Public health management of perinatal hepatitis B virus.
Infants who are born to hepatitis B surface antigen (HbsAg)-positive women are at high risk for contracting perinatal hepatitis B virus (HBV) infection. When maternal status is known, postexposure prophylaxis (PEP) consisting of a birth dose of (HBV) vaccine and Hepatitis B Immune Globulin may be administered within 12 hr of birth to provide 90% protection. Providers' reporting of maternal HBsAg positivity or perinatal HBV should prompt public health nurses to initiate nurse case management (NCM). NCM is the most successful way to ensure that at-risk infants receive PEP and follow-up serology. Unfortunately, reporting laws vary greatly by state and the Centers for Disease Control and Prevention estimate that perinatal HBV is significantly under-reported nationally. This article discusses public health measures for preventing perinatal HBV and presents a case study that used a novel method to assess the extent of under-reporting. We discuss barriers to public health NCM and the importance of a universal HBV vaccine birth dose to protect undetected and unreported cases. Finally, we suggest implications for public health nursing practice.
Libbus
Martha Kay
MK
Sinclair School of Nursing, University of Missouri, Columbia, Missouri, USA. libbusk@missouri.edu
Phillips
Lynelle M
LM
D002487:Centers for Disease Control and Prevention, U.S.; D018563:Disease Notification / Q000331:legislation & jurisprudence / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D017325:Hepatitis B Vaccines; D019694:Hepatitis B, Chronic / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D017589:Immunization Programs; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008403:Mass Screening; D008923:Missouri / Q000453:epidemiology; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011159:Population Surveillance; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000517:prevention & control*; D011296:Prenatal Diagnosis; D011637:Public Health Nursing / Q000458:organization & administration; D015980:Public Health Practice / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
D017325:Hepatitis B Vaccines