1. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov The Burden of Hepatitis C in West Virginia November 2011 West Virginia Public Health Symposium Division of Infectious Disease Epidemiology (DIDE) WVDHHR/BPH/OEPS 1

2. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov Objectives Describe Hepatitis C surveillance in West Virginia. Understand the epidemiology of Hepatitis C in West Virginia. 2

3. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov Hepatitis C Surveillance West Virginia WV Legislative Rule 64-CSR-7 (Reportable Disease Rule) Reportable Condition WHO ReportsWHO to Report WHEN to Report Hepatitis C, Acute Health Care Providers WVDHHRWithin 1 week Hepatitis C, non-A and non-B LaboratoriesWVDHHRWithin 1 week 3

4. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov ActivityAcute Hepatitis C Infection Past or Present HCV Infection SurveillancePassive Type of DataClinical, lab, epi informationLaboratory information Case InvestigationYes, local healthNo Case DefinitionsCDC Surveillance Systems WVEDSS, Hep C Registry Hep C Registry, WVEDSS Data collectionPaper reporting; entered by LHD into WVEDSS Paper reporting; some electronic, entered by DIDE staff into database Hepatitis C Surveillance 4

5. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov Hepatitis C Surveillance, WV (1) ThenNow and the Future DISEASE REPORTING Acute Hepatitis C reported to WVEDSS Acute Hepatitis C reported to new WVEDSS All Hepatitis C reports entered into hepatitis C registry (2010 or earlier reports). All Hepatitis C reports (CY >2011) enter in new WVEDSS: 2011 - acute HCV reported to CDC, 2012 - acute and P/P HCV infection to be reported to CDC Manual data entryIn the future: electronic lab reporting DATA ACCESS Reports in WVEDSS accessed by health dept staff (web-based) Reports in newWVEDSS accessed by health dept staff Hepatitis C registry: selected DIDE staff with access, LHD no access By 2012: LHD have access to acute and P/P HCV reports entered as early as 2011 5

6. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov WVDHHR/BPH/OEPS/DIDE 6 Hepatitis C Surveillance, WV (2) ThenNow and the Future DATA FEEDBACK Only acute hep C data (In WVEDSS) available to both state and LHD, data extraction may be a challenge Building acute and chronic hep C data in newWVEDSS, available to state and LHD, ‘report’ section. Hepatitis C registry data – limited access, delayed feedback By 2012, all LHD have access to acute and p/p hepatitis c reports Notification letter to LHD generated by Hep C Registry No need for letter – report can be viewed by LHD STAFF SUPPORT Consultations – DIDE, Regional Epis Case review: Surveillance Nurse Hep C Data Manager - none Case review: Surveillance Nurse Hep C Registrar – past/present HCV case ascertainment 6

7. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov West Virginia Population, 2010 = 1,852,994 (2.5% increase from 2000) Gender = Female (51%), Male (49%) Race = White (94%), Black (3%) Education = High school graduate (82%), Bachelor or higher (17%) 2007–2008 West Virginia Behavioral Risk Factor Survey Report 2nd highest in 2008 in reporting the general health of adults as either “fair” or “poor.” 1/5 of WV adults age 18 to 64 have no health care coverage 7

8. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov 8

9. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov Acute Hepatitis C cases by REPORTING SOURCE West Virginia, 2001-2010, N=178 9

10. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov Acute Hepatitis C cases in West Virginia, 2001-2010, N=178 Percent Distribution by GENDER Male = 52% (10 per 100,000 pop.) Female = 48% (9 per 100,000 pop.) By GEOGRAPHIC LOCATION Southern counties (3) = 35% Mercer county Raleigh county Logan county Throughout the state = 65% 10

11. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov 11

12. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov 12

13. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov 13

14. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov 14

15. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov 15

16. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov 16

17. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov 17

18. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov

19. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov 19

20. Office of Epidemiology and Prevention Services DIVISION OF INFECTIOUS DISEASE EPIDEMIOLOGY www.dide.wv.gov SUMMARY 20 Hepatitis C infection remains a problem in WV Strengthen hepatitis C surveillance Targeted preventive and control measures