Surveillance for Viral Hepatitis – United States, 2016

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Contents

Summary of Trends in Viral Hepatitis – United States, 2016

Investigation of Health care-associated Outbreak Cases

Table 1.1 Hepatitis B and C Outbreaks by Setting ― United States, 2016

Hepatitis A virus

 

Index
PAGE
DESCRIPTION
Table 2.1 Reported cases of hepatitis A, nationally and by state or jurisdiction ― United States, 2012–2016
Table 2.2 Select clinical characteristics of hepatitis A cases reported in the United States, 2016
Table 2.3 Number and rate of hepatitis A-related deaths, by demographic characteristics and year — United States, 2012–2016
Figure 2.1 Reported number of hepatitis A cases — United States, 2001-2016
Figure 2.2 Incidence of hepatitis A, by age group — United States, 2001–2016
Figure 2.3 Incidence of hepatitis A, by sex — United States, 2001–2016
Figure 2.4 Incidence of hepatitis A, by race/ethnicity — United States, 2001–2016
Figure 2.5 Availability of information on risk exposures/behaviors associated with hepatitis A — United States, 2016
Figure 2.6a Hepatitis A reports, by risk exposure/behavior — United States, 2016
Figure 2.6b Hepatitis A reports, by risk exposure/behavior– United States, 2016
Map 2.1 State Acute Hepatitis A Incidence Compared to Healthy People 2020 National Goal United States, 2016

Hepatitis A virus

Table 2.1. Reported cases of hepatitis A, nationally and by state or jurisdiction ― United States, 2012-2016

Table 2.1.
State
2012
2013
2014
2015
2016
No. Rate* No. Rate* No. Rate* No. Rate* No. Rate*
Alabama 19 0.4 10 0.2 15 0.3 23 0.5 19 0.4
Alaska 1 0.1 1 0.1 1 0.1 4 0.5 2 0.3
Arizona 93 1.4 66 1.0 29 0.4 54 0.8 32 0.5
Arkansas 8 0.3 9 0.3 2 0.1 10 0.3 13 0.4
California 209 0.5 255 0.7 142 0.4 179 0.5 229 0.6
Colorado 28 0.5 51 1.0 23 0.4 25 0.5 22 0.4
Connecticut 23 0.6 19 0.5 23 0.6 9 0.3 16 0.4
Delaware 9 1.0 4 0.4 1 0.1 2 0.2 1 0.1
District of Columbia U U U U U U U U 4 0.6
Florida 87 0.5 115 0.6 90 0.5 108 0.5 115 0.6
Georgia 46 0.5 36 0.4 24 0.2 30 0.3 44 0.4
Hawaii 5 0.4 16 1.1 5 0.4 6 0.4 285 20.0
Idaho 11 0.7 8 0.5 7 0.4 9 0.5 7 0.4
Illinois 67 0.5 79 0.6 82 0.6 57 0.4 71 0.6
Indiana 11 0.2 32 0.5 20 0.3 19 0.3 18 0.3
Iowa 7 0.2 17 0.6 12 0.4 16 0.5 16 0.5
Kansas 15 0.5 11 0.4 7 0.2 7 0.2 5 0.2
Kentucky 25 0.6 24 0.5 19 0.4 16 0.4 9 0.2
Louisiana 7 0.2 14 0.3 5 0.1 5 0.1 12 0.3
Maine 9 0.7 10 0.8 8 0.6 8 0.6 8 0.6
Maryland 28 0.5 29 0.5 27 0.5 19 0.3 37 0.6
Massachusetts 40 0.6 43 0.6 43 0.6 34 0.5 64 0.9
Michigan 100 1.0 83 0.8 45 0.5 51 0.5 112 1.1
Minnesota 29 0.5 32 0.6 19 0.3 21 0.4 15 0.3
Mississippi 11 0.4 5 0.2 3 0.1 2 0.1 2 0.1
Missouri 20 0.3 8 0.1 20 0.3 9 0.1 16 0.3
Montana 6 0.6 6 0.6 5 0.5 2 0.2 3 0.3
Nebraska 16 0.9 13 0.7 9 0.5 6 0.3 21 1.1
Nevada 10 0.4 19 0.7 5 0.2 11 0.4 14 0.5
New Hampshire 6 0.5 9 0.7 5 0.4 2 0.2 8 0.6
New Jersey 60 0.7 68 0.8 59 0.7 59 0.7 74 0.8
New Mexico 10 0.5 20 1.0 8 0.4 6 0.3 4 0.2
New York 111 0.6 167 0.8 84 0.4 123 0.6 99 0.5
North Carolina 34 0.3 46 0.5 38 0.4 45 0.4 52

0.5
North Dakota 2 0.3 9 1.2 9 1.2 5 0.7 2

0.3
Ohio 36 0.3 59 0.5 32 0.3 36 0.3 36

0.3
Oklahoma 12 0.3 14 0.4 17 0.4 11 0.3 11

0.3
Oregon 9 0.2 29 0.7 13 0.3 28 0.7 15

0.4
Pennsylvania 62 0.5 53 0.4 48 0.4 43 0.3 62

0.5
Rhode Island 3 0.3 4 0.4 8 0.8 4 0.4 4

0.4
South Carolina 6 0.1 14 0.3 6 0.1 16 0.3 21

0.4
South Dakota 0 0.0 4 0.5 3 0.4 2 0.2 1

0.1
Tennessee 23 0.4 20 0.3 12 0.2 14 0.2 7

0.1
Texas 134 0.5 109 0.4 124 0.5 147 0.5 139

0.5
Utah 4 0.1 12 0.4 8 0.3 8 0.3 12

0.4
Vermont 2 0.3 7 1.1 1 0.2 3 0.5 5

0.8
Virginia 49 0.6 36 0.4 27 0.3 50 0.6 190

2.3
Washington 29 0.4 45 0.6 26 0.4 26 0.4 31

0.4
West Virginia 8 0.4 4 0.2 12 0.6 8 0.4 15

0.8
Wisconsin 21 0.4 37 0.6 7 0.1 9 0.2 7

0.1
Wyoming 1 0.2 0 0.0 1 0.2 3 0.5 0

0.0
U.S. 1562 0.5 1781 0.6 1239 0.4 1390 0.4 2007 0.6

Source: CDC, National Notifiable Diseases Surveillance System.
*Rate per 100,000 population.
U=No data available for reporting.

