Viral hepatitis and health departments: The challenge of integration

Acute and chronic viral hepatitis infections have emerged as major public health issues for state and local health departments to address. An estimated 3.5 to 5.3 million people are living with these chronic diseases which are now the leading causes of primary liver cancer and cirrhosis in the US. The majority of people living with these infections have not been diagnosed, despite the need for medical care for those individuals. Surveillance for acute and chronic disease is extremely limited reducing health departments' ability to identify and control outbreaks and to better estimate disease burden in their jurisdictions. While service integration into existing public health infrastructure has been recommended for some time, the resources to do so have been dramatically inadequate. The result of this is fractured and limited disease surveillance and service provision throughout the country. With the release of the Institute of Medicine's report “Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C” there are numerous recommendations that would enhance health departments' abilities to address these infections to both prevent susceptible people from being exposed to these viruses and moving those living with these infections into appropriate care. This presentation will review these recommendations and the opportunities to expand and integrate health departments' viral hepatitis programs with the goal of reducing associated morbidity and mortality.