A National Strategy for the Elimination of Hepatitis B and C Phase Two Report (2017) / Chapter Skim
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3 Public Health Information
3 Public Health Information
Pages 57-74
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From page 57... ...
. In forming a national hepatitis strategy, the World Health Organization (WHO)
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. State and local health departments are legally required to conduct surveillance on reportable conditions, including hepatitis B and C, though privacy laws prevent them from sharing identifiable information outside their jurisdictions.
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, in partnership with state and local health departments, should support standard hepatitis case finding measures, and the follow-up, monitoring, and linkage to care of all viral hepatitis cases reported through public health surveillance. The CDC should work with the
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Increasing the diagnosis of hepatitis B is a major part of the strategy, as is the appropriate management and care for chronic hepatitis B In order to better understand the geographic distribution of hepatitis B, the Australasian Society for HIV Medicine and the Victorian Infectious Diseases Ref erence Laboratory at the Peter Doherty Institute for Infection and Immunity began the Hepatitis B Mapping Project in 2012.
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. With input from the CDC, various state and local health departments, and industry, the goal is creating a computing platform capable of using clinical data for public health (Digital Bridge, n.d.)
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As the cooperatives already fund capacity building for other infectious diseases, using this funding tool might allow for better integration of viral hepatitis surveillance with other infectious diseases on a national scale. Funding could be used to improve informatics, giving other jurisdictions access to tools like those used in Massachusetts to mine electronic records, to improve electronic laboratory reporting for all viral hepatitis laboratory results, and to support increased staff capacity.
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From page 63... ...
For example, a negative HCV RNA test on a hepatitis C case after treatment provides health departments with valuable evidence of sustained virologic response. In New York, reporting of negative HCV RNA has been required since 2014, allowing the New York City health department staff to determine that about 40 percent of HCV infections reported in 2015 were cleared, either spontaneously or through treatment (Flanigan, 2017; New York City Department of Health and Mental Hygiene, 2016)
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These registries are usually run by state health departments and can be used to calculate cancer incidence and monitor disease burden over time (American Cancer Society, 2014; Parkin et al., 2001)
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Such research is challenging, as much of the burden of disease is borne by people on society's margins: the imprisoned, people who inject drugs, and people born in endemic countries. The seven jurisdictions that are doing enhanced viral hepatitis surveillance are finding higher burden and more cases among young people than CDC estimates would suggest (CDC, 2016b; Flanigan, 2017; Hart-Malloy et al., 2013; Massachusetts Department of Public Health, 2016; Michigan DHHS, 2015)
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From page 66... ...
. The Chronic Hepatitis Cohort Study Another ongoing epidemiological study of viral hepatitis in the United States, the Chronic Hepatitis Cohort Study (CHeCS)
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The Bureau of Justice Statistics' Survey of Inmates in Federal Correctional Facilities, Survey of Inmates in State Correctional Facilities, and Survey of Inmates in Local Jails are promising vehicles for reaching a key population. The survey in federal facilities has been conducted three times since 1991, the survey in state facilities seven times since 1974, and the survey in jails six times since 1972 (BJS, 2002, 2004a,b)
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From page 68... ...
There is a need for better information about disease burden and the care cascade of viral hepatitis in the United States, including likelihood of linkage to care, sustained virologic response, and risk of reinfection. Research on key populations could provide such information, especially if conducted as a complement to comprehensive public health surveillance.
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2012. Comparison of electronic laboratory reports, admin istrative claims, and electronic health record data for acute viral hepatitis surveillance.
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2014. Chronic hepatitis C virus infection in the United States, National Health and Nutrition Examination Survey, 2003 to 2010.
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2008. Automated identification of acute hepatitis B using electronic medical record data to facilitate public health surveillance.
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2014. Mortality among persons in care with hepatitis C virus infection: The Chronic Hepatitis Cohort Study (CHeCS)
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1998. Prognosis of chronic hepatitis C: Results of a large, prospective cohort study.
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2015. Using nation wide health insurance claims data to augment Lyme disease surveillance.
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