Table 2.2. Select clinical characteristics of hepatitis A cases* reported in the United States, 2016

Table 2.2.
Clinical characteristic
Availability of valid data† for clinical characteristic
Cases with clinical characteristic§
No.
%
No.
%
Jaundice
1,137
56.7
621
54.6
Hospitalized for hepatitis A
1,097
54.7
456
41.6
Died from hepatitis A
1,026
51.1
7
0.7

Source: CDC, National Notifiable Diseases Surveillance System.
*A total of 2,007 hepatitis A cases were reported during 2016.
†Case reports for which questions regarding clinical characteristics were answered with “yes” or “no.” Reports with any other response were excluded.
§Numbers and percentages represent only those case reports for which data regarding clinical characteristics were available; numbers likely are underestimates.

Table 2.3. Number and rate* of hepatitis A-related deaths†, by demographic characteristics and year — United States, 2012–2016

Table 2.3.
Demographic characteristic
2012§
2013
2014
2015
2016
No. Rate No. Rate No. Rate No. Rate No. Rate
  Age Group
(years)		 0–34 2 0.00 2 0.00 0 0.00 1 0.00 2 0.00
35–44 5 0.01 2 0.00 4 0.01 4 0.01 4 0.01
45–54 12 0.03 13 0.03 7 0.02 6 0.01 13 0.03
55–64 23 0.06 30 0.08 28 0.07 19 0.05 20 0.05
65–74 17 0.07 19 0.08 19 0.07 16 0.06 14 0.05
≥75 18 0.09 14 0.07 18 0.09 21 0.10 17 0.08
Race/
ethnicity§		 White NH (non-Hispanic) 51 0.02 63 0.02 51 0.02 45 0.02 50 0.02
Black NH 8 0.02 6 0.01 11 0.03 7 0.02 7 0.02
Hispanic 8 0.02 8 0.02 10 0.02 10 0.03 9 0.02
Asian/Pacific Islander 7 0.05 3 0.02 2 0.01 4 0.02 4 0.03
American Indian/Alaska Native 2 0.08 0 0.00 2 0.10 1 0.04 0 0.00
Sex Male 46 0.03 50 0.03 42 0.02 38 0.02 38 0.02
Female 31 0.02 30 0.01 34 0.02 29 0.02 32 0.02
Overall  77 0.02 80 0.02 76 0.02 67 0.02 70 0.02

Source: CDC, National Vital Statistics System.
*Rates for race, sex, and overall total are age-adjusted per 100,000 U.S. standard population in 2000.
†Cause of death is defined as the underlying cause of death or one of the multiple causes of death and is based on the International Classification of Diseases, 10th Revision (ICD-10) codes B15 (hepatitis A).
§One death in 2012 is not represented under the race/ethnicity category due to missing data.

Figure 2.1. Reported number of hepatitis A cases – United States, 2001-2016

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Figure 2.2. Incidence of hepatitis A, by age group — United States, 2001–2016

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Figure 2.3. Incidence of hepatitis A, by sex — United States, 2001–2016

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Figure 2.4. Incidence of hepatitis A, by race/ethnicity — United States, 2001–2016

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Figure 2.5. Availability of information on risk exposures/behaviors associated with acute hepatitis A — United States, 2016

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Figure 2.6a. Hepatitis A reports, by risk exposure/behavior — United States, 2016

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Figure 2.6b. Hepatitis A reports, by risk exposure/behavior — United States, 2016

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Map 2.1 State Acute Hepatitis A Incidence Compared to Healthy People 2020 National Goal of 0.2 cases/100,000 population / United States, 2016.

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All seven figure slides in PowerPoint [PPT – 829 KB]

Hepatitis B virus

Index
PAGE
DESCRIPTION
Table 3.1 Reported cases of acute hepatitis B, nationally and by state or jurisdiction ― United States, 2012–2016
Table 3.2 Select clinical characteristics of acute hepatitis B cases reported in the United States, 2016
Table 3.3 Number of newly reported case reports of confirmed chronic hepatitis B submitted by states and jurisdictions, 2016
Table 3.4 Reported cases of chronic hepatitis B, by demographic characteristics and laboratory tests — Enhanced Viral Hepatitis Surveillance Sites, 2013-2016
Table 3.5 Number and rate of hepatitis B-related deaths, by demographic characteristics and year — United States, 2012–2016
Table 3.6 Number of newly reported case reports of perinatal hepatitis B submitted by states and jurisdictions, 2016
Figure 3.1 Reported number of acute hepatitis B cases — United States, 2001–2016
Figure 3.2 Incidence of acute hepatitis B, by age group — United States, 2001–2016
Figure 3.3 Incidence of acute hepatitis B, by sex — United States, 2001-2016
Figure 3.4 Incidence of acute hepatitis B, by race/ethnicity — United States, 2001-2016
Figure 3.5 Availability of information on risk exposures/behaviors associated with acute hepatitis B — United States, 2016
Figure 3.6a Acute hepatitis B reports, by risk exposure/behavior —United States, 2016
Figure 3.6b Acute hepatitis B reports, by risk exposure/behavior — United States, 2016
Map 3.1 State Acute Hepatitis B Incidence Compared to Healthy People 2020 National Goal United States, 2016

