 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Jeanette A Miller, MPH1, Lyn Finelli, DrPH2, AM Wasley, ScD3, and Beth Bell, MD, MPH3. (1) Division of Viral Hepatitis, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, (404)371-5910, jmiller4@cdc.gov, (2) Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, (3) National Center for Infectious Diseases, Division of Viral Hepatitis, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333
Background: Reported rates of acute hepatitis B peaked at 11.5 per 100,000 population in the mid 1980s. Recommendations to eliminate hepatitis B virus transmission include universal infant and catch-up childhood vaccination, post-exposure prophylaxis of infants born to infected mothers, and vaccination of adults at high risk. Hepatitis B trends were evaluated to assess the impact of recommendations. Methods: Cases of symptomatic acute hepatitis B reported to state health departments during 1990-2002 and sent weekly to the CDC were analyzed. Results: In 2002, 7,085 cases were reported (rate 2.5/100,000 population) compared to 21,102 in 1990 (rate 8.4/100,000 population) representing a 70% decline. Declines in incidence were noted in all regions of the United States and among both genders and all racial/ethnic and age groups. The greatest decline was among children aged 0-11 years (94%). However, during 1999-2002, incidence among men >20 years rose 7% while incidence in women declined, and the proportion of male cases reporting high risk behaviors also increased. In 1990, 7% of male cases self-identified as men who have sex with men, 15% reported injecting drug use and 15% reported multiple sex partners, compared to 26%, 15% and 33%, respectively, in 2002. Conclusions: Significant declines in hepatitis B incidence have occurred nationwide, especially in cohorts of vaccinated children. Despite recommendation for vaccination of persons at high risk, transmission is increasingly concentrated in those persons. These data highlight the need for continued monitoring of hepatitis B epidemiology, and for developing effective strategies to vaccinate adults at high risk.
Learning Objectives:
Keywords: Hepatitis B, Surveillance
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.