collect more detailed data and to refer people directly into appropriate medical care, including treatment for acute HCV infection (McGovern et al., 2006). Other enhanced surveillance projects should include

  • Determining the level of care that patients receive after diagnosis, including medical and social-service referrals and treatment (Fleming et al., 2006).

  • Following subsets of cases to improve understanding of natural history (Global Burden of Hepatitis C Working Group, 2004).

  • Matching data on chronic hepatitis B and hepatitis C with cancer registries (Global Burden of Hepatitis C Working Group, 2004).

  • Matching data on chronic HBV and HCV infections with HIV/AIDS data to determine the burden of coinfection in communities.

  • Measuring the vaccination status of acute HBV infection cases and identifying missed opportunities for vaccination.

  • Ensuring that viral hepatitis is addressed and integrated with appropriate projects for the National HIV Behavioral Surveillance System.

  • Measuring HBV and HCV seroconversion rates in selected populations.

Partner Services

Partner services have been found to be effective in identifying un-diagnosed cases of HIV (Hogben et al., 2007). Similar programs could potentially be useful identifying cases of hepatitis B and hepatitis C (CDC, 2008e; Hogben and Niccolai, 2009; Marcus et al., 2009). State and local health departments should be funded to pilot and evaluate partner-services programs for suspected acute and chronic cases of HBV infection and acute cases of HCV infection, especially in young people. Integration with existing partner service programs should be explored. Evaluation should focus on the efficacy of referral into care services and on screening of exposed partners—sexual partners for hepatitis B and drug-sharing partners for hepatitis B and hepatitis C (CDC, 2007).

REFERENCES

Allen, C. J., and M. J. Ferson. 2000. Notification of infectious diseases by general practitioners: A quantitative and qualitative study. Medical Journal of Australia 172(7):325-328.

Alter, M. J., W. L. Kuhnert, and L. Finelli. 2003. Guidelines for laboratory testing and result reporting of antibody to hepatitis C virus. Centers for Disease Control and Prevention. Morbidity and Morality Weekly: Recommendations and Reports 52(RR-3):1-13, 15; quiz CE11-CE14.



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