Philadelphia Health Department Advisory – Viral Hepatitis

 We have just released a Health Advisory regarding enhanced surveillance for viral hepatitis. It is available from https://hip.phila.gov, is appended to this email and is attached as a PDF document. To read this attachment, you will need the Adobe Reader software, which can be downloaded at no cost from http://tinyurl.com/6ip.

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Health Advisory
Enhanced Surveillance for Viral Hepatitis Beginning in Philadelphia
May 6, 2013

The Philadelphia Department of Public Health (PDPH) has launched an enhanced viral hepatitis surveillance program.  The goal of this program is to better understand the burden of chronic hepatitis B and chronic hepatitis C and to estimate the level of clinical management for these diseases in Philadelphia. Surveillance information will be used to inform patient and provider educational efforts and identify additional areas for public health action.

PDPH investigators will contact providers and patients by telephone or in person to obtain clinical and risk factor information on positive hepatitis B virus (HBV) and hepatitis C virus (HCV) test reports received by PDPH. The investigations will be brief – less than 10 minutes for providers – and will provide valuable insights on Philadelphians living with chronic viral hepatitis.  PDPH thanks you and your office staff for cooperating with these efforts.

We urge you to incorporate the following into your routine practice:

1.Test individuals at risk for chronic HBV and/or HCV using the following CDC guidelines:
-Patients who test positive for HCV antibody should also be tested for HCV RNA. This distinguishes those who have an active HCV infection from those with past (inactive) infections (Please note: HCV RIBA tests are no longer recommended).
-Patients who test positive for HBV surface antigen should have a repeat test with HBV surface antigen, HBV DNA, and/or HBV envelope antigen no sooner than 6 months after the first test. This distinguishes persons who are chronically infected with HBV from persons who have resolved acute infection.
-All women should be screened for HBV surface antigen at the time of each pregnancy, regardless of whether they have previously had a positive or negative test result. This assists with timely provision of post-exposure prophylaxis to the infant at birth.  

2.Offer Hepatitis A and B vaccination to all susceptible (HBV core antibody-negative) HCV positive patients as well as susceptible household and sexual contacts of HBV infected individuals.

3.Ask all patients about risk factors for chronic viral hepatitis, according to CDC’s ‘Populations at Risk’:
-Hepatitis B: http://www.cdc.gov/hepatitis/HBV/HBVfaq.htm#b4
-Hepatitis C: http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm#c1

4.Test all people born between 1945 and 1965 (ie, “baby boomers”) for HCV, regardless of risk factors.

5.Educate all patients with current HBV or HCV infection about keeping their liver healthy by avoiding alcohol and tobacco, and maintaining a healthy diet.

Please continue reporting all positive viral hepatitis test results for Philadelphia residents to PDPH within five days of receiving the results, by fax to 215-685-6947. For additional information about this project, please call the Hepatitis Epidemiology Program at 215-685-6493. To obtain resources and linkage to care information for patients with viral hepatitis in Philadelphia, please contact The Viral Hepatitis Prevention Program at 215-685-6462.

Pennsylvania Code § 27 and Philadelphia Health Code § 6-202-mandate reporting of all positive HBV and HCV test results for Philadelphia residents to PDPH. These Health Codes also give PDPH the authority to investigate any reported case.

 

 

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