Viral Hepatitis Surveillance Report 2018 — Hepatitis B

ACUTE HEPATITIS B, 2018. 3,322 New cases reported. 1.0 Reported cases per 100,000 population. 21,600 Acute infections estimated

* 95% Bootstrap Confidence Interval: (12,300– 52,800)

AT A GLANCE: Acute Hepatitis B in 2018

Rates of acute hepatitis B remained low in children and adolescents, likely due to childhood vaccinations. However, over half of acute hepatitis B cases reported to CDC in 2018 were among persons aged 30–49 years.

Groups Most Affected by Acute Hepatitis B in 2018

By Age†
30-39 years: 2.0 cases per 100,000 people
40-49 years: 2.6 cases per 100,000 people
50-59 years: 1.6 cases per 100,000 people

By Sex†
Males: 1.3 cases per 100,000 people

By Race/ Ethnicity†
White, Non-Hispanic: 1.0 cases per 100,000 people

By Risk
Injection Drug Use (IDU): Among the 1,518 reported cases with IDU information available, 549 (36%) report IDU

† Indicates groups above the national average in 2018

On This Page

Figure 2.1. Number of reported acute hepatitis B cases and estimated infections — United States, 2011–2018
Table 2.1. Number and rate of reported cases of acute hepatitis B, by state or jurisdiction ― United States, 2014–2018
Figure 2.2. Rates of reported acute hepatitis B, by state — United States, 2017–2018
Figure 2.3. Rates of reported acute hepatitis B, by state or jurisdiction — United States, 2018
Figure 2.4. Rates of reported acute hepatitis B, by age group — United States, 2003–2018
Figure 2.5. Rates of reported acute hepatitis B, by sex— United States, 2003–2018
Figure 2.6. Rates of reported acute hepatitis B, by race/ethnicity — United States, 2003–2018
Table 2.2. Number and rate of reported cases of acute hepatitis B, by demographic characteristics, region — United States 2014–2018
Figure 2.7. Availability of information on risk behaviors/exposures associated with reported cases of acute hepatitis B — United States, 2018
Table 2.3. Reported risk behaviors/exposures among reported cases of acute hepatitis B — United States, 2018
Table 2.4. Number of newly reported cases of perinatal hepatitis B, by state or jurisdiction — United States, 2018
Table 2.5. Number of newly reported cases of chronic hepatitis B, by state or jurisdiction — United States, 2018
Table 2.6. Number and rate of deaths with hepatitis B listed as a cause of death among U.S. residents, by jurisdiction and year ― United States, 2014–2018
Figure 2.8. Rate of deaths with hepatitis B listed as a cause of death among U.S. residents, by jurisdiction and year — United States, 2018
Table 2.7. Number and rate of deaths with hepatitis B listed as a cause of death among U.S. residents, by demographic characteristics, region, and year — United States, 2014–2018

Figure 2.1. Number of reported acute hepatitis B cases and estimated infections* — United States, 2011–2018

Figure 2.1. The number of reported acute hepatitis B cases and estimated acute hepatitis B infection generally remained stable from 2011 through 2018. In 2018 there were 3,322 reported cases of acute hepatitis B and 21,600 estimated acute hepatitis B infections.

Data points for figure 2.1
Hepatitis B	2011	2012	2013	2014	2015	2016	2017	2018
Reported acute cases	2,903	2,895	3,050	2,791	3,370	3,218	3,409	3,322
Estimated acute infections	18,900	18,800	19,800	18,100	21,900	20,900	22,200	21,600

Source: CDC, National Notifiable Diseases Surveillance System
* The number of estimated viral hepatitis infections was determined by multiplying the number of reported cases by a factor that adjusted for under-ascertainment and under-reporting(7). The 95% bootstrap confidence intervals for the estimated number of infections are shown in the Appendix.

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Table 2.1. Number and rate* of reported cases† of acute hepatitis B, by state or jurisdiction ― United States, 2014–2018

