Wednesday, August 8, 2012

Prevalence of Hep A in Brazil

English: Geographic distribution of Hepatitis A prevalence (Anti-HAV-Antibody), 2005
   High : prevalence higher than 8%
   Intermediate : between 2% and 7%
   Low : less than 2%
Deutsch: Weltweite Prävalenz der Hepatitis A (anhand der Anti-HAV-Antikörper), 2005
   Hoch : Prävalenz höher als 8%
   Mittel : zwischen 2% und 7%
   Niedrig : weniger als 2%
Français : Répartition géographique de l'hépatite A, 2005
   Haute : prévalence supérieure à 8%
   Moyenne : entre 2% et 7%
   Basse : inférieure à 2%

This is a map of the prevalence of Hepatitis A in the world.  The highest rates are in maroon.

As you can see Hepatitis A has mostly been eradicated in all 1st world countries, they are colored grey.

Hepatitis A is an acute infectious disease of the liver that is usually spread by the fecal oral route; transmitted person to person by ingestion of contaminated food or water or through direct contact with a person infected.   (Restaurant workers that do not wash their hands well after going to the bathroom).

In a lot of developing countries with poor sanitation its most prevalent-  i.e poo bins

Makes you wonder why Brazil still does not have adequate plumbing in public restrooms to ensure peoples disgusting bodily fluids and fecal matter get flushed down the toilet.  They have trash receptacles that you put your soiled tissue into.  You could call them shit bins.  I wonder which parts of the country are still doing this so I can up my daily dose of xanax medication when I get there.   I know Rio does.  So hypothetically if you go to the bathroom then wipe yourself (especially if you have been drinking) and drop a tissue in the bin and your hand accidentally scrapes up against another person's toilet tissue that has contaminated fecal matter on it?  And lets assume that you are smart enough to REALLY REALLY wash your hands.  Not just wet and go.  I  mean a good down-home LATHER, I mean get the clorox bleach out.  And lets assume that it (the shit) may not all get washed off or that you missed a spot its not an exact science after all.  Then if you eat afterward or somehow your hand comes in contact with your mouth you could possibly get Hep A.  And lets face it some people don't even wash their hands.  Come to think of it this would be a good anti drinking and anti restaurant ad.  The "NO drinking" for the part where your out having a few drinks and you catch a nice buzz and all your worries are drifting away with the nice cool Brazilian breeze and your swaying side to side as your making your way to the next  bar when you realize shit! I need to take a p*ss and you make your way to one of the many public bathrooms in Brazil.  You can hardly see straight and the toilet looks like its moving in front of you, but somehow your not going to touch the huge pile of white fluffy tissue that is teetering on a mound of more white tissue all covered in someone's SHIT............ well you get my drift.   I mean looking at that map and the numbers what do you think the percentages are for restaurant workers who make and deliver your food having Hep A?  Pretty good right?   So to be safe you should probably assume everyone has it.  That's not too relaxing when your out spending you hard earned money on some Brazilian shindig  at your local restaurant.  Soon you'll be missing "The Outback" back in the States and biting your tongue.   Also think about young children who don't yet understand good hygiene habits.  I would not let them go the bathroom anywhere public where this goes on.  I'll let you imagination run wild from here if your not ready to hurl your lunch in a the nearest toilet.

Vigilance is key here!

Side note --These stats are from 2005 and there are some regions of Brazil where the rate will be higher and some regions where the rate will be lower.  And obviously not everyone has Hepatitis A.


  1. Since you know to wash your hands, I think you'll be OK. Brazil isn't the same 3rd world shit hole you think it is. There are good qualities about it, believe it or not.

    I really think you should reconsider your move there, because with the type of outlook you have on it, before even going there, you're going to have an almost impossible time actually liking it.

    1. I don't think Brazil is a shithole, I know Brazil is not all 3rd world but parts of it is. Its not that I have a totally negative view of Brazil either. I just have issues with certain things like toilets that you can't flush toilet paper down. And believe me if their are things in the US that I don't like I will state it.

      I'm just very opinionated and honestly spoiled. When you grow up where I grew up although its not perfect. You just get used to things a certain. My husband says most Americans are spoiled and I agree with him.

  2. I'd say Wikipedia needs to be updated on that one (their data is seven years old). A quick Google search will show you a more recent study that found lower numbers country-wide:

    More importantly, there are major differences between regions (as in any large country) with the South, for example, registering a much more reasonable 2.4%.

  3. According to the World Health Organization with current statistics Brazil still has a high incidence of Hep A, and B. It is still recommended vaccinations.

    1. By all means, take all the shots you think are necessary. No reasonable person would advocate the opposite. The improved statistics are just additional good news, right?

  4. ....I live in the US and I have Hepatitis Vaccinations...