Hepatitis B virus

Table 3.1. Reported cases of acute hepatitis B, nationally and by state or jurisdiction ― United States, 2012–2016

Table 3.1.
State
2012
2013
2014
2015
2016
No. Rate* No. Rate* No. Rate* No. Rate* No. Rate*
Alabama 79 1.6 90 1.9 117 2.4 101 2.1 59 1.2
Alaska 1 0.1 1 0.1 3 0.4 3 0.4 6

0.8
Arizona 14 0.2 28 0.4 31 0.5 25 0.4 14

0.2
Arkansas 74 2.5 50 1.7 28 0.9 36 1.2 49

1.6
California 136 0.4 138 0.4 110 0.3 160 0.4 115

0.3
Colorado 24 0.5 24 0.5 29 0.5 28 0.5 28

0.5
Connecticut 15 0.4 8 0.2 9 0.3 6 0.2 7

0.2
Delaware 11 1.2 14 1.5 8 0.9 8 0.8 3

0.3
District of Columbia U U U U U U U U U

U
Florida 247 1.3 323 1.7 313 1.6 432 2.1 558

2.7
Georgia 109 1.1 104 1.0 103 1.0 119 1.2 100

1.0
Hawaii 5 0.4 4 0.3 6 0.4 14 1.0 0

0.0
Idaho 5 0.3 13 0.8 6 0.4 8 0.5 6

0.4
Illinois 86 0.7 94 0.7 58 0.5 55 0.4 37

0.3
Indiana 90 1.4 101 1.5 126 1.9 133 2.0 146

2.2
Iowa 13 0.4 11 0.4 9 0.3 16 0.5 10

0.3
Kansas 9 0.3 11 0.4 11 0.4 19 0.7 21

0.7
Kentucky 180 4.1 214 4.9 164 3.7 162 3.7 222

5.0
Louisiana 44 1.0 82 1.8 87 1.9 87 1.9 48

1.0
Maine 9 0.7 11 0.8 12 0.9 9 0.7 53

4.0
Maryland 52 0.9 43 0.7 40 0.7 40 0.7 27

0.4
Massachusetts 75 1.1 71 1.1 30 0.4 25 0.4 31

0.5
Michigan 81 0.8 53 0.5 50 0.5 56 0.6 45

0.5
Minnesota 17 0.3 19 0.4 16 0.3 19 0.3 21

0.4
Mississippi 78 2.6 55 1.8 48 1.6 50 1.7 31

1.0
Missouri 48 0.8 61 1.0 31 0.5 35 0.6 40

0.7
Montana 2 0.2 4 0.4 0 0.0 4 0.4 1

0.1
Nebraska 10 0.5 9 0.5 8 0.4 3 0.2 8

0.4
Nevada 28 1.0 29 1.0 21 0.7 25 0.9 22

0.7
New Hampshire 4 0.3 2 0.2 4 0.3 0 0.0 0

0.0
New Jersey 70 0.8 65 0.7 77 0.9 85 0.9 59

0.7
New Mexico 3 0.1 3 0.1 2 0.1 2 0.1 1

0.0
New York 113 0.6 117 0.6 95 0.5 80 0.4 103

0.5
North Carolina 73 0.7 75 0.8 100 1.0 165 1.6 170 1.7
North Dakota 0 0.0 0 0.0 0 0.0 2 0.3

2

0.3
Ohio 178 1.5 225 1.9 171 1.5 409 3.5

299

2.6
Oklahoma 79 2.1 40 1.0 57 1.5 37 0.9

32

0.8
Oregon 25 0.6 32 0.8 32 0.8 24 0.6

20

0.5
Pennsylvania 63 0.5 43 0.3 68 0.5 61 0.5

43

0.3
Rhode Island U U U U U U U U

U

U
South Carolina 37 0.8 58 1.2 37 0.8 30 0.6

34

0.7
South Dakota 2 0.2 5 0.6 3 0.4 2 0.2

2

0.2
Tennessee 240 3.7 262 4.0 232 3.5 243 3.7

204

3.1
Texas 170 0.7 142 0.5 122 0.5 159 0.6

156

0.6
Utah 13 0.5 5 0.2 11 0.4 10 0.3

5

0.2
Vermont 2 0.3 2 0.3 4 0.6 3 0.5

2

0.3
Virginia 84 1.0 72 0.9 61 0.7 69 0.8

56

0.7
Washington 34 0.5 33 0.5 44 0.6 34 0.5

45

0.6
West Virginia 141 7.6 195 10.5 186 10.1 272 14.7

268

14.6
Wisconsin 22 0.4 9 0.2 11 0.2 5 0.1

9

0.2
Wyoming 0 0.0 U U U U U U

U

U
Total 2895 0.9 3050 1.0 2791 0.9 3370 1.1

3218

1.0

Source: CDC, National Notifiable Diseases Surveillance System.
*Rate per 100,000 population.
U=No data available for reporting.

Table 3.2. Select clinical characteristics of acute hepatitis B cases* reported in the United States, 2016

Table 3.2.
Clinical characteristic
Availability of valid data† for clinical characteristic
Cases with clinical characteristic§
No.
%
No.
%
Jaundice
 1,955 60.8 1,330 68.0
Hospitalized for hepatitis B
 1,867 58.0 1,086 58.2
Died from hepatitis B
 1,651 51.3 44 2.7

Source: CDC, National Notifiable Diseases Surveillance System.
*A total of 3,218 hepatitis B cases were reported during 2016.
†Case reports for which questions regarding clinical characteristics were answered with “yes” or “no.” Reports with any other response were excluded.
§Numbers and percentages represent only those case reports for which data regarding clinical characteristics were available; numbers likely are underestimates.