Table 2.1
State	2014 No.	2014 Rate*	2015 No.	2015 Rate*	2016 No.	2016 Rate*	2017 No.	2017 Rate*	2018 No.	2018 Rate*
Alabama	117	2.4	101	2.1	59	1.2	82	1.7	48	1.0
Alaska	3	0.4	3	0.4	6	0.8	9	1.2	7	0.9
Arizona	31	0.5	25	0.4	14	0.2	26	0.4	23	0.3
Arkansas	28	0.9	36	1.2	49	1.6	46	1.5	47	1.6
California	110	0.3	160	0.4	115	0.3	126	0.3	105	0.3
Colorado	29	0.5	28	0.5	28	0.5	32	0.6	21	0.4
Connecticut	9	0.3	6	0.2	7	0.2	10	0.3	10	0.3
Delaware	8	0.9	8	0.8	3	0.3	9	0.9	7	0.7
District of Columbia	U	U	U	U	U	U	U	U	U	U
Florida	313	1.6	432	2.1	558	2.7	588	2.8	617	2.9
Georgia	103	1.0	119	1.2	100	1.0	106	1.0	179	1.7
Hawaii	6	0.4	14	1.0	—	—	—	—	3	0.2
Idaho	6	0.4	8	0.5	6	0.4	6	0.3	6	0.3
Illinois	58	0.5	55	0.4	37	0.3	27	0.2	25	0.2
Indiana	126	1.9	133	2.0	146	2.2	170	2.5	169	2.5
Iowa	9	0.3	16	0.5	10	0.3	12	0.4	14	0.4
Kansas	11	0.4	19	0.7	21	0.7	24	0.8	16	0.5
Kentucky	164	3.7	162	3.7	222	5.0	236	5.3	260	5.8
Louisiana	87	1.9	87	1.9	48	1.0	73	1.6	57	1.2
Maine	12	0.9	9	0.7	53	4.0	77	5.8	52	3.9
Maryland	40	0.7	40	0.7	27	0.4	34	0.6	53	0.9
Massachusetts	30	0.4	25	0.4	31	0.5	51	0.7	46	0.7
Michigan	50	0.5	56	0.6	45	0.5	61	0.6	77	0.8
Minnesota	16	0.3	19	0.3	21	0.4	23	0.4	16	0.3
Mississippi	48	1.6	50	1.7	31	1.0	44	1.5	40	1.3
Missouri	31	0.5	35	0.6	40	0.7	31	0.5	18	0.3
Montana	—	—	4	0.4	1	0.1	3	0.3	1	0.1
Nebraska	8	0.4	3	0.2	8	0.4	10	0.5	3	0.2
Nevada	21	0.7	25	0.9	22	0.7	30	1.0	23	0.8
New Hampshire	4	0.3	—	—	—	—	—	—	4	0.3
New Jersey	77	0.9	85	0.9	59	0.7	57	0.6	64	0.7
New Mexico	2	0.1	2	0.1	1	0.0	1	0.0	2	0.1
New York	95	0.5	80	0.4	103	0.5	81	0.4	56	0.3
North Carolina	100	1.0	165	1.6	170	1.7	190	1.8	220	2.1
North Dakota	—	—	2	0.3	2	0.3	—	—	2	0.3
Ohio	171	1.5	409	3.5	299	2.6	285	2.4	310	2.7
Oklahoma	57	1.5	37	0.9	32	0.8	41	1.0	6	0.2
Oregon	32	0.8	24	0.6	20	0.5	23	0.6	18	0.4
Pennsylvania	68	0.5	61	0.5	43	0.3	69	0.5	61	0.5
Rhode Island	U	U	U	U	U	U	U	U	U	U
South Carolina	37	0.8	30	0.6	34	0.7	40	0.8	45	0.9
South Dakota	3	0.4	2	0.2	2	0.2	2	0.2	1	0.1
Tennessee	232	3.5	243	3.7	204	3.1	215	3.2	192	2.8
Texas	122	0.5	159	0.6	156	0.6	106	0.4	102	0.4
Utah	11	0.4	10	0.3	5	0.2	18	0.6	36	1.1
Vermont	4	0.6	3	0.5	2	0.3	1	0.2	3	0.5
Virginia	61	0.7	69	0.8	56	0.7	61	0.7	58	0.7
Washington	44	0.6	34	0.5	45	0.6	45	0.6	51	0.7
West Virginia	186	10.1	272	14.7	268	14.6	212	11.7	132	7.3
Wisconsin	11	0.2	5	0.1	9	0.2	14	0.2	14	0.2
Wyoming	U	U	U	U	U	U	2	0.3	2	0.3
Total	2,791	0.9	3,370	1.1	3,218	1.0	3,409	1.1	3,322	1.0

Source: CDC, National Notifiable Diseases Surveillance System.
* Rate per 100,000 population.
†For case definition see https://wwwn.cdc.gov/nndss/conditions/hepatitis-b-acute/case-definition/2012/.
—: No reported cases. The reporting jurisdiction did not submit any cases to CDC.
N: Not reportable. The disease or condition was not reportable by law, statue, or regulation in the reporting jurisdiction.
U: Unavailable. The data are unavailable.

