Among the findings were the Enuma Elish, also known as the Epic of creation, which depicts a traditional Babylonian view of creation, the Epic of Gilgamesh, a large selection of “Omen texts” including Enuma Anu Enlil which” contained omens dealing with the moon, its visibility, eclipses, and conjunction with planets and fixed stars, weather, namely lightning, thunder, and clouds, and the planets and their visibility, appearance, and stations”, and astronomic/astrological texts, as well as standard lists used by scribes and scholars such word lists, bilingual vocabularies, list of signs and synonyms, and lists of medical diagnoses.

            All these tablets were stored in a variety of containers such as wooden boxes, woven baskets of reeds, or clay shelves.

            The golden age of libraries began in the 17^th and 18^th Centuries during these period some of the more important libraries were founded in Europe. These include Francis Trigge chained Library of ST. Wulfram’s Church, Grathan, Lincolnshire in (1598), Boldlein library, Norwich city (1608) and British library was established in (1753) etc. By 19^th century, libraries began to expand by reaching most underdeveloped countries, especially in Africa, and Nigeria in particular.

History of Library in Nigeria

The National Library of Nigeria came into effect in the mid-1960s, with the enactment of the National Library Act of 1964. Prior to the passage of the National Library act, a series of educational conferences conducted in Ibadan, had laid the intellectual basis for the creation of a network of libraries funded by the government to provide accessibility of educational materials to Nigerians . A government advisory committee was later created due to the necessity for the development of a local repository of knowledge. The committee was charged with finding a way to aid the government in bringing to prominence the intellectual foundations of its policies, creation of a national bibliographic center and to provide an arena for the promotion of knowledge. The committee was the first major formal body that called for a National Library as part of its recommendations. The government accepted the demands of the advisory committee and undertook the necessary steps to build a National Library.

The construction of the Library began in 1962 and the Library was finally opened in November 1964. The headquarters was moved from Lagos to Abuja ca. 1995.

The Library Act enacted by the House of Representatives of Nigeria guaranteed financial assistance to the project, the act also provided provisions for the training of staff and the creation of a board of directors made up of professionals. In concord with the demands of the Nigerian republic and the assembly, a group of 15 trained librarians were hired to provide a positive role in developing and manning the library. A board was inaugurated in April 1966 by a new military government. The board was made up of government officials instead of professionals as written on the original act. However, the board tried to improve on the original objectives of the library. But the Nigerian civil war hampered funding and formal government actions were not taken until 1970. In 1970, a new legal precedent was set with the creation of the National Library decree, the decree was partly enacted on the advice of the board which wanted to expand the library to other state capitals in order to create a network of repositories

Mission

The library is aided financially by the federal government of Nigeria. Originally, the Ford Foundation was involved with the project. [2] The foundation brought in professionals, donated books and funded the library's expansion. The library over the years has built on its original mission. Today, it is a vital organ that acts as the intellectual memory of the nation. The library provides the intellectual ammunition to aid government officers in policy implementation. However, the general direction of policy instability due to the military incursion to power sometimes created an imbalance between the intellectual memory of prior polices and the intellectual foundation of a new government. The library also stays afloat intellectually by receiving copies of books published in the country by both the government and private authorities, it is today one of the largest depositories of knowledge in the country. It also collects books on contemporary or new ideas from international organizations. Its responsibilities also include the issuance of the ISBN and ISSN to publishing organizations, a process which is today cumbersome in the absence of appropriate enabling technology at the regional offices.

Problems

The library has failed to effectively expand to the 36 state capitals of the federation as designated by the library decree of 1970. In concert with the lack of facilities in the state capitals, a lack of adequate social amenities for the library staff in some state capitals is another obstacle to the library's development. There is also a lack of sufficient professional librarians; the library failed to effectively protect itself by training students in library science, today the few graduates of library science gravitate towards jobs in the publishing business. The lack of adequate amenities provided by the library also does not help in recruitment. There are also insufficient storage devices for audio or visual collections.

