Hepatitis B 2003

Table 1. Hepatitis B Cases by Race and Sex, Indiana, 2003

  2003 1999-2003
Cases Rate* Cases
Total 85 1.38 434
Race
   White 63 1.15 249
   Black 16 3.05 97
   Other 0   4
   Not Reported 6   84
Sex
   Male 68 2.25 288
   Female 17 0.54 142
   Not Reported 0   4

*Rate per 100,000 population based on the U.S. Census Bureau’s population data as of July 1, 2003

Hepatitis B is a serious viral disease of the liver transmitted by direct contact, including sexual contact, with blood or body fluids that contain the virus. Transmission can also occur from an infected mother to her infant in utero or at birth. The hepatitis B incidence rate for Indiana in 2003 was 1.2 acute cases/100,000 population.

A comprehensive strategy was developed and implemented in the 1990s to eliminate hepatitis B in the United States. The strategy includes the following: screening all pregnant women for hepatitis B infection with the provision of postexposure prophylaxis to infants born to infected women; routine vaccination of all infants and children <19 years; and targeted vaccination of individuals at increased risk of hepatitis B including health care workers, dialysis patients, household contacts and sex partners of persons with chronic hepatitis B infection, recipients of certain blood products, persons with a recent history of having multiple sex partners or a sexually transmitted disease, men who have sex with men, and injecting drug users.

In 2003, there were 71 reported cases of acute hepatitis B in Indiana: 80 percent exhibited jaundice, 39 percent were hospitalized, and 1 case resulted in death. The higher incidence of acute hepatitis B among males compared to females is consistent with national data.

Figure 1 shows reported cases of hepatitis B for the five-year period 1999-2003. In 2003, there was a 16 percent decline in incidence of acute hepatitis B compared to 2002. Cases occurred throughout the year in 2003 (Figure 2).

Cases of acute hepatitis B infection varied with age. Figure 3 shows incidence rates of acute hepatitis B cases per 100,000 population by age group. Nationally, higher rates of hepatitis B disease continue among adults, particularly males 25-38 years of age and persons with identified risk factors (i.e., injection drug users, men who have sex with men, and persons with multiple sex partners).
In 2003, 54 persons with acute hepatitis B were interviewed about risk factors for contracting the disease. Not all of those interviewed responded to each question asked. Table 2 highlights identified risk factors for 2003 Indiana cases. Nationally, the proportion of heterosexuals reporting multiple sex partners and self-identified men who have sex with men has increased in the past decade.

In 2003, 17 Indiana counties reported cases of acute hepatitis B. Three counties reported 5 or more cases (adjusted for population): Lake (1.4), Marion (2.5), and St. Joseph (5.3) (Figure 4). Risk factor information was reviewed for St. Joseph County since the number of reportable cases was significantly higher than the number reported in previous years. The risk factors in the majority of cases were consistent with the nationally identified risk factors (i.e., injection drug users, men who have sex with men, and persons with multiple sex partners). No direct links among cases were identified.

Indiana law requires the reporting of both acute and chronic hepatitis B infections during pregnancy and perinatally exposed infants. In 2003, 131 Indiana women were reported as having infectious hepatitis B during pregnancy. Identifying these women during pregnancy facilitates appropriate medical treatment for infants.

You can learn more about hepatitis B by visiting the following Web site:
http://www.cdc.gov/ncidod/diseases/hepatitis/b/index.htm.