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Figure 2.2. Rates of reported acute hepatitis B, by state — United States, 2017–2018

Figure 2.2. The graph shows the distribution of rates of reported acute hepatitis B by state for 2017 and 2018 compared to the 2018 US average rate of 1.0 case per 100,000 population. West Virginia and Kentucky have the highest rates of reported acute hepatitis B in 2018.

Source: CDC, National Notifiable Diseases Surveillance System.
* Excludes District of Columbia and Rhode Island.

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Figure 2.3. Rates of reported acute hepatitis B, by state or jurisdiction — United States, 2018

Figure 2.3. This map displays rates of acute hepatitis B by state or jurisdiction for 2018. States are grouped and shaded based on acute hepatitis B rates (cases per 100,000/population). States with no reported cases are grouped separately.

Color Key Table for Figure 2.3
Color Key	Cases/100,000 Population	States
	0-0.3	AZ, CA, CT, HI, ID, IL, MN, MO, MT, NE, NH, NM, NY, ND, OK, SD, WI, WY
	>0.3-0.6	CO, IA, KS, OR, PA, TX, VT
	>0.6-0.9	AK, DE, MD, MA, MI, NV, NJ, SC, VA, WA
	>0.9-2.0	AL, AR, GA, LA, MS, UT
	>2.0-7.3	FL, IN, KY, ME, NC, OH, TN, WV
	No reported cases	DC, RI

Source: CDC, National Notifiable Diseases Surveillance System.

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Figure 2.4. Rates of reported acute hepatitis B, by age group — United States, 2003–2018

Data points for Figure 2.4.
Age (years)	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018
0-19	0.3	0.2	0.2	0.1	0.1	0.1	0.1	0.1	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0
20-29	4.3	3.5	2.9	2.3	2.1	1.8	1.2	1.1	1.0	0.9	0.8	0.6	0.8	0.6	0.6	0.6
30-39	5.1	4.0	3.7	3.4	3.1	2.7	2.3	2.3	2.0	2.2	2.4	2.2	2.6	2.4	2.3	2.0
40-49	4.3	3.5	3.1	2.8	2.8	2.6	2.2	2.0	1.9	1.9	2.1	2.0	2.4	2.2	2.5	2.6
50-59	2.4	2.3	2.0	1.8	1.8	1.5	1.4	1.5	1.1	1.1	1.1	1.2	1.4	1.5	1.6	1.6
60+	1.2	1.1	0.8	0.8	0.8	0.7	0.7	0.7	0.5	0.4	0.4	0.4	0.5	0.5	0.6	0.6

Source: CDC, National Notifiable Diseases Surveillance System.

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Figure 2.5. Rates of reported acute hepatitis B, by sex — United States, 2003–2018

Figure 2.5. This line graph shows trends in rates of acute hepatitis B for males and females 2003 through 2018. Rates of acute hepatitis B declined for males and females from 2003 through 2009 and remained stable from 2009 through 2018. Rates for males were higher than rates for females for all years.

Data points for Figure 2.5.
Sex	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018
Male	3.2	2.7	2.3	2.1	1.9	1.7	1.4	1.4	1.2	1.2	1.2	1.1	1.3	1.2	1.3	1.3
Female	2.0	1.6	1.4	1.1	1.2	1.0	0.8	0.8	0.7	0.7	0.7	0.6	0.8	0.8	0.8	0.8

Source: CDC, National Notifiable Diseases Surveillance System.

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Figure 2.6. Rates of reported acute hepatitis B, by race/ethnicity — United States, 2003–2018

Data points for Figure 2.6.
Race/ Ethnicity	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018
American Indian/ Alaska Native	2.8	1.5	1.6	1.6	1.4	1.8	1.0	1.1	0.5	0.7	0.7	0.8	0.7	0.5	0.7	0.9
Asian/Pacific Islander	1.6	1.3	1.3	1.3	1.0	0.8	0.7	0.6	0.4	0.4	0.3	0.3	0.4	0.3	0.3	0.3
Black, Non-Hispanic	3.5	2.9	3.0	2.3	2.3	2.2	1.7	1.7	1.4	1.1	1.0	0.8	1.0	0.9	1.0	1.0
White, Non-Hispanic	1.3	1.2	1.1	1.0	1.0	0.9	0.8	0.8	0.8	0.8	0.9	0.9	1.1	1.0	1.1	1.0
Hispanic	1.1	1.0	1.1	1.1	1.0	0.8	0.7	0.6	0.4	0.4	0.4	0.3	0.3	0.3	0.3	0.4

Source: CDC, National Notifiable Diseases Surveillance System.