  5. I really don't know what you are trying to inform (or just denegrate Brazilians) people with this old map with information that doesn't make too much sense and it is not even updated. Andrews is right, the country is too big and you can't trow everyone in the same bucket, is like trying to put people from Mississipi and Massachusetts in the same bucket, you just can't, completely different cultures and realities.
    This is how your post sounded to me: "Brazil is full of shit, EVERYWHERE, shit falls from the trees and you get HEP A by breathing the air!! Run for the hills and get your vaccinations while you are at it!!
    Nothing could be further from the truth, actually when it comes to SHIT, Brazilians are way cleaner than any other people I know. We use bidets, an invention most Americans ignore, completely. Which means, in case you are not aware, we wash our behinds with plenty of running water and soap. You just try to tell a Brazilian you have no bidet, and they will be horrified.
    We live in Rhode Island and have bidets in our bathrooms, yes, our little Cape has bidets.
    The old urban myth of the dirty toilet paper in baskets are a thing of a distant past, or like I said, very poor people, people of a very humble origin or people who still use septic tanks in rural areas.
    If you went to a "RESTAURANT" where people throw dirty toilet paper in a basket, you were in the wrong side of town, I wouldn't be eating in such place either.
    I was born and raised in Brazil and never saw a public restroom with baskets for dirty toilet paper, ever, not in a Mall, not in a School, not in a bus station, Aiport or restaurant or anywhere, EVER, EVAH!!
    There is nothing wrong with the plumbing systems in Brazil by the way.
    In Sao Paulo, only VERY POOR places like favelas or poor rural areas still hold on to the old folcloric habit of throwing dirty toilet paper in a basket to avoid clogging the plumbing.
    Back in the 1950's, most affordable brands of toilet paper were really thick and didn't disolve well in the water, so to avoid clogs, some people, usually very poor people who couldn't affort the better, finer brands of toilet paper had to use those awful little baskets, apparently some stuck with the habit and these are probably the ones (one) who traumatized you.
    I trust the water in Brazil even more so than I trust the water in the US.
    We live in Rhode Island and we have "Water Boil Alerts" all the time. We only drink and cook with "Monadock Spring Water" we buy from Sam's Club.
    In Brazil, we always used tap water, which is of very high quality by the way, it is ludicrous to imply that Brazil is a 3rd world country and you run the risk of HEP A infection from the food and or water.
    I trust the water and the food more in Brazil than I ever will in the US.
    We always hear of all sorts of contamination in the food chain in the US, contaminated beef, spinach, tomatoes, you name it, e-coli and other horrible diseases.
    I am not saying the US is worse than Brazil, but the challenges in the food supply in the US are far greater and we see more problems often.
    You are too scared for absolutely no reason what so ever, and I would like to suggest you look at more positive things about Brazil than to be searching for world map with incidence of diseases.
    There are a lot of good and positive things to look up when moving to Brazil, and incidence of Hep A in poor areas is not one of them.
    I wish you all the best on your move and hope you can focus on more positive stuff.



    1. Hi Ray, I disagree with your ascertain that baskets with poo paper are solely a pursuit of the impoverished. The recent middle class may have big TVs bought on HP, but old habits die hard.

    2. Pernambuco Gyspy,

      That might well be the case in Pernambuco, I am not familiar with that part of Brazil, but absolutely not the same reality in the South of Brazil, much less Sao Paulo, just unheard of...


  6. LOL! Are you serious how did you get shit is falling from the trees from me talking about restaurants and public restrooms? I just stated that the numbers are high. Look I understand some people are getting offended, but honestly I just write what I feel. What bothers me, what causes me anxieties, and shit bins next to the toilets bother me. Its my experience moving from America to Brazil and some things I will not like and I will criticize and write it. Does that mean Brazilians are bad people NO. Does that mean I think the whole country is a dump NO I don't. But to state that the water systems are totally fine in Brazil is ludicrous. People do have issues with sanitation in Brazil and their are parts that are 3rd world. That is a fact. If I state well known facts whether some of the info is a little outdated by a few points and well we're splitting hairs at that point and it offends I'm sorry. But the fact remains they have higher rates of Hep A and B compared to other countries. I looked up recent info with the World Health Organization and they update their statistics every year and Brazil has a moderate to high rate of Hep A. How am I going to differentiate between regions and why am I going to bother? How is that going to help protect me?

    All I am stating is that if the country has a high rate of Hep A in certain regions then you do have more of a risk of contracting it through some sort of contamination. Am I going to live in a plastic bubble well I will try not to but I'm not going to bury my head in the sand either and pretend that everything is hunky dory.

    And thank god you have stated that you have never seen a shit bin, I LOVE it that you have never seen one. Because honestly that is the last thing I want to see. But I have heard they exist. So for me they way my mind works well you get the picture.