Table 3.3. Number of newly reported case* reports† of confirmed chronic hepatitis B submitted by states or jurisdictions, 2016

Table 3.3.
State/Jurisdiction No. chronic hepatitis B
case reports submitted†
Alabama N
Alaska 88
Arizona 175
Arkansas N
California 787
Colorado 165
Connecticut 70
Delaware 178
District of Columbia U
Florida 1,684
Georgia 1,776
Hawaii N
Idaho 63
Illinois 145
Indiana 219
Iowa 86
Kansas 76
Kentucky 17
Louisiana 170
Maine 51
Maryland 747
Massachusetts 334
Michigan 475
Minnesota 284
Mississippi N
Missouri 420
Montana 18
Nebraska 122
Nevada 2
New Hampshire 11
New Jersey 227
New Mexico 20
New York 1,943
North Carolina 660
North Dakota 89
Ohio 717
Oklahoma 56
Oregon 143
Pennsylvania 1,164
Rhode Island U
South Carolina 145
South Dakota 29
Tennessee 624
Texas N
Utah 69
Vermont 37
Virginia 328
Washington 154
West Virginia 244
Wisconsin N
Wyoming 35
Total 14,847

Source: CDC, National Notifiable Diseases Surveillance System.
*For case-definition, see https://wwwn.cdc.gov/nndss/conditions/hepatitis-b-chronic/case-definition/2012/
†Reports may not reflect unique cases.
§ Cases reported by California through NNDSS were all from San Francisco County. The number of cases in this table and table 3.4 differ because NNDSS and CDC’s Secure Access Management System (SAMS)
N= Not Reportable, chronic hepatitis B infection is not reportable in the listed state.
U=No data available for reporting

Table 3.4. Reported cases of chronic hepatitis B, by demographic characteristics and laboratory tests — Enhanced Viral Hepatitis Surveillance Sites, 2013-2016

Table 3.4.
Category FL*
No. %		 MA
No. %		 MI
No. %		 NYS†
No. %		 Phil
No. %		 SF
No. %		 WA
No. %		 Total
No. %
Sex
Female 1,394 689 862 889 228 1,747 243 6,052
45.8% 48.7% 47.9% 40.8% 38.0% 47.4% 42.9% 45.5%
Male 1,645 726 938 1,285 370 1,926 314 7,204
54.1% 51.3% 52.1% 58.9% 61.7% 52.3% 55.5% 54.2%
Unknown /missing 4 1 0 6 2 11 9 33
0.1% 0.1% 0.0% 0.3% 0.3% 0.3% 1.6% 0.2%
Race/Ethnicity
American Indian/ Alaska Native, NH¶ 1 8 16 2 1 4 4 36
0.0% 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% 0.3%
Asian/Pacific Islander, NH 168 474 464 701 215 1,875 103 4,000
5.5% 33.5% 25.8% 32.2% 35.8% 50.9% 18.2% 30.1%
Black,  NH 389 258 314 275 121 58 30 1,445
12.8% 18.2% 17.4% 12.6% 20.2% 1.6% 5.3% 10.9%
White,   NH 561 155 541 322 41 113 65 1,798
18.4% 10.9% 30.1% 14.8% 6.8% 3.1% 11.5% 13.5%
Hispanic 156 83 33 97 22 46 12 449
5.1% 5.9% 1.8% 4.4% 3.7% 1.2% 2.1% 3.4%
Other,  NH 88 88 105 84 16 23 15 419
2.9% 6.2% 5.8% 3.9% 2.7% 0.6% 2.7% 3.2%
Unknown /missing 1,681 350 327 699 184 1,565 337 5,142
55.2% 24.7% 18.2% 32.1% 30.7% 42.5% 59.5% 38.7%
Age group, years
0-14 21 16 40 15 8 25 8 131
0.7% 1.1% 2.2% 0.7% 1.3% 0.7% 1.4% 1.0%
15-24 158 99 144 171 43 149 52 816
5.2% 7.0% 8.0% 7.8% 7.2% 4.0% 9.2% 6.1%
25-39 887 576 562 794 208 1,200 191 4,418
29.1% 40.7% 31.2% 36.4% 34.7% 32.6% 33.7% 33.2%
40-54 981 409 548 667 215 1,250 185 4,255
32.2% 28.9% 30.4% 30.6% 35.8% 33.9% 32.7% 32.0%
55+ 995 316 506 533 126 1,062 130 3,668
32.7% 22.3% 28.1% 24.4% 21.0% 28.8% 23.0% 27.6%
Unknown /missing 1 0 0 0 0 0 0 1
0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0 0.0%
Place of Birth
United States 0 101 433 21 289 41 1 886
0.0% 7.1% 24.1% 1.0% 48.2% 1.1% 0.0% 6.7%
Outside United States 0 600 576 82 274 388 36 1,956
0.0% 42.4% 32.0% 3.8% 45.7% 10.5% 6.4% 14.7%
Unknown /missing 3,043 715 791 2,077 37 3,255 359 10,447
100.0% 50.5% 43.9% 95.3% 6.2% 88.4% 63.4% 78.6%
Hepatitis B laboratory testing**
HBV surface antigen + 2,686 1,224 1,225 1,887 489 3,248   255 11,014
88.3% 86.4% 68.1% 86.6% 81.5% 88.2% 45.1% 82.9%
[IgM anti-HBc] – 2,208 326 254 500 0 0 234 3,522
72.6% 23.0% 14.1% 22.9% 0.0% 0.0% 41.3% 26.5%
HBV “e” antigen + 379 350 79 359 150 347 62 1,726
12.5% 24.7% 4.4% 16.5% 25.0% 9.4% 11.0% 13.0%
HBV NAT + 1,344 1,009 212 872 503 3,034 107 7,081
44.2% 71.3% 11.8% 40.0% 83.8% 82.4% 18.9% 53.3%
Total no. cases 3,043 1,416 1,800 2,180 600 3,684 566 13,289
2013-2016 Estimated population total†† 20,259,003 6,761,108 9,914,094 11,238,360 1,562,194 856,404 6,333,530 56,924,692
Rate per 100,000 population 15.0 20.9 18.2 19.4 38.4 430.2 8.9 23.3

