 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Tara M. Vogt, PhD, MPH, Lyn Finelli, DrPH, and Beth Bell, MD, MPH. Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, (404) 371-5910, tcv3@cdc.gov
Background: Despite declining incidence, hepatitis A remains one of the most frequently reported vaccine-preventable diseases in the United States. Although death from hepatitis A is rare, vaccination is recommended for groups at substantial risk. Because accurate surveillance data can be used to monitor prevention activities, we evaluated hepatitis A mortality reporting in the National Notifiable Disease Surveillance System (NNDSS).
Methods: NNDSS is a CDC-administered, passive surveillance system through which state health departments report disease events, including hepatitis A deaths. The Multiple-Cause Mortality Files (MCMF) contain U.S. national death certificate data. This analysis includes hepatitis A deaths occurring between 1996 and 1998 recorded in NNDSS (n=146) and/or MCMF (n=362). Using MCMF as a reference, NNDSS data quality and reporting completeness were evaluated.
Results: Eight states, comprising ~45% of hepatitis A cases, never report to NNDSS whether infection resulted in death. Eleven percent of reported deaths were serologically negative for acute hepatitis A, and 34% were not hospitalized. NNDSS and MCMF cases differed by age (median, 39 versus 60 years, respectively, p<0.01) and geographic distribution (e.g., 21% versus <1% of total deaths, respectively, occurred in one state), but were similar by sex and race (p>0.05).
Conclusions: Misclassification of hepatitis A deaths and incomplete case ascertainment reduce the capacity of NNDSS to monitor the impact of vaccination recommendations. States should ascertain, report, and verify all hepatitis A deaths, and implement data quality checks at data entry.
Learning Objectives:
Keywords: Hepatitis A, Surveillance
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.