    I have also noted that a lot of people have no problem criticising the US in fact ripping them apart and yet its totally unacceptable to criticize Brazil why do they get special protections?

    I will be a person that lives in both countries and I will write things I do not like about the US as well for example anyone voting for Mitt Romney wink! wink! (hope that's not you).

    For me its "carte blache", no restrictions. I like taboo subjects I not into vanilla. Again I'm sorry if I offended you. But I have to say I love your feisty attitude :)

  7. No need to appologize, you did not offend me.
    Ha, Mitt Romney, hell no! I live in Rhode Island, if I dared to vote Republican, my neighbors would get together and burn me and my husband in a big pit fire, just like they did with the witches around here a couple centuries ago, ok, it was 40 miles to the north, around Salem, but you get my drift. Long story short, gay couple here, HUGE Obama fans, and blue in the face liberals ;)
    I really don't get offended easy, trust me, but my point is not "WHAT" you said about Brazil, but that your impression of the whole (SHIT) subject is an exaggerated distortion of the truth :)
    We will revisit this conversation in a few years and will have some good laughs about it, I guarantee you.
    Listen, if we start looking for stuff on the Internet, we can find for example that HEP E is very bad in the US, it is actually endemic and as bad or worse than Brazil for example.
    I assure you, if you are not moving to a FAVELA, there is absolutely nothing to worry about regarding HEP A.
    And again, there is nothing wrong with plumbing systems in Brazil, the problem is that some people in rural areas or favelas can't use any kind of toilet paper of they will have problems, just like we have problems in the US if you use the wrong toilet paper with your Septic System.
    Brazilian restaurants are the cleanest of any country I have ever visited, there is ABSOLUTELY NO ISSUES WITH WATER in Brazil, NONE what so ever, or food for that matter.
    In Sao Paulo and many parts of Brazil, we have a law that forces restaurants to open their kitchens to visitors at any time for inspections, without any previous notice, so they are forced to keep it ultra clean all the time. You should know that and you can always ask to take a look in the kitchen of any restaurants. Many have built glass walls so people can see the entire kitchen without having to walk in and disturb the work flow.
    You will be safer eating food in a Brazilian restaurant, principally Sao Paulo or any other big city than you have ever been eating at any restaurant in the US.
    I am the first one to criticize Brazil, but I do not sit in silence when I see distortions about the truth, and it happens all the time.
    So, I am glad you didn't take my "feisty" comment the wrong way... :)



  8. Hi Jennifer! I'm sorry if it sounds like I'm being all wannabe-psychoanalyst here, but I think your blog speaks volumes about you. Have you actually moved to Brazil yet? The title of your blog makes it sound like you want to go home already! "I am married to a Brazilian which is pretty adventurous in itself?" - seriously? Ha ha - when you meet people from out of town, do you find yourself saying things like "they're not from 'round heeere"? ;)

    Even the background you have chosen is grey and rainy, full of doom and gloom! You really don't sound like you want to go. "It's too late to look back now"? If you go somewhere determined to hate it, you will!

  9. :) Actually that is partly the point of my blog right now. The metamorphosis and the documentation of the transition (the changes). Like an open diary. I'm conflicted on the one hand I want to go to Brazil because I might actually have a better quality of life. My priorities have changed over the years and I want to explore that. And on the other hand part of me doesn't want to go. Plus the most important fact is I'm married to a Brazilian man and have a beautiful 8 mos old daughter with him, and he has dreams, and Brazil might make them come true. I'm a conundrum. But this blog is not just about moving to Brazil is about anything that my anxieties bring forth, its a venting place. Its a place for ideas and inspiration as well.

  10. Fair enough :) I can understand you feeling daunted - it'll be a big change for sure. I know I certainly haven't found it easy all the time. I hope you can find a way of life here that makes you happy. For all the things that seem negative/unsettling, there are many amazing, wonderful, positive things in Brazil. If you can keep an open mind and give it a chance you may find you love it here! :)

  11. Well, I got my Hep A Vaccine a long time ago. People need to relax a bit. An easily prevented disease, but even my husband (a Brazilian) has never been vaccinated for it. Hell the Travel Medicine Doctor at the Mayo Clinic recommended I get the vaccine for a cruise I went on 3 years ago. I'm sorry, but I don't get the big deal. I was a nurses kid. Heavy vaccinate for preventable diseases. I actually think you would be stupid (sorry for the strong language) if you didn't worry about things like Hep A, Hep B and Etc.

    And I rarely use Public restroom except at the Mall or a fancy restaurant. The first time I had to go to the bathroom in public was pretty much the last time. Water was all over the floor and the shit can was over flowing. No Soap and no Paper towels. Sounds like Hep A Paradise to me. Not Everyone who moves to Brazil lives it the luxurious South! Hell, I live in Fortaleza. It's not necessarily nowhere.