Preventing Perinatal Hepatitis B
The Oregon Health Authority (OHA) perinatal hepatitis B prevention program works to:
- Support local health departments as they take the lead role in coordinating perinatal hepatitis B prevention activities in their respective jurisdictions. These prevention services should be provided to all pregnant women identified as HBsAg-positive regardless of their source of payment for prenatal and delivery services.
- Ensure that all maternity patients are screened for hepatitis B surface antigen (HBsAg).
The Oregon Public Health Laboratory will test specimens submitted on pregnant women and their household, sexual contacts and infants. Hepatitis B vaccine is available from OHA's Immunization Program for infants born to HBsAg-positive women, as well as their household and current sexual contacts. OHA and local health departments will assist with educational and consultative services as needed.
- Ensure that infants of HBsAg positive mothers are given the proper biologicals at birth and that two additional doses of hepatitis B vaccine are given at the appropriate time in infancy.
- Ensure that post-vaccination serology is completed by 3 to 9 months after the final dose of vaccine.
- Ensure that all household and sexual contacts are identified, screened for HBsAg or antibodies to hepatitis B, and given hepatitis B vaccine if indicated.
- Ensure that all infants and household and sexual contacts of HBsAg-positive maternity patients are referred to the program and receive care as outlined above.
Health care providers AND clinical laboratories are required by law to report cases and suspect cases of Hepatitis B to local health departments within one working day of identification. Childhood immunization is recommended.
For County Health Departments
Investigative guidelines (11/12)
Case report form (09/06)
For Hospitals: Standing Order Information (05/09)
2008 Survey of Birthing Hospitals
For physicians and health-care providers: The OHA perinatal hepatitis B program can provide clinical consultations, vaccine, reporting forms and educational publications.
Pregnancy and delivery: What clinicians and hepatitis-B-positive women should know about screening and immunization.
How to prevent perinatal hepatitis B transmission
The problem of hepatitis B and the importance of perinatal hepatitis B prevention
The acute and chronic consequences of hepatitis B virus (HBV) infection are major health problems in the United States. An estimated 1 to 1.25 million infectious carriers of HBV live in this country currently. Many of these chronic carriers are at risk of long term health problems, such as chronic liver damage, cirrhosis of the liver, and liver cancer. Each year approximately 4,000 to 5,000 of these persons die from chronic liver disease.
Since 1991, the American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics (AAP), and the Advisory Committee on Immunization Practices (ACIP) have recommended that all pregnant women be serologically screened for HBV infection. The State of Oregon supports these recommendations and advises that all pregnant women should be tested for hepatitis B as part of their prenatal profile during every pregnancy.
An estimated 150 to 250 infants are born each year in Oregon to women who are contagious with the hepatitis B virus.
- Children who are exposed to hepatitis B during birth and early childhood have up to a 90% chance of becoming chronically infected. Up to 25% of chronic carriers will die as a result of liver disease as an adult. These children are also capable of infecting others by close contact or sexual contact when they mature.
- Perinatal transmission can be prevented if identification of a hepatitis B positive pregnant woman is made in time. Detection of the hepatitis B virus is made through a simple blood test.
- Administering a vaccine to infants born to hepatitis B-positive mothers can reduce the risk of that child becoming infected.
- Annually, about 160 cases of infants are known to be delivered to infected mothers in Oregon.