EPID 394 is the Kentucky Department for Public Health's report for hepatitis B or C infection in a pregnant or postpartum woman, or in a child aged two or under for HBV or three or under for HCV, including an infant born to an infected mother. A clinician meets it when prenatal, delivery or pediatric testing finds one of these infections. It records mother and child together, with hepatitis markers, risk factors and vaccination history.
The health care provider or agency reporting the case completes the whole form, naming the submitting agency and a contact.
Download the current version from the source each time; forms change without notice.
Kentucky Reportable Disease Form: Hepatitis Infection in Pregnant Women or Child (HBV- aged two years or less & HCV- aged three years or less)
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Pregnant or postpartum women with hepatitis B or C, newborns born to mothers with HBV or HCV, and children aged two or younger with hepatitis B or three or younger with hepatitis C. Mother and child information go on the same form, revised 7/2024.
EPID 394 reports hepatitis B or C infection in a pregnant woman or young child, with lab markers, liver enzymes and risk factors. EPID 399 is the perinatal hepatitis B prevention form, documenting an HBsAg-positive mother and her exposed infant's hepatitis B vaccine and HBIG doses given within 12 hours of birth.