Reporting
In
the United States, case reports of viral hepatitis are classified
as hepatitis A, hepatitis B, or hepatitis C/non-A, non-B hepatitis.
Serologic testing is necessary to determine the etiology of viral
hepatitis and case reports should be based on laboratory confirmation.
Each state and territory has regulations and/or laws governing
the reporting of diseases and conditions of public health importance.
There
are two national reporting systems for acute viral hepatitis,
the National Notifiable Disease Surveillance System (NNDSS) and
the Viral Hepatitis Surveillance Program (VHSP).
National
Notifiable Disease Surveillance System
Case
reports of acute hepatitis A and other diseases are transmitted
by the state health department weekly to the Centers for Disease
Control (CDC) via the National Electronic Telecommunications System
for Surveillance (NETSS) and include basic demographic information
(excluding personal identifiers) age, race/ethnicity, sex, date of onset, date of report,
county of residence. It is important to ensure that all acute
case reports have a discrete date of onset of illness, clinical
evidence of hepatitis (jaundice or elevated serum aminotransferase
levels), and appropriate serologic test results before transmission
to CDC by the state health department.
Top
of Page
Viral
Hepatitis Surveillance Program
The
VHSP, in addition to collecting basic demographic information,
also collects serologic and risk factor data on cases. The case investigation worksheet and form should
be filled out forallNNDSS case-reports of acute
hepatitis A. VHSP
forms can be obtained from the state health department or the
Hepatitis Branch, Centers for Disease Control. VHSP case investigations should be conducted within 2 weeks
from the date of onset of illness so appropriate prophylaxis can
be given to household and sexual contacts. VHSP forms should be sent to the Hepatitis Branch, CDC,
by the state health department within 1 month of the date of the
report, or as indicated in your state. In many states, VHSP data can be entered on supplemental
screens in NETSS and transmitted electronically to CDC.
Top
of Page
Information
to collect
The
following information is epidemiologically important to collect
in a case investigation. Additional information may also be collected at the direction
of the state health department.
Demographic
information
- Clinical
details including
- Date onset of illness
- Symptoms including pain, jaundice
- Laboratory
results
- Vaccination
status
- Risk
factors
- Contact
investigation and prophylaxis
Top
of Page
Adverse
reactions to vaccination
Since
1995 there have been over 7 million doses of hepatitis A vaccine
administered in the United States. No reported serious adverse reaction has been reported
within 6 weeks of receiving the injection. The most common reaction
is injection site pain, swelling, or erythema and these are generally
mild and self-limited. Malaise, fatigue, and low-grade fever have
been reported in less than 10% of persons following injection.
The
safety of vaccination during pregnancy has not been determined,
however, because it is an inactivated vaccine the risk to the
fetus is considered low.
The
deltoid or gluteal muscle should be used as the site of the injection.
A single intramuscular dose of 0.02 mL/kg of IG confers protection
for less than 3 months and a 0.06 mL/kg dose protects for 5 months.
IG should be given to exposed persons who have not previously
received the vaccine as soon as possible but not more than two
weeks after the exposure. IG can interfere with the response to live injected vaccines
so these vaccinations should be delayed for at least three months
after the administration of IG.
Top
of Page
Vaccine
Storage
The
hepatitis A vaccine should be shipped and stored at temperatures
ranging from 35.6 degrees Fahrenheit to 46.4 degrees Fahrenheit
and should not be frozen. Reactogenicity and immunogenicity are
not altered by storage for one week at 98.6 degrees Fahrenheit.
Top
of Page
Home
 
|
