Hepatitis C

Cause: Hepatitis C virus, which has 6 genotypes.

Illness and treatment: Most acute infections are asymptomatic but about 20% of cases have abrupt onset with fever, abdominal pain, and jaundice. Chronic infection is typically asymptomatic until complications such as liver damage or cancer develop after decades. A specialist can determine treatment options for hepatitis C virus infections.

Sources: Transmission is usually by contact with blood, particularly while sharing drug paraphernalia, or less commonly with semen or vaginal secretions of an infected person.

Additional risks: Chronic infection follows acute infection in 75-85% of cases and is more likely for males, those infected after 25 years of age, or the immunosuppressed including HIV co-infection.

Prevention: Use safe sexual practices, avoid sharing drug paraphernalia, and screen blood and tissue products to prevent transmission. Routine testing is recommended for those with any bloodborne transmission risk and once for those born 1954-1965.

Recent Washington trends: Each year fewer than 30 acute cases are reported. On average 5,457 cases of chronic hepatitis C were reported per year between 2005 and 2014.

Purpose of Reporting and Surveillance

  • To identify sources of infection and to prevent further transmission from such sources
  • To identify new groups at risk and reduce further cases
  • To inform cases about treatment options
  • To educate cases and contacts about transmission of hepatitis C virus and how to reduce the risk of transmission
  • To better understand the epidemiology of hepatitis C virus infection and the burden of morbidity from chronic infection

Legal Reporting Requirements

Acute Hepatitis C

  • Health care providers: notifiable to local health jurisdiction within 3 business days
  • Health care facilities: notifiable to local health jurisdiction within 3 business days
  • Laboratories: Hepatitis C virus (detection of viral antigen, antibody or nucleic acid) notifiable on a monthly basis. Specimen submission is on request only in outbreak settings.
  • Local health jurisdictions: Acute cases notifiable to the Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (OCDE) 206-418-5500 within 7 days of case investigation completion or summary information required within 21 days.

Chronic Hepatitis C (initial diagnosis only)

  • Health care providers: notifiable to local health jurisdiction within one month
  • Health care facilities: notifiable to local health jurisdiction within one month
  • Laboratories: Hepatitis C virus (detection of viral antigen, antibody or nucleic acid) notifiable to local health jurisdiction of patient residence (or ordering health care provider, if patient residence is unknown) on a monthly basis
  • Local health jurisdictions: Chronic cases (initial diagnosis only) notifiable to DOH Office of Infectious Disease 360-236-3440 within 7 days of case investigation completion or summary information required within 21 days.

Perinatal Hepatitis C (initial diagnosis only)

  • Health care providers: notifiable to local health jurisdiction within one month
  • Health care facilities: notifiable to local health jurisdiction within one month
  • Laboratories: Hepatitis C virus (detection of viral antigen, antibody or nucleic acid) notifiable to local health jurisdiction of patient residence (or ordering health care provider, if patient residence is unknown) on a monthly basis
  • Local health jurisdictions: Perinatal cases (initial diagnosis only) notifiable to DOH OCDE 206-418-5500 within 7 days of case investigation completion or summary information required within 21 days.