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Cause:
Hepatitis B virus.
Illness and treatment:
Acute infection may be asymptomatic or have abrupt
onset with fever, abdominal pain, and jaundice. Chronic
infection is typically asymptomatic until complications such
as liver damage or cancer occur; a specialist can determine treatment options.
Surface antigen positivity (contagious) during pregnancy
from acute or more typically chronic infection gives a risk of transmitting
the virus during delivery. Perinatal infection is typically asymptomatic
but carries a risk for chronic infection.
Sources:
Transmission is by contact with the blood, semen or vaginal secretions
of an infected person, and can occur with minor exposures.
Additional risks:
After acute infection, about 90% of infants and 30% of children under 5 years will
become chronically infected compared to about 5% of adults.
Prevention:
To prevent infection, immunize all children. Also immunize adults with risks for
exposure. Screen all pregnant women, infants born to infected mothers, household
contacts and sex partners of infected individuals to prevent transmission. Routine
testing is recommended for individuals born in Asia, Africa, and other geographical
regions with 2 percent or higher prevalence of chronic hepatitis B virus infections.
Use safe sexual practices, avoid sharing drug paraphernalia, and screen blood and tissue
products to prevent transmission.
Recent Washington trends:
Each year 60 to 100 cases of acute hepatitis B are reported. Acute cases declined
with increased vaccination. 1100 to 1400 cases of chronic hepatitis B are reported
annually with about one death a year due to fulminant infection. Current chronic
hepatitis reports are posted at:
http://www.doh.wa.gov/cfh/Hepatitis/surveillance/default.htm. About 380 hepatitis B
surface antigen positive pregnant women are reported each year with 2 to 6 cases of
perinatal hepatitis B virus infections.
2010:
50 acute cases (0.7 cases/100,000 population), 332 infants born to surface
antigen positive women and 3 perinatal infections were reported.
Purpose of Reporting and Surveillance
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To identify sources of infection and prevent further transmission from such sources
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To educate cases about transmission of hepatitis B and how to reduce the risk of
transmission
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To identify contacts and recommend appropriate preventive measures
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To better understand the epidemiology of hepatitis B virus infection and
the burden of morbidity from chronic infection
Legal Reporting Requirements
Acute Hepatitis B
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Health care providers:
notifiable to local health jurisdiction within 24 hours
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Health care facilities:
notifiable to local health jurisdiction within 24 hours
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Laboratories:
Hepatitis B virus (acute) by IgM positivity notifiable within 24 hours.
Specimen submission is on request only.
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Local health jurisdictions:
notifiable to Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE)
(206-418-5500) within 7 days of case investigation completion or summary information required
within 21 days.
Chronic Hepatitis B (initial diagnosis only)
Hepatitis B Surface Antigen Positive Pregnant Women (each pregnancy)
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Health care providers:
notifiable to local health jurisdiction within 3 business days
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Health care facilities:
notifiable to local health jurisdiction within 3 business days
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Laboratories:
detection of viral antigen, antibody or nucleic acid notifiable on a monthly basis
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Local health jurisdictions:
notifiable to Washington State Department of Health (DOH) Immunization Program (360-236-3595)
per the Perinatal Hepatitis B Prevention Program
Perinatal Hepatitis B
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Health care providers:
notifiable to local health jurisdiction within 3 business days of receiving confirming test result
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Health care facilities:
notifiable to local health jurisdiction within 3 business days of receiving test result
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Laboratories:
detection of viral antigen, antibody or nucleic acid notifiable on a monthly basis
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Local health jurisdictions:
notifiable to CDE (206-418-5500) and the Immunization Program
(360-236-3595) within 7 days of case investigation completion or summary information required within 21 days.
Last update
December 2011 |
