Reporting & Investigation of Hepatitis D

Table of Contents

A. Purpose of Surveillance and Reporting

  • To identify sources and sites of transmission and to prevent spread from those sources.
  • To ensure identification of infected pregnant women and to prevent perinatal transmission to their babies.

B. Laboratory and Healthcare Provider Reporting Requirements

Iowa Administrative Code 641-1.3(139) stipulates that the laboratory and the healthcare provider must report. The preferred reporting method is through the Iowa Disease Surveillance System (IDSS). The reporting phone number for Iowa HHS Center for Acute Disease Epidemiology (CADE) is (800) 362-2736; fax number (515) 281-5698, mailing address:

Iowa HHS, CADE
Lucas State Office Building, 5th Floor
321 E. 12th St.
Des Moines, IA 50319-0075

Postage-paid disease reporting forms are available free of charge from the Iowa HHS clearinghouse. Call (319) 398-5133.

Laboratory Testing Services Available

The University of Iowa State Hygienic Laboratory (SHL) can refer serum specimens for Hepatitis D virus testing. Information about date of collection, date of onset of symptoms, travel history, vaccination and disease history are essential for test interpretation. For additional information on submitting samples or testing, contact the SHL at (319) 335-4500 or visit: www.shl.uiowa.edu/

C.  Local Public Health Agency Follow-up Responsibilities

Case Investigation

  1. If case has not previously been diagnosed with hepatitis B, see the description of hepatitis B for full information on case investigation.
  2. Laboratory confirmation of hepatitis D infection requires anti-HepD to be positive as well as HBsAg or IgM anti-HBc positive. In most persons with HBV-HDV co-infection, both IgM antibody to HDV (anti-HDV) and IgG anti-HDV are detectable during the course of infection. However, in about 15% of patients the only evidence of HDV infection may be the detection of either IgM anti-HDV alone during the early acute period of illness or IgG anti-HDV alone during convalescence. Tests for IgM anti-HDV, HDAg and HDV RNA by PCR are only available in research laboratories
  3. For all suspected or confirmed cases of hepatitis D, complete the Hepatitis B/C case investigation in IDSS. 
  4. If several attempts have been made to obtain case information, but have been unsuccessful (e.g., the case or healthcare provider does not return calls or respond to a letter, or the case refuses to divulge information or is too ill to be interviewed), please fill out the form in IDSS with as much information as has been gathered. Select the appropriate reason under the Event tab in the Event Exception field.
  5. If access to IDSS is not possible, please FAX the form to CADE at (515) 281-5698.
  6. Institution of disease control measures is an integral part of case investigation. It is the responsibility of the local public health agency to understand, and, if necessary, institute the control guidelines listed below.  These are more fully outlined in the hepatitis B section.