CDC Division of Viral Hepatitis - Statistics and Surveillance

Statistics and Surveillance

Statistics

Surveillance for Acute Viral Hepatitis --- United States, 2006
MMWR 2008;57(SS-2)

Reported Cases of Acute Viral Hepatitis, by Type and Year, United States, 1966–2003

Surveillance Guidelines and Forms

Guidelines for Viral Hepatitis Surveillance and Case Management

DRAFT Viral Hepatitis Surveillance Report Form (February 2002)
The forms for reporting cases of viral hepatitis to CDC are currently being revised. The new forms will be used to report cases of viral hepatitis through the new National Electronic Disease Surveillance System (NEDSS). Drafts of these forms are provided here for reference purposes, although use of these forms nationally will only occur once NEDSS is operational.

Hepatitis Case Record Form
National Electronic Telecommunications System for Surveillance

Disease Burden from Hepatitis A, B, and C in the United States

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	Hepatitis A
	2006	2005	2004	2003	2002	2001
No. of Acute Clinical Cases Reported ¹	3,579	4,488	5,683	7,653	8,795	10,616
Estimated No. of Acute Clinical Cases ²	15,000	19,000	24,000	33,000	38,000	45,000
Estimated No. of New Infections ² (current)	32,000	42,000	56,000	61,000	73,000	93,000

Estimated No. of New Infections ²			mean	min	max
(historical)	1990–1999		301,000	181,000	373,000
	1980–1989		254,000	221,000	380,000

No. of Persons with Chronic Infection ³	No chronic infection
Estimated Annual No. of Chronic Liver Disease Deaths †	No chronic infection
Percent Ever Infected ‡	33%

	Hepatitis B
	2006	2005	2004	2003	2002	2001
No. of Acute Clinical Cases Reported ¹	4,758	5,494	6,212	7,526	8,064	7,844
Estimated No. of Acute Clinical Cases ²	13,000	15,000	17,000	22,000	no data
Estimated No. of New Infections² (current)	46,000	51,000	60,000	73,000	79,000	78,000

Estimated No. of New Infections²			mean	min	max
(historical)	1990–1999		140,000	79,000	232,000
	1980–1989		259,000	208,000	287,000

No. of Persons with Chronic Infection ³	1.25 million persons
Estimated Annual No. of Chronic Liver Disease Deaths †	2,000–4,000
Percent Ever Infected ‡	4.9%

	Hepatitis C
	2006	2005	2004	2003	2002	2001
No. of Acute Clinical Cases Reported ¹	no data
Estimated No. of Acute Clinical Cases ²	3,200	3,400	4,200	4,500	4,800	3,900
Estimated No. of New Infections ² (current)	19,000	21,000	26,000	28,000	29,000	24,000

Estimated No. of New Infections ²			mean	min	max
(historical)	1990–1999		67,000	36,000	179,000
	1982–1989		232,000	180,000	291,000

No. of Persons with Chronic Infection ³	3.2 million persons
Estimated Annual No. of Chronic Liver Disease Deaths †	8,000–10,000
Percent Ever Infected ‡	1.6%

¹ Number of Acute Clinical Cases Reported: For hepatitis A and hepatitis B, the number of cases reported to the National Notifiable Diseases Surveillance System (NNDSS). Cases of hepatitis C/NANB are also reported to NNDSS (766 in 2006) but are unreliable for monitoring trends in hepatitis C because these reports include cases based only on a positive lab test for anti-HCV, most of which represent chronic HCV infection (CDC. Summary of Notifiable Diseases, United States, 2006, MMWR 2008;55[53]).

² Estimated Number of Acute Clinical Cases and New Infections: Incidence estimates are derived from catalytic modeling of seroprevalence data from the Third National Health and Nutrition Examination Survey (NHANES III) applied to cases reported to the Nationally Notifiable Diseases Surveillance System (NNDSS) (for hepatitis A and hepatitis B) or to the Sentinel Counties Study of Viral Hepatitis (for hepatitis C).

³ Number of Persons with Chronic Infection: HBV: Margolis HS, Coleman PJ, Brown RE, et al. Prevention of hepatitis B virus transmission by immunization: An economic analysis of current recommendations. JAMA 1995;274(15):1201–8. HCV: Armstrong GL, Wasley A, Simard EP, et al. Prevalence of hepatitis C virus infection in the United States, 1999 through 2002. Ann Int Med 2006;144(10):705–14.

† Estimated Annual Number of Chronic Liver Disease Deaths: HBV: Margolis HS, Coleman PJ, Brown RE, et al. Prevention of hepatitis B virus transmission by immunization: An economic analysis of current recommendations. JAMA 1995; 274(15): 1201–8. HCV: CDC. Recommendations for the prevention and control of hepatitis C virus infection and HCV-related chronic disease. MMWR 1998;47(RR-19):1–39.

