McHenry County Department of Health - Nursing

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Perinatal Hepatitis B

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Perinatal Hepatitis B: Information for the General Public

What is Perinatal Hepatitis B?

Perinatal Hepatitis B is a serious liver disease in newborns caused by the Hepatitis B virus (HBV) transmitted from an infected mother during childbirth. HBV attacks the liver and can lead to cirrhosis, liver cancer, and at times, premature death. Most importantly, it is preventable.

Perinatal Poster

Why does the MCDH get involved?

All pregnant women are routinely tested for Hepatitis B as part of prenatal care. Testing should be performed during the first visit of a pregnant mother to her OB/gyn. If prenatal care is not received, testing should be completed at the hospital before giving birth.

Hepatitis B is a reportable condition in Illinois. This means the lab or provider will send all Hepatitis B positive reports directly to the MCDH for follow-up. Once the MCDH is made aware of a case, a Public Health Nurse reviews all HBV positive laboratory reports in women of childbearing age to determine pregnancy status.

The nurse can then collaborate with the healthcare provider to ensure identification of Hepatitis B positive mothers, proper treatment of infants at birth, timely completion of Hepatitis B vaccination, timely and appropriate post-vaccination serologic testing, identification and referral of household contacts and appropriate education to parents.

How is Hepatitis B spread?

The Hepatitis B virus is spread when someone comes in contact with blood, semen, or other body fluids from an infected person. This can happen through an infected mother passing it to her baby at birth, by having sex with an infected person, injection drug use (sharing needles) is another common source or by direct contact with an infected person, where blood is passed through breaks in the skin or soft tissues such as the nose, mouth, and eyes.

Symptoms

Hepatitis B most often does not have identifiable symptoms. Many people can live with Hepatitis B without feeling sick. Others may experience: 

  • Fever
  • Nausea / Vomiting
  • Jaundice (yellowing of skin or eyes)
  • Dark urine, pale stool, diarrhea

Prevention / Vaccination

Your baby should get the first shot of Hepatitis B vaccine, and a shot called Hepatitis B immune globulin (HBIG) within 12 hours of birth. HBIG is a medicine that gives your baby extra help to fight the virus.  HBIG is only given to babies born of mother’s who have Hepatitis B.  These shots work best when given within 12 hours of being born.

Depending on the baby’s weight and the vaccine brand, your baby will get 3 or 4 shots in all.  The next shot is given at 1-2 months and the last shot between 6-18 months.

What's Next?
After the vaccine series, your doctor will test your baby's blood. This test tells you and your doctor if your baby is protected against Hepatitis B. It should be completed 2-3 months after the series is complete. Therefore, your baby should be at least 9 months of age before getting this test.

Additional Resources:

Protect Your Baby for Life (1)

Perinatal Hepatitis B: Information for Providers

MCDH Involvement

The MCDH's Communicable Disease Program collaborates with local healthcare providers to prevent perinatal Hepatitis B transmission.

Provider Responsibilities

Universal Screening of Pregnant Women

  • Screen all pregnant women for Hepatitis B surface antigen (HBsAg).
  • Report all positive cases to your Local Health Department (LHD) for counseling and recommendations regarding testing and immunization contacts.

Case Management & Infant Care

  • Ensure timely post-exposure prophylaxis and follow-up for infants born to HBsAg-positive mothers.
  • For preterm infants weighing less than 2,000 grams born to an HBsAg-positive mother:
    • Administer Hepatitis B immune globulin (HBIG) and the first vaccine dose within 12 hours of birth.
    • This initial vaccine dose does not count toward the primary series; a total of four doses will be required. Educate parents on this requirement.

Post-Vaccine Serologic Testing

  • Perform serologic testing at 9-12 months of age, or 1-2 months after the final vaccine dose if the series is delayed.
  • Test for HBsAg and anti-HBs only. DO NOT test for antibodies to Hepatitis B core antigen (anti-HBc).

Referral and Patient Education

  • Refer HBsAg-positive women to a liver specialist for evaluation and possible antiviral therapy.
  • Educate parents on Hepatitis B prevention, including:
    • Infant and household contact vaccination
    • HBIG administration
    • Risk reduction strategies, such as safe sex practices, avoiding needle sharing, proper blood spill cleanup, and wound care.
  • Reassure mothers that breastfeeding does not transmit Hepatitis B to their infants.

Additional Resources: