Baby on board? evaluating perinatal hepatitis b surveillance, New Jersey 2010-2011

Background: Infants born to hepatitis B virus (HBV) infected women are at risk for perinatal HBV transmission and subsequent chronic liver disease. Appropriate and timely treatment with the hepatitis B immunoglobulin (HBIG) and HBV vaccine is up to 95% effective in preventing transmission. To identify at-risk infants, the New Jersey Department of Health perinatal HBV surveillance utilizes multiple reporting sources and confirms all reports. We evaluated the sensitivity for the identification of infants born to HBV-infected mothers by assessing surveillance and clinical management.

Methods: The surveillance system was evaluated with a focus on sensitivity of at-risk infant identification. Clinical management completion was also analyzed. To evaluate electronic birth certificates (EBC), a representative reporting source, and its review process, EBC data were matched to surveillance data. To evaluate as a potential reporting source, independent hospital discharge data were matched to surveillance data.

Results: Of 805 infants with confirmed perinatal HBV exposure, 787 (98%) received the birth dose of the HBV vaccine and 754 (94%) received HBIG within one calendar day of birth. Among 714 infants residing in NJ during clinical management, 504 (71%) completed HBV vaccine series by age 8 months. Evaluation of EBC data identified 513 at-risk infants; of these 421 were reported in the surveillance system and 92 were not. Evaluation of hospital discharge data identified 484 at-risk infants; of these 192 were not identified in the surveillance system.

Conclusions: Hospital discharge data can be a useful additional reporting source to improve surveillance of at-risk infants.