Locations

            Despite the challenges and problems faced by the library in Nigeria has branches in the following areas or states;

1.            National Library of Nigeria, Emir's Palace Road, Kano City, Kano State.

2.            National Library of Nigeria, Oda Road (Opposite Ondo State Law Commission), Akure, Ondo State.

3.            Ondo State Public Library, St Peters Bus Stop, Oyemekun Road, Akure, Ondo State.

4.            National Library of Nigeria Festival Road P.M.B. 1, Area 2 (Near Shopping Centre) Garki, Abuja.

5.            National Library of Nigeria, 227, Herbert Macaulay Way, Yaba, Lagos State.

6.            Illupeju Public Library, Opposite LSDPC, Illupeju, Lagos State.

7.            National Library Enugu, NTA road, beside ESBS junction, Enugu.

8.            Enugu State Library, Market Road, Opposite Mgbemena Park, Enugu.

9.            National Library, No 1 Bida road, opposite CBN, Kaduna

10.        Kaduna State Library, No 3 Bida road, opposite NBTE, Kaduna

11.        Kwara State Library, No 16, Sulu Gambari way, opposite NIPOST Office, Ilorin Kwara State.

12.        Akwa-ibom State Library: Plot 43 IBB way, Uyo akwa-ibom state

13.        Edo State Public Library, Benin City.

14.        Federal Library, Jos Beside Plateau State Polytechnic Holshe

15.        State Library, Jos Tafawa Balewa, Opp Plateau Riders Jos-North.

16.        National Library of Nigeria, Iyaganku, Ibadan, Oyo State.

The first national librarian of Nigeria was Dr. Carl White was appointed to come and head the national library in 1962. His appointment was to lay a foundation for national library in Nigeria. The current national librarian of Nigeria is prof. L.O. Aina, who succeded Mallam Habib Jato.

Use of the Library

The primary function of the Library of Congress is to serve the Congress. In addition, the Library provides service to government agencies, other libraries, scholars, and the general public. The Library welcomes public use of its general reference facilities and endeavors to offer the widest possible use of its collections consistent with their preservation and with its obligation to serve the Congress and other government agencies.

All researchers preparing to come to the Library are strongly encouraged to pursue preliminary exploration in appropriate public, academic, or special libraries, so that they can make efficient use of the Library of Congress. Readers should be prepared to present photo-identification showing a current address (e.g., a currently valid driver's license or passport) in order to obtain a Library-issued Reader Identification card, needed for admission to Library reading rooms and when requesting materials from the collections stored in closed stacks (LCR 1810-2). Anyone over high school age with appropriate photo-identification may apply for a Reader Identification card; a written introduction is not required.

The use of the different types of library services shall be subject to the following conditions:

General Reference Books:

General reference books and materials (encyclopedias, dictionaries, atlases, etc.) shall be for room use only. General reference books may be issued for classroom use upon the request of a faculty member, but these shall be returned within the day.

Theses, Dissertations, and Periodicals:

Theses, dissertations, and periodicals shall be for room use only. However, faculty and officials of the University may borrow a periodical, other than the latest issue for a period of not more than one (1) week.

Reserve Books. Reserve books (required reading materials for courses offered during the semester/ summer) shall be lent for room use only and recalled two hours after issue. It may also be borrowed for overnight use upon request and be returned not later than 9:00 A.M. the next working day.

Circulation Books:

Books for home use are usually loaned for two weeks.

Special Collections. Special collections (rare books, personal papers and Archives Sections, AV materials, microforms, diskettes, art collections, and certain types of Fine Arts books, etc.) shall be for room use only.

The use of archival materials, such as: official records, personal papers, manuscripts, diaries, legal papers, memorabilia, etc. shall be subject to any restrictions that may have been imposed on particular records by the originating office of the University of the Philippines System or the donor as stipulated in the deed of donation.

Members using special facilities, such as microforms, computers and the media resources, shall be assessed prescribed fees.

The student has exhausted all local library resources (school, public, and university) and has identified specific materials available only at the Library of Congress. (This will usually require consultation with a local librarian and an Internet search of the Library's Online Catalog or a search of other bibliographic resources).

The student has a letter from his or her principal describing in detail the student's project and the specific materials the student needs to use. The student is interviewed by a reference librarian in the appropriate reading room, who makes the final determination as to whether or not the student's project requires use of the Library's collections. The Library provides much material of potential use to high school students through its website, and an examination of this material may prove sufficient for a student's needs. 

