BACKGROUND:
Approximately 20,000 infants are born to hepatitis b surface antigen (HBsAg) positive women in the United States each year. Chronic hepatitis b infection develops in 90% of those infected as infants. Appropriate treatment of these infants is essential to stop the spread of hepatitis b. Indiana's current perinatal hepatitis b program has been in existence for four years and each year the completion rates have improved.

OBJECTIVE:
To decrease perinatal hepatitis b transmission in the state of Indiana.

METHOD:
The current program includes a supervisor and three field investigators. The program functions include: (1) Case identification; (2) Case management (including: following infants through immunizations and getting serology and contact investigation completed);
(3)Managing cases with an internet based program;
(4)Partnering with hospital OB nurse managers; (5)Partnering with local health departments; and (6)Partnering with physicians involved in the care of the case mother, infant, and contacts.

RESULT:
Based on the CDC annual assessment, the number of perinatal hepatitis b cases in Indiana has increased from 50 in 1999 to 113 in 2002. Increases have also been made in the rate of immunizations and serologies performed on vaccinated infants, the number of contacts identified/treated, and the number of hospitals giving the hepatitis b birth dose. Indiana's program was given an award at the 2003 National Hepatitis Coordinators Conference from the CDC for an increase of 37% in the administration of hepatitis b immune globulin (HBIG) and the three dose series by 6-8 months of age for 2000-2001.

CONCLUSION:
There will always be barriers in perinatal hepatitis b case management. This program has developed methods that have led to success in breaking down these barriers.

LEARNING OBJECTIVES:
Participants will learn about the different components of Indiana's perinatal hepatitis b program. Participants will be introduced to new processes that can be implemented in existing programs.