Source: CDC, Enhanced Viral Hepatitis Surveillance Sites.
Abbreviations: FL, Florida, MA, Massachusetts; MI, Michigan; NYS, New York State; Phil, Philadelphia; SF, San Francisco; WA, Washington State
Percentages may not sum to 100% due to rounding.
*New York City was not included in the case count for New York State, therefore cases and population estimates from New York excluded those who resided in New York City.
†The denominator used to calculate proportions was the total number of cases reported for each site.
§NH: Non-Hispanic
¶Cases can be reported with more than one laboratory test result.
**Population estimates for the United States: https://wonder.cdc.gov/bridged-race-population.html
HBV: Hepatitis B Virus; IgM anti-HBc (Anti-Hepatitis B core IgM); NAT: HBV nucleic acid testing.

Table 3.5. Number and rate* of hepatitis B-related deaths†, by demographic characteristics and year— United States, 2012–2016

Table 3.5.
Demographic
characteristic
2012
2013
2014
2015
2016
No. Rate No. Rate No. Rate No. Rate No. Rate
  Age Group
(years)§		 0–34 38 0.03 40 0.03 35 0.02 31 0.02 40 0.03
35–44 123 0.30 146 0.36 126 0.31 120 .3 118 .29
45–54 428 0.97 389 0.89 384 0.88 332 0.77 325 0.76
55–64 639 1.66 704 1.79 684 1.71 611 1.49 578 1.39
65–74 314 1.31 343 1.36 358 1.36 384 1.39 384 1.34
≥75 229 1.20 251 1.29 256 1.29 236 1.17 253 1.23
Race / ethnicity White NH (non-Hispanic) 818 0.31 868 0.33 853 0.32 809 0.3 771 0.29
Black NH 322 0.81 384 0.98 330 0.80 320 0.78 316 0.73
Hispanic 139 0.39 149 0.39 155 0.38 134 0.32 128 0.3
Asian / Pacific Islander 469 2.93 451 2.64 478 2.71 420 2.24 457 2.39
American Indian / Alaska Native 18 0.74 14 0.55 11 0.43 16 0.58 18 0.68
Sex Male 1,272 0.75 1,375 0.79 1,307 0.74 1277 0.72 1238 0.69
Female 499 0.27 498 0.26 536 0.27 438 0.22 460 0.23
Overall  1,771 0.50 1,873 0.52 1,843 0.50 1,715  0.45  1,698  0.45 

Source: CDC, National Vital Statistics System.
*Rates for race, sex, and overall total are age-adjusted per 100,000 U.S. standard population in 2000.
†Cause of death is defined as the underlying cause of death or one of the multiple causes of death and is based on the International Classification of Diseases, 10th Revision (ICD-10) codes B16, B17.0, B18.0, B18.1 (hepatitis B).
§ One death in 2015 is not represented under the age group category due to missing data.
¶ Five deaths in 2012, seven deaths in 2013, 16 deaths in 2014, 16 deaths in 2015, and 8 deaths in 2016 are not represented under the race/ethnicity category due to missing data.

Table 3.6. Number of newly reported case* reports† of perinatal hepatitis B§ submitted by states and jurisdictions, 2016

Table 3.6.
State/Jurisdiction No. Perinatal hepatitis B
case reports† submitted
California 15
Georgia 1
Kentucky 2
Louisiana 1
Minnesota 1
New York 2
North Carolina 1
Pennsylvania 2
Tennessee 2
Texas 2
Washington 1
West Virginia 1
Wisconsin 1
Total 32

Source: CDC, National Notifiable Diseases Surveillance System.
*For case-definition, see https://wwwn.cdc.gov/nndss/conditions/hepatitis-b-perinatal-virus-infection/case-definition/1995/
†Reports may not reflect unique cases.
§ Perinatal hepatitis B is not reportable disease in ALL jurisdictions

Figure 3.1. Reported number of acute hepatitis B cases — United States, 2001–2016

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Figure 3.2. Incidence of acute hepatitis B, by age group — United States, 2001–2016

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Figure 3.3. Incidence of acute hepatitis B, by sex — United States, 2001–2016

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Figure 3.4. Incidence of acute hepatitis B, by race/ethnicity — United States, 2001–2016

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Figure 3.5. Availability of information on risk exposures/behaviors associated with acute hepatitis B — United States, 2016

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Figure 3.6a. Acute hepatitis B reports, by risk exposure/behavior — United States, 2016

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Figure 3.6b. Acute hepatitis B reports, by risk exposure/behavior — United States, 2016

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Map 3.1 State Acute Hepatitis B Incidence Compared to Healthy People 2020 National Goal of 1.5 cases/100,000 population / United States, 2016.