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Table 2.2. Number and rate* of reported cases† of acute hepatitis B, by demographic characteristics, regions — United States 2014–2018

Table 2.2
State	2014 No.	2014 Rate*	2015 No.	2015 Rate*	2016 No.	2016 Rate*	2017 No.	2017 Rate*	2018 No.	2018 Rate*
Total^§	2,791	0.9	3,370	1.1	3,218	1.1	3,409	1.1	3,322	1.0
Age group (years)
0–19	14	0.0	19	0.0	18	0.0	16	0.0	27	0.0
20–29	282	0.6	348	0.8	286	0.6	271	0.6	249	0.6
30–39	888	2.2	1,094	2.6	1,000	2.4	998	2.3	868	2.0
40–49	818	2.0	961	2.4	906	2.2	1,028	2.5	1,052	2.6
50–59	504	1.2	615	1.4	655	1.5	700	1.6	675	1.6
60+	272	0.4	312	0.5	342	0.5	395	0.6	450	0.6
Sex
Male	1,778	1.1	2,080	1.3	1,957	1.2	2,095	1.3	2,050	1.3
Female	1,001	0.6	1,280	0.8	1,252	0.8	1,301	0.8	1,260	0.8
Race/ethnicity
American Indian/ Alaskan Native	21	0.8	18	0.7	14	0.5	19	0.7	25	0.9
Asian/Pacific Islander	53	0.3	67	0.4	56	0.3	64	0.3	55	0.3
Black, Non-Hispanic	343	0.8	398	1.0	386	0.9	411	1.0	405	1.0
White, Non-Hispanic	1,713	0.9	2,150	1.1	2,059	1.0	2,197	1.1	2,084	1.0
Hispanic	158	0.3	175	0.3	194	0.3	196	0.3	222	0.4
HHS Region^¶
Region 1	59	0.4	43	0.3	93	0.7	139	1.0	115	0.8
Region 2	172	0.6	165	0.6	162	0.6	138	0.5	120	0.4
Region 3	363	1.2	450	1.5	397	1.3	385	1.3	311	1.0
Region 4	1,114	1.8	1,302	2.0	1,378	2.1	1,501	2.3	1,601	2.4
Region 5	432	0.8	677	1.3	557	1.1	580	1.1	611	1.2
Region 6	296	0.7	321	0.8	286	0.7	267	0.6	214	0.5
Region 7	59	0.4	73	0.5	79	0.6	77	0.5	51	0.4
Region 8	43	0.4	46	0.4	38	0.3	57	0.5	63	0.5
Region 9	168	0.3	224	0.4	151	0.3	182	0.4	154	0.3
Region 10	85	0.6	69	0.5	77	0.6	83	0.6	82	0.6

Source: CDC, National Notifiable Diseases Surveillance System.
* Rate per 100,000 population.
† For the case definition, see https://wwwn.cdc.gov/nndss/conditions/hepatitis-b-acute/
§ Numbers reported in each category may not add up to the total number of reported cases in a year due to cases with missing data or, in the case of race/ethnicity, cases categorized as “Other”.
^¶ Health and Human Services Regions were categorized according to the grouping of states and U.S. Territories assigned under each of the ten Department of Health and Human Services regional offices (https://www.hhs.gov/about/agencies/iea/regional-offices/index.html). For the purposes of this report, regions with US territories (Region 2 and Region 9) contain data from states only.

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HEPATITIS B – RISK BEHAVIORS AND EXPOSURES

Figure 2.7. Availability of information on risk behaviors/exposures* associated with reported cases of acute hepatitis B — United States, 2018

Color Key with three items listed. Risk identified*, No risk identified, and Risk data missing

Figure 2.7. The pie chart provides information on the availability of risk behaviors/exposures for reported cases of acute hepatitis B for 2018. At least one risk behavior/exposure was identified for 26% of cases, no risk was identified for 25% of cases, and risk data were missing for 48% of cases.