Conclusion

Library education in Nigeria was characterized by one problem or the other, since the establishment of the first two library schools on different professional and philosophical foundations. This gave rise to the proliferation of many library science programs in various kinds of Institutions resulting in varying professional Qualifications, differences in curriculum content with divergent aims and objectives. The inability of the profession to monitor and harmonize these differences at that time indicated the weakness of the foundation upon which the education of librarians in Nigeria is based. It is hoped that with the current intervention of bodies such as LRCN, NLA, NUC and ETF on the issue of curriculum harmonization, provision of resources and facilities; and staff training and development, positive changes will be witnessed and library schools in Nigeria will be the pride of librarians in the country.

References

Enyia, Chris O. National library of Nigeria at 30: its history and prospects for the

future (1992)

Everts, Bart. “Independent Reading? A History of the Nigerian National Library”

Presentation at the Missouri Valley History Conference, Omaha, NE,

March 6-8, 2014.

                Casson, Lionel (11 August, 2002). Libraries in the ancient world, Yale University Press

P.3 Retreved 7, March 2012.

                “Library – Denifition and more from the free Merriam Webster Dictionary.

Information for researchers using Library of Congress (www.loc.gov/Researchers).

           

A GREAT RESEACH ON HEPATITIS

What is hepatitis?

Hepatitis is an inflammation of the liver. The condition can be self- limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer. Hepatitis viruses are the most common cause of hepatitis in the world but other infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases can also cause hepatitis.

Types of Hepatitis.

There are 5 main hepatitis viruses, referred to as types A, B, C, D and E. These 5 types are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer. Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids. Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment and for hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact. Acute infection may occur with limited or no symptoms, or may include symptoms such as jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.

Q: What are the different hepatitis viruses?

A: Scientists have identified 5 unique hepatitis viruses, identified by the letters A, B, C, D, and E. While all cause liver disease, they vary in important ways. Hepatitis A virus (HAV) is present in the faeces of infected persons and is most often transmitted through consumption of contaminated water or food. Certain sex practices can also spread HAV. Infections are in many cases mild, with most people making a full recovery and remaining immune from further HAV infections.

However, HAV infections can also be severe and life threatening. Most people in areas of the world with poor sanitation have been infected with this virus. Safe and effective vaccines are available to prevent HAV.

What is hepatitis A?

Hepatitis A is an illness caused by the hepatitis A virus. The virus mainly causes inflammation of the liver. Symptoms include:

Generally feeling unwell.

Yellowing of your skin and the whites of your eyes (jaundice).

Sometimes, being sick (vomiting).

A raised temperature (fever).

However, some people who are infected do not develop any symptoms (a subclinical illness). The illness is not usually serious and full recovery is usual but the symptoms can be quite unpleasant for a while. The hepatitis A virus is passed out in the stools (faeces) of infected people and infection is usually spread by eating dirty (contaminated) food or drink.

Who should be immunised against hepatitis A?

Immunisation is generally recommended for anyone over the age of 1 year.

Close contacts of someone found to have hepatitis A infection (for example, family members or other members of the institution) may be offered immunisation. This only happens rarely. The most important measure for anybody with hepatitis A is good personal hygiene.

In particular, washing hands after going to the toilet or before eating. People with chronic liver disease. If you have a persistent (chronic) liver disease (for example, cirrhosis) it is suggested that you have the hepatitis A vaccine. Hepatitis A infection is not more common in those with chronic liver disease but, if infection does occur, it can cause a more serious illness. People exposed to hepatitis A at work. For example, laboratory workers who are exposed to hepatitis A during their work and sewage workers are advised to be immunized against hepatitis A. Staff of some large residential institutions. Outbreaks of hepatitis A have been associated with large residential institutions for people with learning difficulties, where standards of personal hygiene among clients or patients may be poor. Therefore, immunisation of staff and residents of some institutions may be recommended. Injecting drug users who share drug injecting equipment are also thought to have an increased risk of hepatitis A infection and so should consider immunisation. People with certain blood clotting problems (such as haemophilia) who need to receive blood clotting factors, may have an increased risk of hepatitis A infection. This is because the hepatitis A virus may not be completely destroyed during the preparation of these blood products. Immunisation is therefore suggested for these people. Men who have sex with men , and other people whose sexual practices involve oral-anal contact, may also like to consider immunisation against hepatitis A.

Note: if you have been infected with hepatitis A in the past, you should be immune to further infection and therefore not need immunisation. A blood test can detect antibodies to check if you are already immune.

