Journal Article

Hepatitis A Virus Infections in Travelers, 1988–2004

Margot Mutsch, Virginie Masserey Spicher, Christoph Gut and Robert Steffen

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 42, issue 4, pages 490-497
Published in print February 2006 | ISSN: 1058-4838
Published online February 2006 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/499816
Hepatitis A Virus Infections in Travelers, 1988–2004

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Background. Uncertainty exists about the current risk of hepatitis A virus infection in nonimmune travelers to destinations with high or intermediate risk of transmission. We analyzed recent epidemiological data on imported hepatitis A to determine region-specific attack rates and incidences.

Methods. Surveillance data on hepatitis A virus infections diagnosed during 1988–2004 were evaluated on the basis of notification by laboratories, additional reports of physicians, and traveler's statistics. This study focuses on international travelers with hepatitis A virus infection detected after their return to Switzerland.

Results. The rate of imported hepatitis A virus infections decreased 75% from 1988 to 2004 and accounted overall for 42% of all hepatitis A cases reported in Switzerland. The actual incidence of hepatitis A in travelers to countries of high or intermediate risk of transmission was 3.0–11.0 per 100,000 person-months abroad for all travelers and 6.0–28.0 per 100,000 for those presumed to be nonimmune. The actual proportion of those visiting friends and relatives among patients with hepatitis A has increased to 28.2%, with children aged 0–14 years predominating. Reductions in the incidence by hepatitis A vaccination were estimated to vary between 35.0% and 61.8% for different destinations.

Conclusions. The risk of hepatitis A virus infections has decreased by a factor of 10–50-fold over time, compared with findings from older studies. The risk, however, remains very considerable at many destinations, including frequently visited places, such as Mexico. Children of immigrants are a high-risk population. Strategies are needed to reach those at highest risk.

Journal Article.  3825 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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