By Corinna Dan, RN, MPH, Viral Hepatitis Policy Advisor, Office of HIV/AIDS and Infectious Disease Policy and Anna Gribble, MSW, MPH, Health Policy Fellow, Office of Disease Prevention and Health Promotion
Representatives from more than 20 federal departments, agencies, and offices worked under the coordination of the HHS Office of HIV/AIDS and Infectious Disease Policy to update the National Viral Hepatitis Action Plan, 2017 – 2020. The Action Plan provides a strategic framework to work collaboratively across diverse sectors to achieve four key goals: 1) Prevent new hepatitis B and C infections, 2) reduce deaths and improve the health of people living with viral hepatitis, 3) reduce viral hepatitis health disparities, and 4) coordinate, monitor, and report on implementation and viral hepatitis activities. The Action Plan identifies strategies and recommended actions to help focus and guide the efforts of federal, state, tribal, county, city, and organizational partners and indicators to track the progress in achieving these goals. In addition, the Action Plan includes 19 indicators to promote transparency and accountability for results and movement toward the 2020 goals.
Goal One of the Action Plan sets forth eight strategies to prevent new viral hepatitis infections in a wide range of groups and settings. Two of these strategies address the capacity of the health care workforce and the reduction of viral hepatitis transmission in health care settings among patients and health care workers. Ongoing work of the Office of Disease Prevention and Health Promotion to improve health care quality is critical to these efforts. The National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination is an example of one of ODPHP’s activities that support the goals of the National Viral Hepatitis Action Plan. In addition, the strategies and recommended actions described in the Action Plan are supportive of other HHS goals such as Healthy People 2020’s goal to “reduce viral hepatitis transmission among patients and health care personnel related to health care interventions.”
There is reason to be concerned about the spread of viral hepatitis in health care settings. The Centers for Disease Control and Prevention investigated 59 health care-associated hepatitis B and C outbreaks from 2008 – 2015. This is likely an underestimation of the problem because viral hepatitis infections often cause no symptoms and go undetected. The majority of these outbreaks occurred in non-hospital settings such as long-term care facilities, hemodialysis, and a variety of other outpatient settings. Recommended actions within the Action Plan are to:
- Provide regular training for health care providers on effective infection control practices in health care settings.
- Identify patients at risk of hepatitis B exposure related to health care, including persons with diabetes and end stage renal disease, and refer them for vaccination as appropriate.
A key issue for health care workers is the prevention of hepatitis B and C transmission. The transmission of both can be prevented with the consistent use of recommended infection control practices. The hepatitis B vaccine is safe and effective and recommended for ALL health care workers. A related indicator identified to measure the progress towards this goal is increasing the rate of hepatitis B vaccination among health care personnel to 90%. In 2014, the rate was 67.7%, so continued efforts to ensure universal vaccination of health care workers are needed.
Both ODPHP and OHAIDP are part of the HHS Office of the Assistant Secretary for Health (OASH). The aligning of efforts throughout OASH reinforces the importance of this public health concern and provides a framework for a coordinated response. The implementation of the recommendations within the National Viral Hepatitis Action Plan, 2017 – 2020 and the National Action Plan for Health Care-Associated Infections will help reduce the transmission of viral hepatitis in health care settings and improve the quality of care provided in high risk settings by expanding testing, providing safe and effective vaccination for hepatitis B and treatment for hepatitis C, and improving infection control practices.
Learn what you can do to join the fight against viral hepatitis and help move us toward a vision for the future that includes the elimination of new viral hepatitis infections, all persons with hepatitis B or C knowing their status, and everyone with chronic hepatitis B or C being able to access high quality care and treatment that is free from stigma and discrimination.