Hepatitis B 2002

Table 1. Hepatitis B Cases by Race and Sex, Indiana, 2002

  2002 1998-2002
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, 2002

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 the United States in 2002 was 2.8 acute cases/100,000 population. As shown in Table 1, the incidence rate of hepatitis B in Indiana was below the national average.

A comprehensive strategy was developed and implemented in the 1990s to eliminate hepatitis B in the United States. Since the start of this effort, the incidence of hepatitis B has declined 67 percent. 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 of age; 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 2002, there were 85 reported cases of acute hepatitis B in Indiana: 81 percent exhibited jaundice, 33 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 1998-2002. The number of reported cases in 2002 was slightly higher than the number of reported cases in 2001. Cases occurred throughout the year in 2002 (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 2002, 63 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 2002 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. 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).

In 2002, 23 Indiana counties reported cases of acute hepatitis B. The incidence rates were highest among the following counties reporting five or more cases: Vanderburgh (5.8), Marion (3.7), and Lake (2.3). Figure 4 shows counties reporting five or more cases.

Indiana law requires the reporting of both acute and chronic hepatitis B infections during pregnancy and perinatally exposed infants. In 2002, 113 Indiana women were reported as having infectious hepatitis B during pregnancy. Identifying these women during pregnancy facilitates appropriate medical treatment for infants. One case of perinatal transmission was reported in 2002.

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