This may be worthwhile doing if you have had a history of yellowing of your skin and the whites of your eyes (jaundice) or come from an area where hepatitis A is common.

Hepatitis A vaccine.

There are a number of different hepatitis A vaccines available. There are also some combined vaccines for both hepatitis A and hepatitis B and also hepatitis A and typhoid fever. A combined vaccine may be useful if you require protection against both diseases. The hepatitis A single vaccine is given as two doses. The first dose of the vaccine protects against hepatitis A for about one year. The vaccine causes your body to make antibodies against the virus. These antibodies protect you from illness should you become infected with this virus. Ideally, you should have an injection at least two weeks before travel to allow immunity to develop. However, the vaccine may still be advised even if there is less than two weeks before you travel.

A second dose of the vaccine, 6-12 months after the first gives protection for about 20 years. If you are late with this second dose, you should have it as soon as possible but you don't need to start with the first dose again. Another booster dose of hepatitis A vaccine after 20 years can be given to those people still at risk of infection. The doses of the combined vaccines against both hepatitis A and hepatitis B or hepatitis A and typhoid may need to be given at slightly different time intervals.

Are there any side-effects from the vaccine?

Some people develop a temporary soreness and redness at the injection site. Much less common are:

ü  A mild raised temperature (fever).

ü  Tiredness.

ü  Headaches.

ü  Feeling sick (nauseated).

ü  Feeling off your food for a few days.

Severe reactions are extremely rare.

Who should not receive hepatitis A vaccine?

There are a very few situations where the hepatitis A vaccine is not recommended. They include:

If you have an illness causing a high temperature. In this situation, it is best to postpone immunisation until after you have fully recovered from the illness. If you have had an allergic reaction to the vaccine or to any of its components in the past. One type of vaccine (Epaxal®) should not be given to anyone who is known to be allergic to eggs. Children under the age of 1 year. However, the risk of hepatitis A in children under the age of 1 year is very low. The hepatitis A vaccine is not licensed for this age group. The vaccine may be given if you are pregnant or breast-feeding and immunisation against hepatitis A is thought to be necessary.

Other points Remember; immunisation for travellers is only one aspect of preventing illness. No immunization is 100% effective. So when travelling to at-risk areas, you should have very good personal hygiene and also be careful about what you eat and drink. You should avoid eating and drinking the following when travelling to areas where the risk of hepatitis A is higher:

Raw or inadequately cooked shellfish, Raw salads and vegetables that may have been washed in unclean (contaminated) water. (Wash fruit and vegetables in safe water and peel them yourself.) Other foods that may have been grown close to the ground, such as strawberries. Untreated drinking water, including ice cubes made from untreated water. (Remember also to use only treated or bottled water when brushing your teeth.) Unpasteurised milk, cheese, ice cream and other dairy products.

Also, be careful when buying food from street traders. Make sure that food has been recently prepared and that it is served hot and on clean serving plates. Food that has been left out at room temperature (for example, for a buffet) or food that may have been exposed to flies could also pose a risk.

Hepatitis B

Hepatitis B is a serious disease that affects the liver. It is caused by the hepatitis B virus. Hepatitis B can cause mild illness lasting a few weeks, or it can lead to a serious, lifelong illness. Hepatitis B virus infection can be either acute or chronic. Acute hepatitis B virus infection is ashort-term illness that occurs within the first 6 months after someone is exposed to the hepatitis B virus. This can lead to: fever, fatigue, loss of appetite, nausea, and/or vomiting jaundice (yellow skin or eyes, dark urine, clay-colored bowel movements) pain in muscles, joints, and stomach Chronic hepatitis B virus infection is a long-term illness that occurs when the hepatitis B virus remains in a person's body. Most people who go on to develop chronic hepatitis B do not have symptoms, but it is still very serious and can lead to: liver damage (cirrhosis) liver cancer death Chronically-infected people can spread hepatitis B virus to others, even if they do not feel or look sick themselves.

How Hepatitis B is been spread

Hepatitis B is spread when blood, semen, or other body fluid infected with the Hepatitis B virus enters the body of a person who is not infected. People can become infected with the virus through Sharing items such as razors or toothbrushes with an infected person, Contact with the blood or open sores of an infected person, Sex with an infected partner.

