Hepatitis Surveillance

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About Viral Hepatitis

Hepatitis A is a vaccine preventable liver infection caused by the hepatitis A virus (HAV.) It is spread through the fecal-oral route when someone ingests the virus either through close personal or sexual contact with an infected person or through eating contaminated food or drink. Symptoms typically last less than 2 months. HAV does not cause chronic disease. HAV infection can be prevented with the HAV vaccine. Immune globulin can also provide protection against HAV shortly after exposure. According to the Centers for Disease Control and Prevention (CDC), in 2021 a total of 5,728 cases of hepatitis A were reported in the US, but due to underreporting, the actual number of cases is likely around 11,500. Since 2016, there have been hepatitis A outbreaks in multiple states caused by person-to-person spread primarily among adults who use drugs and experience homelessness.

Hepatitis B is a vaccine preventable liver infection caused by the hepatitis B virus (HBV). It can spread from an infected person to a non-infected person via blood, semen, or other bodily fluids. Acute infections can cause short-term illness within the first 6 months after exposure. For some, an acute infection can lead to a long-term chronic infection which can lead to serious, life-threatening health issues like liver cancer. The younger a person is when infected with HBV, the greater the chance of developing chronic infection. According to the CDC, in 2021 there were 14,229 newly reported cases of chronic hepatitis B nationwide. The CDC recommends that all adults 18 and older be tested for HBV at least once in their lifetime and all pregnant women during every pregnancy.

Hepatitis C is a liver infection caused by the hepatitis C virus (HCV). An estimated 2.4 million people in the US were living with hepatitis C during 2013–2016. HCV is spread when blood from an infected person enters the body of someone who is not infected. Today, most people become infected with HCV by sharing needles or other equipment used to prepare and inject drugs. For some people hepatitis C is an acute, short-term illness. However, more than half of people infected with HCV develop chronic illness that can lead to serious adverse health outcomes, including cirrhosis, liver cancer, and death. Over 90% of people infected with HCV can be cured with 8–12 weeks of oral therapy. The CDC recommends that all adults 18 and older be tested for HCV at least once in their lifetime and all pregnant women during every pregnancy.

Current Surveillance Practices

Northern Nevada Public Health (NNPH) Communicable Disease (CD) Program regularly conducts disease surveillance for viral hepatitis in Washoe County. The objectives of this surveillance are:

  • Identify new cases.
  • Estimate disease burden.
  • Characterize risk factors of infected persons.
  • Provide disease prevention education and refer infected persons and their contacts for medical follow-up, immunization, and/or post-exposure prophylaxis.
  • Provide healthcare providers and the public with local data to support hepatitis testing, treatment, and prevention services.

NNPH investigates all reports of acute viral hepatitis. Cases are interviewed by a member of the CD Program to learn their signs and symptoms, identify potential sources of exposure, identify contacts and refer them for testing or post-exposure prophylaxis, and provide recommendations for disease prevention and control. Due to resource constraints, cases of chronic hepatitis B and C are not routinely interviewed by NNPH. However, NNPH maintains laboratory-based surveillance for all reports of chronic viral hepatitis. These data are made available each year in NNPH's Annual Communicable Disease Report.

NNPH also conducts specialized surveillance for pregnant women infected with hepatitis B virus. For additional information about this program, please visit the Perinatal Hepatitis B Prevention Program webpage.

Disease Reporting

Hepatitis A, B, C, and D have been reportable conditions in Nevada since 1992 per Nevada Administrative Code 441A. Hepatitis E virus (HEV) was added as a reportable condition in 2011. Nevada healthcare providers and laboratories are required to report all cases of HAV, HBV, HCV, HDV, and HEV infections, whether acute or chronic, to their local health jurisdiction. Providers in Washoe County can report viral hepatitis infections to NNPH using the Nevada Communicable Disease Report Form.

Viral Hepatitis Data and Reports

NNPH's Annual Communicable Disease Report

United States Viral Hepatitis Surveillance

Recent Viral Hepatitis Editions of NNPH’s Epi News

Provider Guidance and Resources

CDC’s Professional Resources Webpage for HAV, HBV, and HCV (includes testing algorithms, fact sheets, and hepatitis serology training)

HBV Testing Guidance

HBV Vaccination and Treatment Guidance

HCV Surveillance

HCV Testing Guidance

HCV Treatment Guidance

Patient Education Materials

Hepatitis A

Hepatitis B

Hepatitis C

 

Last modified on 12/15/2023