Reporting & Investigation of Hepatitis E

Table of Contents

A. Purpose of Surveillance and Reporting

To identify sources and sites of transmission and to prevent spread from those sources.

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 method of reporting is by utilizing the Iowa Disease Surveillance System (IDSS).  However, if IDSS is not available, the reporting number for IDPH Center for Acute Disease Epidemiology (CADE) is (800) 362-2736; fax number (515) 281-5698, mailing address:

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

Laboratory Testing Services Available

The University of Iowa State Hygienic Laboratory (SHL) can refer serum specimens for Hepatitis E virus testing. Accurate 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 State Hygienic Laboratory at (319) 335-4500.

C.  Local Public Health Agency Follow-up Responsibilities

Case Investigation

  1. Verify the diagnosis.
    • Diagnosis of hepatitis E requires clinical illness similar to viral hepatitis A (elevated liver enzymes and or jaundice or dark urine plus at least 2 other symptoms including nausea, vomiting, fever, diarrhea, or malaise with abrupt onset).
      • AND
    • A history of travel out of the country to an underdeveloped country or a country known to have endemic or epidemic hepatitis E.
      • AND
    • The patient is not known or suspected of having risk factors for hepatitis B or C.
      • AND
    • The hepatitis lab profile is negative for anti HAV-IgM, negative for HBsAg and if performed, negative for anti-HCV. 
    • For all cases of hepatitis E, complete the Hepatitis E Case Investigation form in IDSS. 
  2. 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 with as much information as possible.  Select the appropriate reason under the Event tab in the Event Exception field.
  3. Complete the IDSS case investigation form. If IDSS is unavailable after completing the form, place the form in an envelope marked “Confidential” to the Center for Acute Disease Epidemiology.  The mailing address is:
    • Iowa Department of Public Health, CADE
      Lucas State Office Building, 5th Floor
      321 E. 12th Street
      Des Moines, IA 50319-0075
  4. Make appropriate recommendations for preventing the spread of illness. See Controlling Spread tab.