Hepatitis B virus (HBV) can also be transmitted through exposure to infective blood, semen, and other body fluids. HBV can be transmitted from infected mothers to infants at the time of birth or from family member to infant in early childhood. Transmission may also occur through transfusions of HBV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. HBV also poses a risk to healthcare workers who sustain accidental needle stick injuries while caring for infected-HBV patients. Safe and effective vaccines are available to prevent HBV.

Hepatitis B vaccine.

What You Need to Know Why get vaccinated?

Hepatitis B vaccine can prevent hepatitis B and its consequences, including liver cancer and cirrhosis.

Hepatitis B vaccine is made from parts of the hepatitis B virus. It cannot cause hepatitis B infection. The vaccine is usually given as 3 or 4 shots over a 6-month period. Infants should get their first dose of hepatitis B vaccine at birth and will usually complete the series at 6 months of age. All children and adolescents younger than 19 years of age who have not yet gotten the vaccine should also be vaccinated. Hepatitis B vaccine is recommended for unvaccinated adults who are at risk for hepatitis B virus infection, including:

People whose sex partners have hepatitis B.

Sexually active persons who are not in a long-term monogamous relationship Persons seeking evaluation or treatment for a sexually transmitted disease Men who have sexual contact with other men People who share needles, syringes, or other drug-injection equipment People who have household contact with someone infected with the hepatitis B virus.

Health care and public safety workers at risk for exposure to blood or body fluids Residents and staff of facilities for developmentally disabled persons.

Persons in correctional facilities. Victims of sexual assault or abuse Travelers to regions with increased rates of hepatitis B People with chronic liver disease, kidney disease, HIV infection, or diabetes Anyone who wants to be protected from hepatitis B There are no known risks to getting hepatitis B vaccine at the same time as other vaccines. Some people should not get this vaccine Tell the person who is giving the vaccine:

If the person getting the vaccine has any severe, life-threatening allergies. If you ever had a life-threatening allergic reaction after a dose of hepatitis B vaccine, or have a severe allergy to any part of this vaccine, you may be advised not to get vaccinated. Ask your health care provider if you want information about vaccine components. If the person getting the vaccine is not feeling well. If you have a mild illness, such as a cold, you can probably get the vaccine today. If you are moderately or severely ill, you should probably wait until you recover.

Risks of a vaccine reaction with any medicine, including vaccines, there is a chance of side effects. These are usually mild and go away on their own, but serious reactions are also possible. Most people who get hepatitis B vaccine do not have any problems with it. Minor problems following hepatitis B vaccine include:

Soreness where the shot was given temperature of 99.9°F or higher If these problems occur, they usually begin soon after the shot and last 1 or 2 days. Other problems that could happen after this vaccine: People sometimes faint after a medical procedure, including vaccination. Sitting or lying down for about 15 minutes can help prevent fainting and injuries caused by a fall. Tell your provider if you feel dizzy, or have vision changes or ringing in the ears.

Some people get shoulder pain that can be more severe and longer-lasting than the more routine soreness that can follow injections. This happens very rarely.

Any medication can cause a severe allergic reaction. Suchm reactions from a vaccine are very rare, estimated at about 1 in a million doses, and would happen within a few minutes to a few hours after the vaccination. As with any medicine, there is a very remote chance of a vaccine causing a serious injury or death. The safety of vaccines is always being monitored. For more information, visit the vaccine safety site.

What if there is a serious problem?

What should I look for?

Look for anything that concerns you, such as signs of a severe allergic reaction, very high fever, or unusual behavior. Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness. These would usually start a few minutes to a few hours after the vaccination.

Hepatitis C

What is hepatitis C?

One virus that causes hepatitis C is called the hepatitis C virus (HCV).

Hepatitis C is also sometimes called 'hep C'. Hepatitis C was only discovered in the 1980s so it is still a relatively new disease; some aspects of this disease are still not completely understood. Hepatitis C is a virus which is carried in the bloodstream to the liver. It can then affect and damage your liver. However, this virus can also affect other parts of the body, including the digestive system, the immune system and the brain.

People with persistent infection remain free of symptoms, although others have symptoms. Persistent infection can lead to 'scarring' of the liver (cirrhosis) and may lead to liver cancer.

What does the liver do?

