Hepatitis Remains a Major Health Threat in Sabah

KUALA LUMPUR, JULY 2026 – Hepatitis remains a major public health concern in Sabah despite advances in vaccination, screening and treatment, with health experts warning that many infections can remain undetected for years until serious liver damage develops.

The warning comes ahead of World Hepatitis Day on July 28, which carries the 2026 theme, “Hepatitis: Let’s Break It Down.” The campaign highlights the need to improve public understanding of viral hepatitis and remove barriers that prevent people from accessing testing, vaccination and treatment.

Global figures show that chronic hepatitis B and C caused approximately 1.3 million deaths worldwide in 2024, underlining the continuing impact of the disease despite the availability of preventive and medical interventions.

In Sabah, Ministry of Health data recorded 1,909 notified hepatitis B cases in 2024, an increase from 1,637 cases in 2023. The state’s incidence rate reached 51.01 cases per 100,000 people, more than double Malaysia’s national rate of 24.60 per 100,000.

Hepatitis refers to inflammation of the liver and can be caused by five main viruses: hepatitis A, B, C, D and E. Although they affect the same organ, the viruses differ in the way they spread, the illnesses they cause and the preventive measures available.

Hepatitis A is mainly transmitted through contaminated food or water and is often associated with poor hygiene and inadequate sanitation. Most patients recover completely because the infection does not usually become chronic, although severe cases can occasionally lead to liver failure.

Hepatitis B can spread from an infected mother to her baby during childbirth, as well as through infected blood, sexual contact and contaminated needles or sharp instruments. Hepatitis C is primarily spread through exposure to infected blood.

Unlike hepatitis A, hepatitis B and C can develop into chronic infections. Without early diagnosis and proper medical management, they may eventually cause liver scarring, cirrhosis and liver cancer.

Malaysia has provided universal hepatitis B immunisation for newborns since 1989. Babies born to mothers who test negative for hepatitis B should receive the first vaccine dose within 24 hours of birth.

When a mother tests positive, the newborn should receive both the hepatitis B vaccine and hepatitis B immunoglobulin within 12 hours. This early protection is critical because a baby infected around the time of birth faces an estimated 90 per cent risk of developing chronic hepatitis B.

Adults who were born before universal vaccination began, did not complete their vaccine series or remain uncertain about their vaccination status are advised to seek medical guidance.

Vaccination may still be recommended for susceptible adults, particularly healthcare workers, household members of people living with hepatitis B and individuals whose occupations or circumstances increase their exposure to blood and bodily fluids.

Talvinder Kaur Jeswant Singh, a lecturer at the Ministry of Health Training Institute in Kota Kinabalu, said hepatitis B vaccination is an important requirement for nursing and medical trainees before clinical placements because they may encounter blood, body fluids and sharp instruments during patient care.

She said protection should not be viewed as relevant only to healthcare trainees. Members of the public with incomplete vaccination, unknown vaccination status or recognised risk factors should seek advice on whether screening and vaccination are necessary rather than waiting for symptoms to appear.

Sabah has also faced a notable hepatitis A burden. By epidemiological week 39 of 2025, Malaysia had recorded 231 hepatitis A cases, with Sabah accounting for 122 cases, or 53 per cent of the national total—the highest number among all states.

Health authorities identified contaminated shellfish, poor sanitation and inadequate cooking as significant transmission risks in Sabah.

The public is therefore advised to cook seafood, especially shellfish, thoroughly, use safe water and practise proper hand hygiene when preparing or serving food.

Although a hepatitis A vaccine is available, it is not included in Malaysia’s routine National Immunisation Programme. It may be recommended for selected groups, including travellers to higher-risk areas, people with chronic liver disease and those with occupational exposure such as healthcare workers, laboratory personnel and food handlers.

Authorities also rely on public health and food safety laws to control outbreaks. Viral hepatitis is a notifiable infectious disease under the Prevention and Control of Infectious Diseases Act 1988, requiring diagnosed cases to be reported for surveillance and investigation.

When hepatitis A transmission is linked to food, authorities may also take action under the Food Act 1983 and Food Hygiene Regulations 2009, including inspecting premises and ordering the closure of unsanitary food businesses.

Experts warn that the absence of obvious symptoms does not mean a person is free from infection. Chronic hepatitis B and C may remain silent for many years, and patients may not develop visible signs such as yellowing of the eyes until liver damage has progressed.

There is currently no vaccine for hepatitis C, but modern direct-acting antiviral medicines can cure more than 95 per cent of infections. Hepatitis B can largely be prevented through vaccination, while chronic cases can be monitored and treated when medically necessary.