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Perinatally Acquired Hepatitis B

Mara Larson, MPH North Carolina Immunization Branch. Perinatally Acquired Hepatitis B. Presentation Overview. NC Perinatal Hepatitis B Birth Cohort Summary NCEDSS Case Management Tips Linking Clinical Package Laboratory Tab Risk Package. 2009 NC Birth Cohort Summary.

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Perinatally Acquired Hepatitis B

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  1. Mara Larson, MPH North Carolina Immunization Branch Perinatally Acquired Hepatitis B

  2. Presentation Overview • NC Perinatal Hepatitis B Birth Cohort Summary • NCEDSS Case Management Tips • Linking • Clinical Package • Laboratory Tab • Risk Package

  3. 2009 NC Birth Cohort Summary Data at time of reporting to CDC in March 2011.

  4. *At time of reporting to CDC in March 2011. Lost to follow up events for 2009 n=24

  5. Northampton Gates Vance Currituck Ashe Rockingham Surry Camden Caswell Granville Stokes Warren Person Hertford Pasquotank Halifax Watauga Perquimans Wilkes Alamance Yadkin Chowan Bertie Forsyth Mitchell Avery Franklin Orange Caldwell Nash Guilford Durham Yancey Davie Edgecombe Tyrrell Madison Davidson Iredell Wake Martin Washington Dare *Burke Randolph Chatham Wilson Catawba Buncombe Rowan Pitt McDowell Beaufort Swain Haywood Johnston Greene Hyde Lincoln Lee Rutherford Cabarrus Montgomery Graham *Harnett Wayne Gaston Jackson Polk Moore Cleveland Stanly Transylvania Lenoir Craven Mecklenburg Cherokee Macon Cumberland Pamlico Clay Sampson Hoke Jones Anson Richmond Duplin Union Onslow Scotland Carteret Robeson Bladen Pender Columbus New Hanover Brunswick NorthCarolina 2009 Perinatally Acquired Hepatitis B Cohort by County n=229 Alleghany Alexander Henderson Counties with 1 case Counties with 2-10 cases Counties with 11-24 cases Counties with 25-55 cases County with event reported after closing date * Counties with a positive case

  6. 2009 Mothers by Place of Birth n=225* Over 35 countries are represented with Vietnam, China and Mexico as the most common countries of birth. *There were 225 mothers for the 2009 birth cohort

  7. Summary for 2010 & 2011 Data as of July 13, 2011

  8. Post-Vaccination Serology Recommended by 9-15 months of age Only two tests are required for perinatal cases: Hepatitis B Surface Antigen (HBsAg) – detects disease Hepatitis B Antibody (Anti-HBs) – proves immunity

  9. Interstate Perinatal Cases • Per CDC • Any child born to a HBsAg positive mom in the US or US territories is followed for Hep B vaccination series and post-vaccination serology. • Any child born to a HBsAg positive mom in another country but moves to NC is not to be followed as a Perinatally Acquired Hep B case but as a Chronic Hep B case. • Take away – children that move to NC that are US residents are to be case managed even if they are not born in NC.

  10. Missing moms and babies? • CDC estimates that NC could have between 360 to 594 HBsAg positive pregnant women each year. • In the last four years the highest number detected in NC was 264.

  11. North Carolina Electronic Disease Surveillance System (NCEDSS): Do we have to?????? • What??? Do we have to fill that out in NCEDSS??

  12. To add a child – click on LinkedContacts

  13. Linking from mother’s case –to the child’s. Either select person if already in system OR add the child here.

  14. Clinical Package: choose yes for an infant entering the program. A drop down lab section will display. Fill this out with the most up to date lab information.

  15. Please fill out the mom’s demographic and clinical information in the infant’s clinical package Please type HBIG in clinical package not in vaccine package

  16. Infants that need 2nd series of Hep B Add second lab result here Use the lab result section in clinical package for most up to date lab results.

  17. Lost to follow up events – please fill out the reason why in the Risk Package

  18. Thank you • Questions? Please call me with any case management questions • Contact: Mara Larson • 919-707-5577 • Mara.larson@dhhs.nc.gov

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