HEPATITIS D (DELTA)

Wisconsin Division of Public Health Disease Surveillance Manual (EpiNet, May 2005)

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I. IDENTIFICATION

A. CLINICAL DESCRIPTION: An illness with abrupt onset of symptoms resembling those of hepatitis B and always associated with coexistent hepatitis B virus infection. The infection may be self-limiting or progress to chronic hepatitis.

B. REPORTING CRITERIA: Laboratory confirmation.

C. LABORATORY CRITERIA FOR CONFIRMATION:

Hepatitis B surface antigen (HBsAg) or IgM anti-HBc positive and anti-HDV positive.

D. WISCONSIN CASE DEFINITION: Laboratory confirmation.


II. ACTIONS REQUIRED / PREVENTION MEASURES

A. WISCONSIN DISEASE SURVEILLANCE CATEGORY II: Report to the patient's local health officer on an Acute and Communicable Disease Case Report (DPH 4151) or other means within 72 hours of the identification of a case or suspected case.

B. EPIDEMIOLOGY REPORTS REQUESTED:

1. Acute and Communicable Diseases Report (DPH 4151)
2. Viral Hepatitis Case Record (CDC 53.1) Acute disease only.

C. PREVENTION MEASURES:

See Hepatitis B page for persons susceptible to hepatitis B.

Teach persons with acute or chronic hepatitis B infections to avoid exposure to any potential source of HDV (e.g., contaminated sharps). Hep B vaccine, HBIG and IG do not protect persons chronically infected with HBV from infection by HDV.

D. PUBLIC HEALTH INTERVENTIONS:

See Hepatitis B page.

III. CONTACTS FOR CONSULTATION

A. BCDP / IMMUNIZATION PROGRAM: (608) 266-8621.

B. REGIONAL STAFF: See Epinet Introduction: “REGIONAL OFFICE CONTACTS”.

C. WSLH / HEPATITIS SEROLOGY: (608) 262-2303.

IV. RELATED REFERENCES

1. “Hepatitis D” 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, 2004:264-266.

3. Pickering LK, ed. Hepatitis D. In: Red Book: 2003 Report of the Committee on Infectious Diseases. 26 th ed. Elk Grove Village , IL : American Academy of Pediatrics, 2003:340-341.

V. DISEASE TRENDS

Hepatitis D is reported infrequently in Wisconsin . Between 1986 and 1995, 10 cases were reported. Of these, five (50%) were from Milwaukee County .