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Cause:
Hepatitis D virus and hepatitis E virus.
Hepatitis D virus infection always
occurs with hepatitis B infection, either with a chronic
hepatitis B infection (superinfection) or as two
simultaneous new infections (coinfection).
Illness and treatment:
Hepatitis D and E typically have abrupt onset of
fever, nausea, and abdominal
pain followed by jaundice.
Hepatitis D may progress to chronic hepatitis.
Sources:
Humans are the reservoir for
hepatitis D, which is usually
transmitted by contact with blood or body fluids,
particularly sharing drug paraphernalia. Humans and animals
(swine) are the reservoir for hepatitis E which is
transmitted most commonly through fecally
contaminated food, water, and environment.
Additional risks:
Pregnant women have higher risk for hepatitis E
complications. Japan has reported more virulent hepatitis E
strains.
Prevention:
To avoid simultaneous
hepatitis B infection, immunize all children and any adults
with risks for exposure. Use safe sexual practices, avoid
sharing drug paraphernalia, and screen blood and tissue
products to prevent hepatitis D transmission. Use
precautions while traveling to ensure safe food and water to
avoid hepatitis E infection.
Recent Washington trends:
Reports are rare. Cases of hepatitis D are typically
associated with injection drug use. Cases of hepatitis E are
typically travel associated.
2008:
Three cases of hepatitis D were reported.
Purpose of Reporting and
Surveillance
- To better characterize the epidemiology of infectious
hepatitis not due to hepatitis A, B, or C viruses.
- To recommend appropriate preventive measures, including
immunization against other types of hepatitis which are
vaccine-preventable.
Legal Reporting Requirements
-
Health care providers:
notifiable to local health jurisdiction within 3 work
days
-
Hospitals: notifiable to local
health jurisdiction within 3 work days
-
Laboratories: no requirements
for reporting
-
Local health jurisdictions:
notifiable to Washington State Department of Health (DOH)
Communicable Disease Epidemiology Section (CDES) within
7 days of case investigation completion or summary
information required within 21 days
Last
update
November 2009 |
