Hepatitis A, B & C

Reporting viral hepatitis

To leave a voicemail, call the reporting line: 360-778-6150.
Send copies of clinical notes, case report forms, or labs to 360-778-6103.

For hepatitis C, fill out the reporting form:
HCV Reporting Form

Reporting requirements

Within 24 hours—acute hepatitis A, B or E.
Within 3 days—hepatitis C (acute), hepatitis D (acute or chronic) and pregnant women who test positive for hepatitis B surface antigen.
Monthly—newly diagnosed chronic hepatitis B or C.

HAV guidelinesHBV guidelinesHCV guidelines

Transmission risk

Hepatitis A can lead to large-scale outbreaks. Its fecal-oral or contaminated water/food transmission route, extended incubation period, and robust ability to withstand degradation in the environment contribute to its ability to trigger large and long-lasting outbreaks. It is critical to promptly investigate suspected hepatitis A infections to aide in public health interventions.

Work or childcare exclusions

School-aged children with hepatitis A should not return to school until their diarrhea has ceased.

Food handlers, healthcare workers, and childcare workers or attendees should not return to that setting until they are no longer considered infectious. The infectious period ends when diarrhea has resolved and at least 7 days have passed since the onset of jaundice.

Vaccination as prevention

The prevalence of people experiencing HAV infections has decreased over time in the United States due to regular scheduled HAV vaccinations for children. However, there are many other populations who would benefit from HAV vaccination. These include:

  • All persons diagnosed with HIV infections for a year or more
  • Persons who have penises and have sex with other persons with penises
  • Persons who use recreational or illegal drugs
  • Persons experiencing unstable housing or homelessness
  • Persons with chronic liver disease, including but not limited to hepatitis B/C infections, cirrhosis, and more
  • Pregnant persons with identified risk factors such as international travel, recreational drug use, or unstable housing
  • Persons who utilize service settings that focus on populations with a high proportion of risk factors, such as group homes, shelters for those without stable housing, and medical facilities that serve these populations
  • Eligible persons who are traveling to areas with intermediate or high prevalence of HAV
  • Members of a household with a newly adopted child from a country where HAV is common

Testing and diagnosis

It is important to consider all potential causes of acute hepatitis when evaluating someone with symptoms that could be hepatitis A. The most common confirmatory lab is a positive HAV IgM indicative of an antibody response to an acute infection. This should be paired with a congruent clinical presentation, including observed jaundice, elevated bilirubin, or elevated ALT >200 IU/L.

False positive HAV IgM can occur, especially with older individuals who are asymptomatic.

Treatment

There is no treatment specific to HAV infection. Treatment should be supportive based on the individual’s medical needs.

Hep C: From Test to Cure card.
Customizable wallet card for patients with information on testing, status, treatment, and prevention.

Customizable wallet cards for patients [Adapted from Philadelphia Department of Public Health]

Print Wallet Cards

Resources and Links

Hepatitis Elimination

Washington State Department of Health

State and National Hepatitis Organizations

  • Hepatitis Education Project —provides educational materials and support for patients with hepatitis.
  • Hepatitis C Online – addresses diagnosis, monitoring and management of hepatitis C virus infection.
  • Hepatitis Network for Education and Testing (HepNET) – a CDC corporative agreement between NASTAD (National Alliance of State and Territorial AIDS Directors), NVHR (National Viral Hepatitis Roundtable), and NACCHO (National Association of County and City Health Officials) focused on improving the health of people who inject drugs (formed in 2022).

Vulnerable Populations

Viral Hepatitis in Specific Settings

Professional Articles