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Table 2.3. Reported risk behaviors/exposures† among reported cases of acute hepatitis B — United States, 2018

Table 2.3
Risk behaviors/exposures	Risk identified*	No risk identified	Risk data missing
Injection drug use	549	969	1,804
Multiple sex partners	199	671	2,452
Surgery	117	962	2,243
Men who have sex with men §	49	353	1,648
Sexual contact ¶	42	603	2,677
Needlestick	71	959	2,292
Household contact (non-sexual) §	12	633	2,677
Occupational	4	1,369	1,949
Dialysis patient	13	1,022	2,287
Transfusion	1	1,103	2,218

Source: CDC, Nationally Notifiable Diseases Surveillance System.
* Case reports with at least one of the following risk behaviors/ exposures reported 6 weeks to 6 months prior to symptom onset: 1) injection drug use;
2) multiple sex partners; 3) underwent surgery; 4) men who have sex with men; 5) sexual contact with suspected/confirmed hepatitis B case; 6) sustained
a percutaneous injury; 7) household contact with suspected/confirmed hepatitis B case; 8) occupational exposure to blood; 9) dialysis; and 10) transfusion
† Reported cases may include more than one risk behavior/exposure.
§ A total of 2,050 acute hepatitis B cases were reported among males in 2018.
¶ Cases with more than one type of contact reported were categorized according to a hierarchy: (1) sexual contact; (2) household contact (non-sexual).

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Table 2.4. Number of newly reported cases* of perinatal hepatitis B, by state or jurisdiction — United States, 2018

Table 2.4
State	Perinatal Hepatitis B
Alabama	–
Alaska	1
Arizona	1
Arkansas	–
California	4
Colorado	–
Connecticut	–
Delaware	–
District of Columbia	U
Florida	2
Georgia	1
Hawaii	–
Idaho	–
Illinois	–
Indiana	–
Iowa	–
Kansas	–
Kentucky	1
Louisiana	–
Maine	–
Maryland	–
Massachusetts	–
Michigan	1
Minnesota	–
Mississippi	–
Missouri	–
Montana	–
Nebraska	–
Nevada	–
New Hampshire	–
New Jersey	–
New Mexico	–
New York	4
North Carolina	–
North Dakota	–
Ohio	1
Oklahoma	1
Oregon	–
Pennsylvania	3
Rhode Island	U
South Carolina	–
South Dakota	–
Tennessee	1
Texas	1
Utah	–
Vermont	–
Virginia	–
Washington	1
West Virginia	–
Wisconsin	–
Wyoming	–
Total	23

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Table 2.5. Number of newly reported cases** of chronic hepatitis B, by state or jurisdiction — United States, 2018

Table 2.5
State	Chronic Hepatitis B
Alabama	N
Alaska	30
Arizona	180
Arkansas	N
California	–
Colorado	186
Connecticut	N
Delaware	140
District of Columbia	U
Florida	2,090
Georgia	1,421
Hawaii	U
Idaho	72
Illinois	545
Indiana	342
Iowa	54
Kansas	41
Kentucky	N
Louisiana	274
Maine	70
Maryland	690
Massachusetts	308
Michigan	329
Minnesota	305
Mississippi	N
Missouri	450
Montana	15
Nebraska	51
Nevada	U
New Hampshire	U
New Jersey	407
New Mexico	28
New York	1,806
North Carolina	509
North Dakota	41
Ohio	683
Oklahoma	53
Oregon	96
Pennsylvania	834
Rhode Island	U
South Carolina	184
South Dakota	21
Tennessee	644
Texas	N
Utah	95
Vermont	13
Virginia	446
Washington	391
West Virginia	304
Wisconsin	42
Wyoming	17
Total	14,207

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Source: CDC, National Notifiable Diseases Surveillance System.
* For case definition, see https://wwwn.cdc.gov/nndss/conditions/hepatitis-b-perinatal-virus-infection/

** For case definition, see https://wwwn.cdc.gov/nndss/conditions/hepatitis-b-chronic/
—: No reported cases. There porting jurisdiction did not submit any cases to CDC.
N: Not reportable. The disease or condition was not reportable by law, statue, or regulation in the reporting jurisdiction.
U: Unavailable. The data are unavailable.

Table 2.6. Number and rate* of deaths with hepatitis B listed as a cause of death† among U.S. residents, by jurisdiction and year ― United States, 2014–2018