The liver is in the upper right part of the abdomen. It has many functions which include:

Storing fuel for the body (glycogen) which is made from sugar. When required, glycogen is broken down into glucose which is released into the bloodstream. Helping to process fats and proteins from digested food. Making proteins that are essential for blood to clot (clotting factors). Processing many medicines which you may take. Helping to remove or process alcohol, poisons and toxins from the body. Making bile which passes from the liver to the gut down the bile duct. Bile breaks down the fats in food so that they can be absorbed from the bowel.

How can you get hepatitis C?

The main source of infection is from blood from an infected person. Most cases are caused by using contaminated needles or injecting equipment (spoons, syringes, filters, water for injection, etc) to inject drugs ('sharing needles'). Even a tiny amount of an infected person's blood left on a needle is enough to cause spread to others. There is also a risk of contracting hepatitis C from needlestick accidents, or other injuries involving blood spillage from infected people. There is a small risk of contracting the virus from sharing toothbrushes, razors and other such items which may be contaminated with infected blood. (The virus can live outside the body, possibly for up to four days.) There is even a small risk from inhaling drugs like cocaine, as these can make the inside of your nose bleed. If that happens, tiny spots of blood can fall on to the note you are using and, if that is used by someone else, your blood can travel up their nose and into their bloodstream.

There is also a small risk from re- used equipment used for tattooing, body piercing, acupuncture, etc. There is a small risk that an infected mother can pass on the infection to her baby. There is a small risk that an infected person can pass on the virus whilst having sex. The virus is not passed on during normal social contact, such as holding hands, hugging, or sharing cups or crockery.

What are the symptoms and how does hepatitis C progress?

Many people with hepatitis C feel entirely well and have few or no symptoms. Any symptoms that may be present (see below) are often initially thought to be due to another illness. This may mean that hepatitis C may be diagnosed when you have had the virus for some time. Many people have hepatitis C without knowing it. It is helpful to think of two phases of infection with hepatitis C virus (HCV). An acute phase when you first become infected and a chronic (persistent) phase in people where the virus remains long-term.

Acute phase of hepatitis C

Acute means 'new' or 'for a short time'. This phase lasts for the first six months. When first infected with the virus, most people have no symptoms, or only mild ones. If symptoms do occur, they develop about 7-8 weeks after being exposed to the virus and may include feeling sick (nausea), being sick (vomiting) and feeling generally unwell. Some people go 'yellow' (become jaundiced). This is due to a build-up of the chemical bilirubin which is made in the liver and spills into the blood in some liver conditions. It is unusual to get severe symptoms. Following the initial infection:

In about 1 in 5 cases the virus is cleared from the body by the immune system within 2-6 months. If this happens then you will have no long-term effects from the virus. Younger people and women are more likely to clear the virus in this way. In about 4 in 5 cases, the virus remains active in the liver and bloodstream long-term. This is called chronic infection with hepatitis C.

Chronic  hepatitis C.

Chronic phase of hepatitis C When infection with hepatitis C lasts for longer than six months, it is known as chronic hepatitis C infection. The course of the chronic infection varies considerably between people and it is very unpredictable. Of those people who develop chronic infection: Some people have mild or no symptoms. However, even if you have no symptoms, you can still pass on HCV to others who may develop problems. Some people develop some symptoms due to persistent inflammation of the liver. For example, feeling sick, lack of appetite, intolerance of alcohol, pains over the liver, jaundice and depression. The most common symptoms of chronic hepatitis C are extreme tiredness, poor concentration and memory problems, and muscle and joint aches. There is actually no relationship between the severity of symptoms and the degree of liver damage. This means that some people can have liver inflammation without having any symptoms. About one third of people with chronic hepatitis C infection develop cirrhosis over a period of about 20-30 years. Cirrhosis is like a 'scarring' of the liver, which can cause serious problems and 'liver failure' when it is severe.

Some people with chronic hepatitis C have no symptoms for many years until they develop cirrhosis. Only when the liver starts to fail with cirrhosis do symptoms appear. A small number of people who develop cirrhosis go on to develop liver cancer.

How is hepatitis C diagnosed?

