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Cause:
Hepatitis D virus and hepatitis E virus. Hepatitis D virus infection always
occurs with hepatitis B infection, either with a chronic hepatitis B infection
(superinfection) or as two simultaneous new infections (coinfection).
Illness and treatment:
Hepatitis D and E typically have abrupt onset of fever, nausea, and abdominal
pain followed by jaundice. Hepatitis D may progress to chronic hepatitis.
Sources:
Humans are the reservoir for hepatitis D, which is usually transmitted by contact
with blood or body fluids, particularly sharing drug paraphernalia. Humans and
animals (swine) are the reservoir for hepatitis E which is transmitted most commonly
through fecally contaminated food, water, and environment.
Additional risks:
Pregnant women have higher risk for hepatitis E complications. Japan has reported
more virulent hepatitis E strains.
Prevention:
To avoid simultaneous
hepatitis B infection, immunize all children and any adults with risks for exposure.
Use safe sexual practices, avoid sharing drug paraphernalia, and screen blood and
tissue products to prevent hepatitis D transmission. Use precautions while traveling
to ensure safe food and water to avoid hepatitis E infection.
Recent Washington trends:
Reports are rare. Cases of hepatitis D are typically associated with injection drug use.
Cases of hepatitis E are typically travel associated.
2010:
One case of hepatitis E was reported with exposure in Vietnam.
Purpose of Reporting and Surveillance
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To better characterize the epidemiology of infectious hepatitis not due to hepatitis A, B, or C viruses
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To recommend appropriate preventive measures, including immunization against other types of hepatitis
which are vaccine-preventable
Legal Reporting Requirements
1. Hepatitis D (acute and chronic)
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Health care providers:
notifiable to local health jurisdiction within 3 business days
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Health care facilities:
notifiable to local health jurisdiction within 3 business days
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Laboratories:
Hepatitis D virus (detection of viral antigen, antibody or nucleic acid) notifiable within 2 business days
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Local health jurisdictions:
notifiable to the Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE)
within 7 days of case investigation completion or summary information required within 21 days.
2. Hepatitis E (acute)
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Health care providers:
notifiable to local health jurisdiction within 24 hours
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Health care facilities:
notifiable to local health jurisdiction within 24 hours
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Laboratories:
Hepatitis E virus (detection of viral antigen, antibody or nucleic acid) notifiable within 24 hours
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Local health jurisdictions:
notifiable to the Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE)
within 7 days of case investigation completion or summary information required within 21 days.
Last update
December 2011 |