Table 2.6
State	2014 No.	2014 Rate*	2015 No.	2015 Rate*	2016 No.	2016 Rate*	2017 No.	2017 Rate*	2018 No.	2018 Rate*
Alabama	20	0.37	15	UR^§	19	UR^§	19	UR^§	19	UR^§
Alaska	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§
Arizona	38	0.48	30	0.36	29	0.34	19	UR^§	31	0.34
Arkansas	18	UR^§	12	UR^§	10	UR^§	22	0.60	17	UR^§
California	406	0.96	355	0.82	337	0.78	346	0.80	304	0.67
Colorado	23	0.38	23	0.40	23	0.39	32	0.51	26	0.39
Connecticut	14	UR^§	17	UR^§	S^¶	UR^§	S^¶	UR^§	13	UR^§
Delaware	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§
District of Columbia	15	UR^§	S^¶	UR^§	11	UR^§	12	UR^§	S^¶	UR^§
Florida	105	0.40	108	0.40	98	0.36	129	0.45	109	0.41
Georgia	51	0.47	43	0.37	35	0.30	34	0.28	40	0.35
Hawaii	25	1.47	13	UR^§	26	1.50	15	UR^§	14	UR^§
Idaho	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§
Illinois	31	0.21	30	0.21	40	0.28	30	0.19	31	0.20
Indiana	26	0.35	21	0.27	26	0.32	29	0.34	16	UR^§
Iowa	12	UR^§	S^¶	UR^§	16	UR^§	15	UR^§	19	UR^§
Kansas	S^¶	UR^§	S^¶	UR^§	15	UR^§	11	UR^§	12	UR^§
Kentucky	30	0.66	26	0.54	36	0.72	35	0.75	47	0.98
Louisiana	49	0.88	36	0.63	26	0.49	30	0.53	36	0.60
Maine	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§
Maryland	29	0.44	25	0.38	31	0.43	31	0.43	37	0.52
Massachusetts	38	0.47	46	0.54	32	0.37	36	0.47	28	0.36
Michigan	33	0.27	35	0.29	27	0.18	28	0.22	33	0.25
Minnesota	18	UR^§	31	0.45	25	0.42	21	0.30	33	0.51
Mississippi	23	0.65	20	0.61	22	0.64	23	0.67	20	0.61
Missouri	18	UR^§	20	0.25	13	UR^§	19	UR^§	24	0.31
Montana	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^¶
Nebraska	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	10	UR^§
Nevada	10	UR^§	18	UR^§	23	0.66	13	UR^§	20	0.51
New Hampshire	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^¶
New Jersey	49	0.44	48	0.45	39	0.34	43	0.43	41	0.39
New Mexico	11	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^¶
New York	147	0.64	115	0.50	138	0.60	123	0.50	115	0.47
North Carolina	34	0.29	40	0.34	42	0.37	36	0.29	35	0.27
North Dakota	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§
Ohio	58	0.41	58	0.44	44	0.34	55	0.42	42	0.32
Oklahoma	31	0.71	34	0.77	43	0.95	40	0.95	54	1.16
Oregon	28	0.59	35	0.67	27	0.54	29	0.52	23	0.45
Pennsylvania	46	0.29	44	0.27	41	0.25	35	0.20	34	0.22
Rhode Island	S^¶	S^¶	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	11	UR^§
South Carolina	30	0.54	22	0.35	38	0.60	26	0.39	26	0.42
South Dakota	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§
Tennessee	54	0.68	54	0.70	55	0.71	63	0.83	50	0.61
Texas	140	0.49	130	0.43	149	0.51	150	0.51	119	0.40
Utah	S^¶	UR^§	10	UR^§	S^¶	UR^§	11	UR^§	S^¶	UR^§
Vermont	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§
Virginia	23	0.23	25	0.26	23	0.24	29	0.30	28	0.28
Washington	56	0.66	48	0.53	47	0.55	47	0.56	53	0.57
West Virginia	16	UR^§	21	0.89	11	UR^§	14	UR^§	23	1.26
Wisconsin	16	UR^§	18	UR^§	19	UR^§	21	0.31	19	UR^§
Wyoming	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§	S^¶	UR^§
Total	1,837	0.90	1,707	0.46	1,690	0.45	1,727	0.46	1,649	0.43

Source: CDC, National Center for Health Statistics, Multiple Cause of Death 1999–2018 on CDC WONDER Online Database. Data are from the 2014–2018 Multiple Cause of Death files and are based on information from all
death certificates filed in the vital records offices of the fifty states and the District of Columbia through the Vital Statistics Cooperative Program. Deaths of nonresidents (e.g., nonresident aliens, nationals living abroad, residents
of Puerto Rico, Guam, the Virgin Islands, and other U.S. Territories) and fetal deaths are excluded. Numbers are slightly lower than previously reported for 2013–2016 due to NCHS standards which restrict displayed data to U.S.
residents. Accessed at http://wonder.cdc.gov/mcd-icd10.html on February 14, 2020. CDC WONDER dataset documentation and technical methods can be accessed at https://wonder.cdc.gov/wonder/help/mcd.html#.
* Rates are age-adjusted per 100,000 U.S. standard population in 2000 using the following age group distribution (in years): <1, 1–4, 5–14, 15–24, 25–34, 35–44, 45–54, 55–64, 65–74, 75–84, and 85+. For
age-adjusted death rates, the age-specific death rate is rounded to one decimal place before proceeding to the next step in the calculation of age-adjusted death rates for NCHS Multiple Cause of Death on CDC
WONDER. This rounding step may affect the precision of rates calculated for small numbers of deaths. Missing data are not included.
† Cause of death is defined as 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).
UR^§ Unreliable rate: Rates where death counts were less than 20 were not displayed due to the instability associated with those rates.
S^¶ Suppressed: Sub-national data representing fewer than ten deaths (0-9) are suppressed or CDC WONDER did not have the functionality to calculate rates.