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Hepatitis C virus

Index
PAGE
DESCRIPTION
Table 4.1 Reported cases of acute hepatitis C, nationally and by state or jurisdiction ― United States, 2012-2016
Table 4.2 Select clinical characteristics of acute hepatitis C cases reported in the United States, 2016
Table 4.3 Number of newly reported case reports of confirmed chronic hepatitis C submitted by states and jurisdictions, 2016
Table 4.4 Reported cases of chronic hepatitis C, by demographic characteristics and laboratory tests — Enhanced Viral Hepatitis Surveillance Sites, 2013-2016
Table 4.5 Number and rate of hepatitis C-related deaths, by demographic characteristic and year — United States, 2012-2016
Figure 4.1 Reported number of acute hepatitis C cases — United States, 2001–2016
Figure 4.2 Incidence of acute hepatitis C, by age group — United States, 2001–2016
Figure 4.3 Incidence of acute hepatitis C, by sex — United States, 2001-2016
Figure 4.4 Incidence of acute hepatitis C, by race/ethnicity — United States, 2001–2016
Figure 4.5 Availability of information on risk exposures/behaviors associated with acute hepatitis C — United States, 2016
Figure 4.6a Acute hepatitis C reports, by risk exposure/behavior — United States, 2016
Figure 4.6b Acute hepatitis C reports, by risk exposure/behavior — United States, 2016
Map 4.1 State Acute Hepatitis C Incidence Compared to Healthy People 2020 National Goal United States, 2016

Hepatitis C virus

Table 4.1. Reported cases of acute hepatitis C, nationally and by state and jurisdiction ―United States, 2012-2016

Table 4.1.
State
2012
2013
2014
2015
2016
No. Rate* No. Rate* No. Rate* No. Rate* No. Rate*
Alabama 24 0.5 30 0.6 35 0.7 70 1.4 32 0.7
Alaska U U U U U U U U U U
Arizona U U U U U U U U U U
Arkansas 5 0.2 30 1.0 13 0.4 2 0.1 0 0.0
California 63 0.2 72 0.2 73 0.2 59 0.2 60 0.2
Colorado 42 0.8 21 0.4 33 0.6 40 0.7 35 0.6
Connecticut 34 0.9 U U U U U U 17 0.5
Delaware U U U U U U 4 0.4 25 2.6
District of Columbia U U U U U U U U U U
Florida 107 0.6 134 0.7 93 0.5 126 0.6 236 1.1
Georgia 82 0.8 48 0.5 57 0.6 84 0.8 93 0.9
Hawaii U U U U U U U U U U
Idaho 11 0.7 14 0.9 6 0.4 4 0.2 7 0.4
Illinois 26 0.2 37 0.3 27 0.2 31 0.2 21 0.2
Indiana 110 1.7 175 2.7 122 1.8 138 2.1 146 2.2
Iowa 3 0.1 U U U U U U U U
Kansas 16 0.6 17 0.6 28 1.0 22 0.8 15 0.5
Kentucky 178 4.1 226 5.1 176 4.0 119 2.7 103 2.3
Louisiana 11 0.2 19 0.4 22 0.5 24 0.5 5 0.1
Maine 8 0.6 8 0.6 31 2.3 30 2.3 25 1.9
Maryland 39 0.7 53 0.9 42 0.7 38 0.6 35 0.6
Massachusetts 37 0.6 174 2.6 228 3.4 249 3.7 424 6.2
Michigan 76 0.8 74 0.7 78 0.8 83 0.8 107 1.1
Minnesota 32 0.6 47 0.9 40 0.7 37 0.7 51 0.9
Mississippi U U U U U U U U U U
Missouri 4 0.1 6 0.1 6 0.1 8 0.1 24 0.4
Montana 9 0.9 16 1.6 13 1.3 15 1.5 20 1.9
Nebraska 3 0.2 2 0.1 2 0.1 8 0.4 2 0.1
Nevada 12 0.4 9 0.3 6 0.2 12 0.4 16 0.5
New Hampshire U U U U U U U U U U
New Jersey 71 0.8 106 1.2 113 1.3 130 1.5 122 1.4
New Mexico 21 1.0 12 0.6 16 0.8 40 1.9 18 0.9
New York 93 0.5 131 0.7 126 0.6 121 0.6 179 0.9
North Carolina 63 0.6 79 0.8 111 1.1 144 1.4 82 0.8
North Dakota 0 0.0 4 0.6 0 0.0 0 0.0 1 0.1
Ohio 7 0.1 116 1.0 105 0.9 122 1.1 187 1.6
Oklahoma 80 2.1 40 1.0 45 1.2 35 0.9 32 0.8
Oregon 37 0.9 14 0.4 15 0.4 13 0.3 19 0.5
Pennsylvania 66 0.5 81 0.6 69 0.5 129 1.0 225 1.8
Rhode Island U U U U U U U U U U
South Carolina 1 0.0 0 0.0 4 0.1 5 0.1 10 0.2
South Dakota U U U U U U U U 20 2.3
Tennessee 129 2.0 98 1.5 123 1.9 173 2.6 150 2.3
Texas 44 0.2 28 0.1 47 0.2 48 0.2 40 0.1
Utah 17 0.6 11 0.4 38 1.3 30 1.0 76 2.5
Vermont 6 1.0 3 0.5 4 0.6 1 0.2 5 0.8
Virginia 76 0.9 41 0.5 54 0.6 52 0.6 43 0.5
Washington 54 0.8 63 0.9 82 1.2 63 0.9 62 0.9
West Virginia 55 3.0 58 3.1 62 3.4 63 3.4 94 5.1
Wisconsin 26 0.5 40 0.7 49 0.9 64 1.1 103 1.8
Wyoming U U U U U U U U U U
Total 1778 0.6 2138 0.7 2194 0.7 2436 0.8 2967 1.0

Source: CDC, National Notifiable Diseases Surveillance System.
*Rate per 100,000 population.
U=No data available for reporting.

