PUBLIC HEALTH
PREVENTION OF PERINATAL HEPATITIS B
TRANSMISSION
AUTHORS Lori Caloia, MD, and John T. Stutts, MD, MPH
I
nfant hepatitis B infection is a preventable
communicable disease, and prompt and
appropriate treatment of infants born to
a mother with hepatitis B infection can
change the outcome of these young lives.
We receive a lot of phone calls at Louis-
ville Metro Department of Public Health
and Wellness about management of perinatal
hepatitis B virus. What do I do if I have a mother who is Hepatitis
B Surface Antigen (HBsAg) positive? What about a newborn? A
pre-term infant? This article will answer these questions for you,
and our expert nursing staff in Communicable Diseases will be
there to answer any questions you may have—just give them a call
at (502) 574-6677.
The Kentucky Administrative Regulation, 902 KAR 2:020, re-
quires all licensed health care professionals and health care facilities
to report cases of acute hepatitis B infection as well as hepatitis B
infection in pregnant women to the local or state health department 1 .
The local health department has a Perinatal Hepatitis B Prevention
Coordinator who assists with case management of infants. This indi-
vidual ensures the implementation of the state and federal protocols
for the Perinatal Hepatitis B Prevention Program, which consists
of surveillance, monitoring and testing, and case management of
these infants. When our Perinatal Hepatitis B Prevention Program
Coordinator contacts you, please comply with the requested testing,
immunization recommendations, and provide the documentation
upon completion of each action in order to fulfill the mandated
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LOUISVILLE MEDICINE
program requirements.
At the time of hospital admission, the HBsAg status of all preg-
nant women should be reviewed. If no HBsAg status is available, then
testing should be performed as soon as possible. Women with risk
factors for HBV who test negative early in pregnancy (> six months
prior to delivery) should be retested at the time of delivery 2 . Preg-
nant women who have risk factors for hepatitis B infection should
be vaccinated. These risks include: injection drug use, household
or sexual contact of someone with hepatitis B virus, more than one
sex partner during the previous six months and seeking evaluation
or treatment for a sexually transmitted infection 3 .
At the time of hospital discharge, the mother should receive the
infant’s immunization record and must be instructed to bring it to
the first pediatrician/family physician visit. This information should
also be forwarded to the office of the infant’s planned provider in
conjunction with the discharge summary. All mothers should be
instructed to complete the infant’s three-shot HBV vaccine series
within six months. Mothers with positive HBsAg status should
be reported to the Louisville Metro Department of Public Health
and Wellness within 24 hours via fax at (502) 574-5865. If you
are outside of Jefferson County, this should be faxed to your local
health department or to the Kentucky Department of Public Health
(KDPH) at (502) 564-4760. Hepatitis B reporting can be complet-
ed by filling out this form: EPID 200 Kentucky Reportable Disease
Form (https://bit.ly/2WI3LMB) & EPID 394 Hepatitis Infection in
Pregnant Women or Child (https://bit.ly/2W5LVWR) and faxing to
the appropriate location.