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Figure 2.8. Rate of deaths with hepatitis B listed as a cause of death among U.S. residents, by jurisdiction and year — United States, 2018

Figure 2.8. The map shows rate of deaths with hepatitis B listed as a cause of death by states in 2018. States are grouped and shaded based on reported rate of deaths per 100,000/population. States with unreliable data are grouped separately.

Color Key Table for Figure 2.8
Color Key	Cases/100,000 Population	States
	0-0.33	IL, MI, MO, NC, OH, PA, VA
	>0.33-0.41	AZ, CO, FL, GA, MA, NJ, TX
	>0.41-0.52	MD, MN, NV, NY, OR, SC
	>0.52-0.69	CA, LA, MS, TN, WA
	>0.69-1.26	KY, OK, WV
	Unreliable rate	AL, AK, AR, CT, DE, DC, HI, ID, IN, IA, KS, ME, MT, NE, NH, NM, ND, RI, SD, UT, VT, WI, WY

Source: CDC, National Center for Health Statistics, Multiple Cause of Death 2018 on CDC WONDER Online Database. Unreliable rates where death
counts were less than 20 were not displayed due to the instability associated with those rates.

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Table 2.7. Number and rate* of deaths with hepatitis B listed as a cause of death† among U.S. residents, by demographic characteristics, region, and year — United States, 2014–2018