A simple blood test can detect antibodies to the hepatitis C virus (HCV) in your blood. (Antibodies are proteins made by the immune system to attack germs such as viruses, bacteria, etc.) A positive test means that you have at some stage been infected with hepatitis C. However, this test remains positive even in people who have cleared the virus from their body. (The antibodies remain even if the virus has gone.) Also, it can take up to six months for the antibody test to become positive after a person has first been infected, as the body may take a while to make these antibodies. So, a negative test does not necessarily rule out a recently acquired infection. A repeat test in a few months may be advised in some people who have recently been at risk of catching hepatitis C. If the antibody test is positive then a further blood test is needed to see if the virus is still present. This is called a PCR test. This is a more specialised test which detects particles of the virus. Tests may also be done to find exactly which type of HCV you are infected with. Assessing the severity of the infection If you are found to have virus present then other tests may be advised to check on the extent of inflammation or damage to the liver. For example:

Blood tests called liver function tests. These measures the activity of chemicals (enzymes) and other substances made in the liver.

This gives a general guide as to whether the liver is inflamed and how well it is working. See separate leaflet called Liver function tests.

An ultrasound scans of the liver. Other tests may be done if cirrhosis or other complications develop. There are other specialised blood tests being developed which assess the development and severity of cirrhosis. A small sample of the liver taken to look at under the microscope (a liver biopsy) used to be recommended before considering treatment. However, this is no longer routine prior to treatment.

How can I prevent passing on the virus to others?

If you have a current hepatitis C infection you should:

Not share any injecting equipment such as needles, syringes, etc.

Not donate blood or carry a donor, card.

Not share razors, toothbrushes or anything else that may possibly be contaminated with blood.

Use condoms when having sex.

The risk of passing on hepatitis C virus (HCV) during sex is small but risk is reduced even further by using condoms. However, your partner in a regular faithful relationship may accept the small risk of having sex without condoms. There is currently no vaccine available to protect against hepatitis C.

What is the treatment of hepatitis C?

The treatment of hepatitis C has advanced in recent years which has greatly improved the outlook for people with hepatitis C. The mai aim of treatment is to clear the hepatitis C virus (HCV) from the body and so prevent severe liver damage leading to cirrhosis. As the damage caused by the hepatitis C is usually very gradual, the time at which people with hepatitis C start treatment varies between cases. Your specialist will be able to discuss with you in detail the most appropriate time for you to start treatment. The usual treatment is a combination of two different medicines called pegylated interferon and ribavirin. Overall, this treatment can clear the virus ('cure') in over half of all cases.

However, the outlook does vary depending on the type (genotype) of the virus. The treatment clears the virus in almost half of those infected with genotype 1 but clears the virus in about 4 in 5 people infected with genotype 2 or 3. Pegylated interferon is also known as peginterferon. It is a form of a medicine called interferon which is similar to a substance produced in your body, also called interferon. It helps your body get rid of HCV. This may stop the virus damaging your liver. This is usually given as one injection each week. Ribavirin is a medicine that fights viruses. It is given in combination with pegylated interferon and is taken each day as a tablet or as a liquid. A course of treatment lasts 6-12 months, depending upon your type of hepatitis C. It takes about 12 weeks to tell if this treatment is working. You will usually have a blood test about 12 weeks after you start the medicines, to see if the amount of virus in your body has reduced. If so, then with the full course of treatment you have a good chance of completely clearing the virus from your body.

Other medicines such as boceprevirand telaprevir may be given in some cases. These are newer medicines that work by preventing HCV from reproducing in the body. They are both given as tablets. Side-effects from these treatments can occur which may include tiredness, feeling sick (nausea), headaches, and depression. Some people need to change their treatment, or take a lower strength, if they have troublesome side-effects. Sofosbuvir, simeprevir and daclatasvir are also medicines that may be used to treat some people with hepatitis C.

Liver transplant for some people with advanced 'scarring' of the liver (cirrhosis), liver transplantation may be an option. Although this is a major operation, the outlook following a liver transplant can be very good.

Hepatitis D

Hepatitis D virus (HDV) infections occur only in those who are infected with HBV. The dual infection of HDV and HBV can result in a more serious disease and worse outcome. Hepatitis B vaccines provide protection from HDV infection.

Hepatitis E

Hepatitis E virus (HEV) is mostly transmitted through consumption of contaminated water or food. HEV is a common cause of hepatitis outbreaks in developing parts of the world and is increasingly recognized as an important cause of disease in developed countries. Safe and effective vaccines to prevent HEV infection have been developed but are not widely available.