Table 4.2. Select clinical characteristics of acute hepatitis C cases* reported in the United States, 2016

Table 4.2.
Clinical characteristic
Availability of valid data† for clinical characteristic
Cases with clinical characteristic§
No.
%
No.
%
Jaundice
 2,380 80.2 1,054 44.3
Hospitalized for acute hepatitis C
 1,993 67.2 923 46.3
Died from acute hepatitis C
 1,687 56.9 52 3.1

Source: CDC, National Notifiable Diseases Surveillance System.
*A total of 2,967 acute hepatitis C cases were reported during 2016.
†Case reports for which questions regarding clinical characteristics were answered with “yes” or “no.” Reports with any other response were excluded.
§Numbers and percentages represent only those case reports for which data regarding clinical characteristics were available; numbers likely are underestimates.

Table 4.3. Number of newly reported case* reports† of confirmed chronic hepatitis C submitted by states and jurisdictions, 2016

Table 4.3.
State/Jurisdiction No. chronic hepatitis C
case reports submitted†
Alabama N
Alaska 754
Arizona U
Arkansas 0
California§ 697
Colorado 2,917
Connecticut 1,631
Delaware 1,328
District of Columbia U
Florida 17,724
Georgia 7,086
Hawaii U
Idaho 895
Illinois 5,568
Indiana U
Iowa 734
Kansas 1,205
Kentucky 44
Louisiana 3,534
Maine 494
Maryland 4,367
Massachusetts 4,609
Michigan 5,178
Minnesota 1,420
Mississippi N
Missouri 5,068
Montana 1,026
Nebraska 801
Nevada 4
New Hampshire 10
New Jersey 8,006
New Mexico 1,205
New York 8,985
North Carolina N
North Dakota 701
Ohio 14,272
Oklahoma 543
Oregon 3,541
Pennsylvania 13,029
Rhode Island U
South Carolina 3,121
South Dakota 483
Tennessee 10,632
Texas N
Utah 1,221
Vermont 723
Virginia 5,150
Washington 4,294
West Virginia 3,106
Wisconsin 2,347
Wyoming 479
Total 148,932

Source: CDC, National Notifiable Diseases Surveillance System
*For case-definition, see https://wwwn.cdc.gov/nndss/conditions/hepatitis-c-chronic/case-definition/2016/.
†Reports may not reflect unique cases.
§Cases reported by California through NNDSS were all from San Francisco County. Differences in the number of cases in this table and table 4.4 are because NNDSS and CDC’s Secure Access Management System (SAMS) have different data close-out dates by which all annual data must be submitted.
N=Not Reportable, chronic hepatitis C is not reportable in the listed state.
U= No data available for reporting

Table 4.4. Reported cases of chronic hepatitis C, by demographic characteristics and laboratory tests — Enhanced Viral Hepatitis Surveillance Sites, 2013-2016

Table 4.4.
Category FL*
No. %§		 MA
No. %		 MI
No. %		 NYS†
No. %		 Phil
No. %		 SF
No. %		 WA
No. %		 Total
No. %
Sex
Female 18,034 8,002 9,495 9,554 2,198 1,540 6,839 55,662
40.2% 38.6% 36.5% 38.4% 34.2% 28.2% 38.3% 38.1%
Male 26,740 12,628 16,439 15,141 4,145 3,879 10,733 89,705
59.5% 61.0% 63.2% 60.9% 64.6% 71.0% 60.1% 61.3%
Unknown /missing 135 83 66 171 75 42 284 856
0.3% 0.4% 0.3% 0.7% 1.2% 0.8% 1.6% 0.6%
 Race/ethnicity
American Indian/
Alaska Native, NH		 81 49 214 117 6 30 121 618
0.0% 0.0% 0.0% 0.0% 0.0% 0.5% 0.0% 0.0%
Asian/Pacific Islander,  NH 104 308 140 290 52 205 131 1,230
0.2% 1.5% 0.5% 1.2% 0.8% 3.8% 0.7% 0.8%
Black, NH 1,796 816 4,476 2,187 793 851 399 11,318
4.0% 3.9% 17.2% 8.8% 12.4% 15.6% 2.2% 7.7%
White, NH 13,714 8,552 12,296 11,525 783 1,919 4,366 53,155
30.5% 41.3% 47.3% 46.3% 12.2% 35.1% 24.5% 36.4%
Hispanic 1,744 1,144 472 1,513 320 378 343 5,914
3.9% 5.5% 1.8% 6.1% 5.0% 6.9% 1.9% 4.0%
Other,  NH 544 637 290 383 33 35 122 2,044
1.2% 3.1% 1.1% 1.5% 0.5% 0.6% 0.7% 1.4%
Unknown /missing 26,926 9,207 8,112 8,851 4,431 2,043 12,374 71,944
60.0% 44.5% 31.2% 35.6% 69.0% 37.4% 69.3% 49.2%
Age group, years
0-14 95 145 96 47 26 1 49 459
0.2% 0.7% 0.4% 0.2% 0.4% 0.0% 0.3% 0.3%
15-24 3,901 2,755 2,053 2,880 255 133 1,315 13,292
8.7% 13.3% 7.9% 11.6% 4.0% 2.4% 7.4% 9.1%
25-39 12,605 7,714 6,334 7,228 1,341 958 4,045 40,225
28.1% 37.2% 24.4% 29.1% 20.9% 17.5% 22.7% 27.5%
40-54 10,846 4,923 5,908 5,912 1,847 1,629 5,241 36,306
24.2% 23.8% 22.7% 23.8% 28.8% 29.8% 29.4% 24.8%
55+ 17,441 5,156 11,600 8,747 2,947 2,695 7,192 55,778
38.8% 24.9% 44.6% 35.2% 45.9% 49.3% 40.3% 38.1%
Unknown /missing 21 20 9 52 2 45 14 163
0.0% 0.1% 0.0% 0.2% 0.0% 0.8% 0.1% 0.1%
 Hepatitis C laboratory testing**
Anti-HCV+ 28,145 14,800 15,689 17,458 3,957 3,137 8,889 92,075
62.7% 71.5% 60.3% 70.2% 61.7% 57.4% 49.8% 63.0%
HCV RNA+ 33,059 15,900 10,689 18,461 6,067 4,006 11,378 99,560
73.6% 76.8% 41.1% 74.2% 94.5% 73.4% 63.7% 68.1%
Total no. cases   44,909 20,713 26,000 24,866 6,418 5,461 17,856 146,223
2013-2016 Estimated population total†† 20,259,003 6,761,108 9,914,094 11,238,360 1,562,194 856,404 6,333,530 56,924,692
Rate per 100,000 population 221.7 306.4 262.3 221.3 410.8 637.7 281.9 256.9

