Wisconsin Division of Public Health Disease Surveillance Manual (EpiNet, February 2005)
I. IDENTIFICATION
A. CLINICAL DESCRIPTION: An illness caused by the hepatitis A virus characterized by abrupt onset of fever, malaise, nausea, abdominal discomfort and fatigue, followed within a few days by jaundice. Severity of illness is highly variable and can be milder or asymptomatic in young children.
B. REPORTING CRITERIA: Clinical diagnosis initially; laboratory confirmation required to meet case definition.
C. LABORATORY CRITERIA FOR CONFIRMATION: IgM anti-HAV positive serology.
D. WISCONSIN CASE DEFINITION: A person with a clinically compatible illness that is laboratory confirmed OR an asymptomatic person who is IgM anti-HAV positive and is linked epidemiologically to a confirmed case of hepatitis A.
II. ACTIONS REQUIRED / PREVENTION MEASURES
A. WISCONSIN DISEASE SURVEILLANCE CATEGORY I: Report IMMEDIATELY BY TELEPHONE to the patient's local health officer upon identification of a case or suspected case. Complete and mail an Acute and Communicable Disease Case Report (DPH 4151) to the local health officer within 24 hours.
B. EPIDEMIOLOGY REPORTS REQUESTED:
1. Acute and Communicable Diseases Report (DPH 4151).
2. Viral Hepatitis Case Report (CDC 53.1).C. PUBLIC HEALTH INTERVENTIONS:
- Confirm that a separate assay for IgM was performed and was positive.
- Conduct assessment of patient for high-risk activities (food worker, day care attendee/provider, health care provider).
- Assess need for immune globulin (IG) for persons exposed by case-patient and educate case contacts regarding risk of hepatitis A virus transmission.
- Source investigation by LHD. (Search for history of exposure to other cases, travel outside U.S. , raw shellfish ingestion, etc.)
NOTE: The above interventions can be substantially accomplished by administering the questionnaire in Hepatitis A: A handbook for public health personnel (See reference 3).
- Advise persons to obtain the hepatitis A vaccine if they will be at increased risk of exposure in the future or if the patient is at risk of a severe outcome of hepatitis A (e.g., international travelers, sexually active gay males, persons with hepatitis C or other chronic liver disease, etc. - See reference 5). Hepatitis A vaccine can be obtained through the Vaccine for Children Program for use in select communities that have high rates of hepatitis A.
III. CONTACTS FOR CONSULTATION
A. BCDP / COMMUNICABLE DISEASE EPIDEMIOLOGY SECTION: (608) 267-7321
B. REGIONAL STAFF: See Epinet Introduction: “REGIONAL OFFICE CONTACTS”.
C. WSLH / HEPATITIS SEROLOGY: (608) 262-2302.
IV. RELATED REFERENCES
1. “Hepatitis A” DPH Disease Fact Sheet Series: View a list of all current Communicable Disease Fact Sheets
2. Heymann DL, ed. HEPATITIS VIRAL. In: Control of Communicable Diseases Manual. 18 th ed. Washington , DC : American Public Health Association, 2004:247-253.
3. “Hepatitis A: A handbook for public health personnel”, Wisconsin Division of Public Health, POH 4554 (11/92).
4. Pickering LK, ed. Hepatitis A. In: Red Book: 2003 Report of the Committee on Infectious Diseases. 26 th ed. Elk Grove Village , IL : American Academy of Pediatrics, 2003:309-318.
5. CDC. Prevention of Hepatitis A Thorough Active or Passive Immunization. Recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR 1996; 45 (RR-15): 1-30.
V. DISEASE TRENDS
