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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.
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 during pregnancy to identify infected
women. Use safe sexual practices, avoid sharing drug
paraphernalia, and screen blood and tissue products to
prevent transmission.
Recent Washington trends:
Around 60 to 100
cases of acute hepatitis B and 1,100 to 1,200 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/IDRH-Assessment/HepC.htm
Acute cases declined with
increased vaccination. About 380 hepatitis B surface antigen
positive pregnant women are reported each year with 2 to 6
cases of perinatal hepatitis B virus infections.
2008:
56 acute cases (0.9
cases/100,000 population), 360 infants born to surface
antigen positive women and no perinatal infections were
reported.
Purpose of Reporting and
Surveillance
- To identify sources of
infection and prevent further transmission from such sources
- To educate cases about
transmission of hepatitis B and how to reduce the risk of
transmission
- To identify contacts and
recommend appropriate preventive measures
-
To better understand the epidemiology of hepatitis B virus
infection and the burden of morbidity from chronic infection
Legal Reporting Requirements
1.
Acute Hepatitis B
a.
Health care providers:
notifiable to local health jurisdiction within 3 work days
b.
Hospitals: notifiable to
local health jurisdiction within 3 work days
c.
Laboratories: detection of
viral antigen, antibody or nucleic acid notifiable on a
monthly basis
d.
Local health jurisdictions:
notifiable to Washington State Department of Health (DOH)
Communicable Disease Epidemiology Section (CDES)
(206-418-5500) within 7 days of case investigation
completion or summary information required within 21 days
2.
Chronic Hepatitis B (initial diagnosis
only)
a.
Health care providers:
notifiable to local health jurisdiction within one month
b.
Hospitals: notifiable to
local health jurisdiction within one month
c.
Laboratories: detection of
viral antigen, antibody or nucleic acid notifiable on a
monthly basis
d.
Local health jurisdictions:
notifiable to Washington State Department of Health (DOH)
Infectious Disease and Reproductive Health (IDRH)
(866-917-4437) within 7 days of case investigation
completion or summary information required within 21 days
3.
Hepatitis B Surface Antigen Positive
Pregnant Women (each pregnancy)
a.
Health care providers:
notifiable to local health jurisdiction within 3 work days
b.
Hospitals: notifiable to
local health jurisdiction within 3 work days
c.
Laboratories: detection of
viral antigen, antibody or nucleic acid notifiable on a
monthly basis
d.
Local health jurisdictions:
notifiable to Washington State Department of Health (DOH)
Immunization Program (360-236-3595) per the Perinatal
Hepatitis B Prevention Program.
4.
Perinatal Hepatitis B
a.
Health care providers:
notifiable to local health jurisdiction within 3 work days
of receiving confirming test result
b.
Hospitals: notifiable to
local health jurisdiction within 3 work days of receiving
test result
c.
Laboratories: detection of
viral antigen, antibody or nucleic acid notifiable on a
monthly basis
d.
Local health jurisdictions:
notifiable to CDES (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
November 2009 |