‡ Percent Ever Infected: Seroprevalence estimates for HAV, HBV, and HCV come from the National Health and Nutrition Examination Survey. HAV: Bell BP, Kruszon-Moran D, Shapiro CN et al. Hepatitis A virus infection in the United States: Serologic results from the Third National Health and Nutrition Examination Survey. Vaccine 2005;23(5):5798–806. HBV: McQuillan GM, Coleman PJ, Kruszon-Moran D, et al. Prevalence of hepatitis B virus infection in the United States: The National Health and Nutrition and Examination Surveys, 1976 through 1994. AJPH 1999;89(1):14–18. HCV: Armstrong GL, Wasley A, Simard EP, et al. Prevalence of hepatitis C virus infection in the United States, 1999 through 2002. Ann Int Med 2006; 144(10):705–14.

Acute Disease Burden Data, 1980–2006

Line chart titled, "Incidence of hepatitis A, United States" with years 1980 through 2006 along the X axis and number of cases along the Y axis. Estimated Acute case count starts at 124,000 in 1980, dipps to lows in 1983 and 1992 and peaks in 1989 and 1995 before descending to all time low of 32,000 by 2006. Reported Acute case count starts at 29,087 in 1980, dipps to lows in 1983 and 1992 and peaks in 1989 and 1995 before descending to all time low of 15,000 by 2006.

Incidence of hepatitis A, United States
Year	Reported Acute Cases	Estimated Acute Cases	Estimated Total New Infections
1980	29,087	124,000	234,000
1981	25,802	110,000	223,000
1982	23,404	100,000	228,000
1983	21,534	92,000	221,000
1984	22,038	94,000	232,000
1985	23,211	99,000	228,000
1986	23,429	100,000	239,000
1987	25,280	108,000	255,000
1988	28,506	122,000	305,000
1989	35,822	153,000	380,000
1990	31,522	135,000	373,000
1991	24,219	104,000	288,000
1992	23,112	99,000	274,000
1993	24,238	104,000	284,000
1994	26,796	115,000	333,000
1995	31,582	135,000	356,000
1996	31,032	133,000	335,000
1997	30,021	128,000	341,000
1998	23,299	99,000	243,000
1999	17,047	73,000	181,000
2000	13,397	57,000	143,000
2001	10,616	45,000	93,000
2002	8,795	38,000	73,000
2003	7,653	33,000	61,000
2004	5,683	24,000	56,000
2005	4,488	19,000	42,000
2006	3,579	15,000	32,000

Line chart titled, "Incidence of hepatitis B, United States" with years 1980 through 2006 along the X axis and number of cases along the Y axis. Estimated Acute case count starts at 208,000 in 1980, peaks in 1985, and descends to all time low of 46,000 by 2006. Reported Acute case count starts at 19,014 in 1980, peaks in 1985, and descends to all time low of 4,758 by 2006.

Incidence of hepatitis B, United States
Year	Reported Acute Cases	Estimated Acute Cases	Estimated Total New Infections
1980	19,014	53,000	208,000
1981	21,151	59,000	229,000
1982	22,176	62,000	239,000
1983	24,319	68,000	267,000
1984	26,116	73,000	281,000
1985	26,612	74,000	287,000
1986	26,106	73,000	283,000
1987	25,915	72,000	287,000
1988	23,175	65,000	253,000
1989	23,421	65,000	255,000
1990	21,277	59,000	232,000
1991	17,911	50,000	193,000
1992	16,126	45,000	175,000
1993	13,361	37,000	144,000
1994	12,517	35,000	133,000
1995	10,805	30,000	113,000
1996	10,637	30,000	112,000
1997	10,416	29,000	110,000
1998	10,258	29,000	109,000
1999	7,694	21,000	79,000
2000	8,036	22,000	81,000
2001	7,844	22,000	78,000
2002	8,064	23,000	79,000
2003	7,526	21,000	73,000
2004	6,212	17,000	60,000
2005	5,494	15,000	51,000
2006	4,758	13,000	46,000

Line chart titled, "Incidence of hepatitis C, United States" with years 1982 through 2006 along the X axis and number of cases along the Y axis. Estimated case count starts at 28,500 in 1982, peaks in 1989, and descends to all time low of 3,200 by 2006.

Incidence of hepatitis C, United States
Year	Estimated Acute Cases	Estimated Total New Infections
1982	29,500	180,000
1983	30,800	188,000
1984	36,000	219,000
1985	42,700	261,000
1986	43,000	262,000
1987	35,400	216,000
1988	39,400	240,000
1989	47,800	291,000
1990	29,400	179,000
1991	18,400	112,000
1992	12,000	73,000
1993	9,400	57,000
1994	8,900	54,000
1995	5,900	36,000
1996	5,900	36,000
1997	6,300	38,000
1998	6,800	41,000
1999	6,400	39,000
2000	6,300	38,000
2001	3,900	24,000
2002	4,800	29,000
2003	4,500	28,000
2004	4,200	26,000
2005	3,400	21,000
2006	3,200	19,000