Reduce the rate of hepatitis A — IID‑10 Data Methodology and Measurement

About the National Data


Baseline: 1.0 cases of hepatitis A per 100,000 population were reported in 2017

Target: 0.4 per 100,000

Number of hepatitis A cases.
Number of persons in reporting states.
Target-setting method

Maintain consistency with national programs, regulations, policies, or laws

Target-setting method details
Target-setting method justification
The target was selected to align with the 2030 target presented in the Viral Hepatitis National Strategic Plan (VH-NSP) for the indicator "Reduce new hepatitis A infections by 40% by 2025 and 65% by 2030." The Indicators subcommittee of the VH-NSP, in consultation with HHS leadership, set quantitative targets to eliminate viral hepatitis as a public health threat by 2020. For hepatitis A, most of the improvement in the trend is anticipated from 2021 to 2025, which would allow efforts from 2026 to 2030 to focus on maintaining incidence at or below the lowest rate of 0.4 cases per 100,000 seen before multistate outbreaks began during the past decade.


Methodology notes

Acute hepatitis A is a reportable disease in all states, the District of Columbia (DC), and New York City (CSTE query) and nationally notifiable (CDC NNDSS List of Notifiable Conditions, historically by year). The NNDSS is a nationwide collaboration that enables all levels of public health to share notifiable-disease-related health information. In some jurisdictions, viral hepatitis is a reportable disease: health care providers, hospitals, and laboratories are mandated to report cases to the state health department. In other jurisdictions, viral hepatitis is a notifiable disease, rendering such case reporting voluntary. Each state has its own laws and regulations defining whether viral hepatitis is reportable or notifiable. CDC in turn receives voluntary viral hepatitis case notification from each state or reporting jurisdiction. In 2016, all 50 states and DC submitted reports of hepatitis A to CDC (2016 Surveillance Summary). Surveillance for viral hepatitis through NNDSS is based on case definitions developed and approved by CSTE and CDC. Reported cases of hepatitis A are required to meet specific clinical and laboratory criteria. Only these confirmed cases are included in the numerator. Case rates per 100,000 US population are calculated based on the resident population of the United States for the data years and reporting states involved. For census years (e.g., 2010), population counts enumerated as of April 1 are used. For all other years, population estimates as of July 1 are used.

Limitations: Viral hepatitis is largely underreported in the NNDSS. Based on a simple probabilistic model for estimating the fraction of patients who would have been symptomatic, sought health care tests, and reported to health officials, actual hepatitis A cases are estimated to be 1.96 times the number reported to CDC (Klevens 2014). Additionally, rates may vary over time based on changes in public and provider awareness, changes in laboratory and diagnostic techniques, and changes in the definition of the condition (NPR).


Comparable HP2020 objective
Retained, which includes core objectives that are continuing from Healthy People 2020 with no change in measurement.
Revision History

In 2021, to align with the Viral Hepatitis National Strategic Plan (VH-NSP), the target-setting method was changed from "projection" to "maintain consistency with national programs, regulations, policies or laws." The target remained unchanged.