The committee offers the following recommendations aimed at making viral hepatitis surveillance systems more consistent among jurisdictions and improving their ability to collect and report data on acute and chronic hepatitis B and hepatitis C more accurately:

Recommendation 2-2. The Centers for Disease Control and Prevention should develop specific cooperative viral-hepatitis agreements with all state and territorial health departments to support core surveillance for acute and chronic hepatitis B and hepatitis C.

The agreements should include

  • A funding mechanism and guidance for core surveillance activities.

  • Implementation of performance standards regarding revised and standardized case definitions, specifically through the use of

    • Revised case-reporting forms with required, standardized components.

    • Case evaluation and followup.

  • Support for developing and implementing automated data-collection systems, including

    • Electronic laboratory reporting.

    • Electronic medical-record extraction systems.

    • Web-based, Public Health Information Network-compliant reporting systems.

Recommendation 2-3. The Centers for Disease Control and Prevention should support and conduct targeted active surveillance, including serologic testing, to monitor incidence and prevalence1 of hepatitis B virus and hepatitis C virus infections in populations not fully captured by core surveillance.

  • Active surveillance should be conducted in specific (sentinel) geographic regions and populations.

  • Appropriate serology, molecular biology, and followup will allow for distinction between acute and chronic hepatitis B and hepatitis C.


Incidence refers to the number of new cases within a specified period of time. Prevalence refers to the number of existing cases in a specified population at a designated time.

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