Source: CDC, Enhanced Viral Hepatitis Surveillance Sites.
Abbreviations: FL, Florida, MA, Massachusetts; MI, Michigan; NYS, New York State; Phil, Philadelphia; SF, San Francisco; WA, Washington State; HBV: Hepatitis B Virus; IgM anti-HBc (Anti-Hepatitis B core IgM); NAT: HBV nucleic acid testing.
Percentages may not sum to 100% due to rounding.
*New York City was not included in the case count for New York State, therefore cases and population estimates from New York excluded those who resided in New York City.
†The denominator used to calculate proportions was the total number of cases reported for each site.
§NH: Non-Hispanic
¶Cases can be reported with more than one laboratory test result.
**Population estimates for the United States: https://wonder.cdc.gov/bridged-race-population.html
HCV: Hepatitis C virus; Anti-HCV: Hepatitis C Antibody: HCV RNA: Ribonucleic acid.

Table 4.5. Number and rate* of hepatitis C-related deaths†, by demographic characteristic and year — United States, 2012-2016

Table 4.5.
Demographic characteristic
2012
2013
2014
2015
2016
No. Rate No. Rate No. Rate No. Rate No. Rate
Age Group (years)§ 0–34 158 0.11 121 0.08 162 0.11 196 0.13 165 0.11
35–44 622 1.54 573 1.42 552 1.36 597 1.47 536 1.32
45–54 4,749 10.73 4,344 9.93 4,118 9.48 3,676 8.51 3,038 7.10
55–64 9,235 23.93 9,899 25.18 9,999 24.95 9,702 23.73 9,032 21.78
65–74 2,515 10.49 3,004 11.91 3,390 12.84 4,023 14.60 4,086 14.27
>75 1,369 7.15 1,425 7.31 1,433 7.22 1,434 7.10 1,292 6.27
Race/ ethnicity White, NH (non-Hispanic) 11,839 4.35 12,219 4.40 12,455 4.46 12,355 4.38 11,422 3.97
Black, NH 3,232 7.81 3,520 8.35 3,540 8.12 3,606 8.14 3,365 7.42
Hispanic 2,668 7.19 2,699 6.91 2,767 6.81 2,699 6.40 2,482 5.69
Asian/Pacific Islander 472 3.15 495 3.09 438 2.56 445 2.49 405 2.14
American Indian/Alaska Native 313 11.81 324 12.22 317 11.2 367 12.95 312 10.75
Sex Male 13,300 7.31 13,745 7.40 13,998 7.39 14,095 7.31 12,863 6.52
Female 5,350 2.77 5,623 2.85 5,661 2.81 5,534 2.71 5,290 2.55
Overall 18,650 4.96 19,368 5.03 19,659 5.01 19,629 4.91 18,153 4.45

Source: CDC, National Vital Statistics System.
*Rates for race, sex, and overall total are age-adjusted per 100,000 U.S. standard population in 2000.
†Cause of death is defined as the underlying cause of death or one of the multiple causes of death and is based on the International Classification of Diseases, 10th Revision (ICD-10) codes B17.1, and B18.2 (hepatitis C).
§Two deaths in 2012, two deaths in 2013, five deaths in 2014, one death in 2015, and four deaths in 2016 are not represented under the age category due to missing age data.
¶The race/ethnicity category was added starting in 2010 to incorporate bridged race categories. 126 deaths in 2012, 111 deaths in 2013, 142 deaths in 2014, 157 deaths in 2015, and 167 deaths in 2016 are not represented under the race/ethnicity category due to missing data.

Figure 4.1. Reported number of acute hepatitis C cases — United States, 2001–2016

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Figure 4.2. Incidence of acute hepatitis C, by age group — United States, 2001–2016

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Figure 4.3. Incidence of acute hepatitis C, by sex — United States, 2001–2016

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Figure 4.4. Incidence of acute hepatitis C, by race/ethnicity — United States, 2001–2016

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Figure 4.5. Availability of information on risk exposures/behaviors associated with acute hepatitis C — United States, 2015

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Figure 4.6a. Acute hepatitis C reports, by risk exposure/behavior — United States, 2016

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Figure 4.6b. Acute hepatitis C reports, by risk exposure/behavior — United States, 2016

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Map 4.1 State Acute Hepatitis C Incidence Compared to Healthy People 2020 National Goal of 0.25 cases/100,000 population / United States, 2016.

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