Table 2.7
Demographic characteristic	2014 No.	2014 (95% CI)	2015 No.	2015 (95% CI)	2016 No.	2016 (95% CI)	2017 No.	2017 (95% CI)	2018 No.	2018 (95% CI)
Age group (years)
0–34	35	0.02 (0.02-0.03)	30	0.02 (0.01- 0.03)	39	0.03 (0.02-0.04)	29	0.02 (0.01-0.03)	32	0.02 (0.01-0.03)
35–44	126	0.31 (0.26-0.37)	118	0.29 (0.24-0.34)	116	0.29 (0.23-0.34)	106	0.26 (0.21-0.31)	122	0.3 (0.24-0.35)
45–54	384	0.88 (0.80-0.97)	330	0.76 (0.68-0.85)	324	0.76 (0.67-0.84)	323	0.76 (0.68-0.85)	283	0.68 (0.60-0.76)
55–64	682	1.7 (1.57-1.83)	610	1.49 (1.37-1.61)	576	1.39 (1.28-1.50)	548	1.3 (1.20-1.41)	520	1.23 (1.12-1.34)
65–74	356	1.35 (1.21-1.49)	382	1.39 (1.25-1.53)	383	1.34 (1.20-1.47)	417	1.4 (1.27-1.54)	422	1.38 (1.25-1.52)
75+	254	1.28 (1.12-1.44)	236	1.17 (1.02-1.32)	252	1.22 (1.07-1.37)	303	1.43 (1.27-1.59)	270	1.23 (1.08-1.38)
Race/ethnicity
White, Non-Hispanic	851	0.33 (0.30-0.46)	805	0.28 (0.26-0.30)	767	0.29 (0.27-0.31)	776	0.28 (0.26-0.30)	760	0.27 (0.25-0.29)
Black, Non-Hispanic	330	0.81 (0.72-0.89)	318	0.75 (0.67-0.84)	315	0.73 (0.65-0.81)	320	0.74 (0.66-0.83)	304	0.7 (0.62-0.79)
Hispanic	156	0.4 (0.33-0.46)	136	0.32 (0.27-0.38)	128	0.3 (0.25-0.36)	109	0.26 (0.21-0.32)	122	0.28 (0.23-0.33)
Asian/ Pacific Islander, Non-Hispanic	475	2.69 (2.44-2.93)	419	2.23 (2.01-2.45)	454	2.38 (2.16-2.60)	492	2.45 (2.23-2.67)	439	2.1 (1.90-2.30)
American Indian/ Alaska Native, Non-Hispanic	10	UR§	13	UR§	16	UR§	17	UR§	6	UR§
Sex
Male	1,301	0.74 (0.70-0.78)	1,270	0.7 (0.66-0.74)	1,231	0.67 (0.64-0.71)	1,275	0.7 (0.66-0.74)	1,191	0.65 (0.61-0.69)
Female	536	0.27 (0.24-0.29)	437	0.21 (0.19-0.23)	459	0.22 (0.20-0.24)	452	0.23 (0.20-0.25)	458	0.22 (0.20-0.24)
DHHS Region
Region 1: Boston	76	0.42 (0.33-0.54)	81	0.43 (0.34-0.54)	56	0.28 (0.21-0.37)	60	0.35 (0.27-0.46)	64	0.34 (0.26-0.45)
Region 2: New York	196	0.58 (0.50-0.67)	163	0.48 (0.41-0.56)	177	0.51 (0.43-0.59)	166	0.47 (0.39-0.54)	156	0.44 (0.36-0.51)
Region 3: Philadelphia	137	0.38 (0.31-0.44)	126	0.35 (0.28-0.41)	118	0.32 (0.26-0.38)	128	0.32 (0.27-0.38)	130	0.35 (0.29-0.41)
Region 4: Atlanta	347	0.46 (0.41-0.51)	328	0.43 (0.38-0.48)	345	0.44 (0.39-0.49)	365	0.45 (0.41-0.50)	346	0.45 (0.40-0.50)
Region 5: Chicago	182	0.3 (0.25-0.34)	193	0.32 (0.27-0.36)	181	0.29 (0.25-0.33)	184	0.29 (0.24-0.33)	174	0.28 (0.24-0.33)
Region 6: Dallas	249	0.58 (0.51-0.66)	220	0.5 (0.43-0.56)	230	0.51 (0.44-0.57)	247	0.55 (0.48-0.62)	230	0.47 (0.41-0.53)
Region 7: Kansas City	41	0.27 (0.19-0.37)	44	0.26 (0.19-0.36)	52	0.33 (0.24-0.44)	50	0.29 (0.22-0.39)	65	0.38 (0.29-0.48)
Region 8: Denver	39	0.33 (0.23-0.45)	42	0.35 (0.25-0.47)	35	0.27 (0.19-0.38)	48	0.37 (0.27-0.49)	34	0.25 (0.17-0.35)
Region 9: San Francisco	479	0.88 (0.80-0.97)	416	0.72 (0.65-0.79)	415	0.73 (0.66-0.80)	393	0.69 (0.62-0.76)	369	0.62 (0.56-0.69)
Region 10: Seattle	91	0.57 (0.45-0.70)	94	0.56 (0.45-0.69)	81	0.51 (0.40-0.63)	86	0.52 (0.41-0.64)	81	0.47 (0.37-0.59)
Overall	1,837	0.5 (0.47-0.52)	1,707	0.46 (0.44-0.49)	1,690	0.45 (0.43-0.48)	1,727	0.46 (0.44-0.49)	1,649	0.43 (0.41-0.45)

Source: CDC, National Center for Health Statistics, Multiple Cause of Death 1999–2018 on CDC WONDER Online Database. Data are from the 2014–2018 Multiple Cause of Death files and are based on information from all
death certificates filed in the vital records offices of the fifty states and the District of Columbia through the Vital Statistics Cooperative Program. Deaths of nonresidents (e.g., nonresident aliens, nationals living abroad, residents
of Puerto Rico, Guam, the Virgin Islands, and other U.S. Territories) and fetal deaths are excluded. Numbers are slightly lower than previously reported for 2013–2016 due to NCHS standards which restrict displayed data to U.S.
residents. Accessed at http://wonder.cdc.gov/mcd-icd10.html on February 14, 2020. CDC WONDER dataset documentation and technical methods can be accessed at https://wonder.cdc.gov/wonder/help/mcd.html#.
* Rates for race/ethnicity, sex, and the overall total are age-adjusted per 100,000 U.S. standard population in 2000 using the following age group distribution (in years): <1, 1–4, 5–14, 15–24, 25–34, 35–44, 45–54, 55–64,
65–74, 75–84, and 85+. For age-adjusted death rates, the age-specific death rate is rounded to one decimal place before proceeding to the next step in the calculation of age-adjusted death rates for NCHS Multiple Cause of
Death on CDC WONDER. This rounding step may affect the precision of rates calculated for small numbers of deaths. Missing data are not included.
† Cause of death is defined as 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).
UR§ Unreliable rate: Rates where death counts were less than 20 were not displayed due to the instability associated with those rates.

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