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Epidemiology and prevention of hepatitis A in travelers


Steffen, Robert; Kane, Mark A; Shapiro, Craig N; Billo, Nils; Schoellhorn, K Janine; van Damme, Pierre (1994). Epidemiology and prevention of hepatitis A in travelers. JAMA : the Journal of the American Medical Association, 272(11):885-889.

Abstract

OBJECTIVE: To assess the risk of hepatitis A in international travelers and to recommend preventive measures.
DATA SOURCES: Index Medicus, 1974 through 1983; MEDLINE, 1984 through 1993; and unpublished data of the Centers for Disease Control and Prevention.
STUDY SELECTION: Review of all retrospective and cohort studies on hepatitis A and other vaccine-preventable diseases in travelers, of seroepidemiologic surveys of hepatitis A virus (HAV) antibodies in travelers, of data on the various hepatitis A vaccines, of economic analyses, and of recommendations of recognized organizations.
DATA EXTRACTION: Independent analysis by multiple observers.
DATA SYNTHESIS: The incidence rate for unprotected travelers, including those staying in luxury hotels, is estimated to be three per 1000 travelers per month of stay in a developing country. Persons eating and drinking under poor hygienic conditions have a rate of 20/1000 per month. This makes hepatitis A the most frequent infection in travelers that may be prevented by immunization. In many industrialized countries persons born after 1945 have an HAV antibody seroprevalence (immunity) of less than 20%. New inactivated HAV vaccines induce protective antibodies in more than 95% of recipients and offer protection estimated to last for 10 years or more, whereas protection by immune globulin lasts only 3 to 5 months.
CONCLUSIONS: Hepatitis A vaccine, or immune globulin where HAV vaccine is not available, is recommended for all nonimmune travelers visiting developing countries. Prescreening for antibodies to HAV in travelers living in countries with low prevalence is usually not necessary in persons born after 1945.

Abstract

OBJECTIVE: To assess the risk of hepatitis A in international travelers and to recommend preventive measures.
DATA SOURCES: Index Medicus, 1974 through 1983; MEDLINE, 1984 through 1993; and unpublished data of the Centers for Disease Control and Prevention.
STUDY SELECTION: Review of all retrospective and cohort studies on hepatitis A and other vaccine-preventable diseases in travelers, of seroepidemiologic surveys of hepatitis A virus (HAV) antibodies in travelers, of data on the various hepatitis A vaccines, of economic analyses, and of recommendations of recognized organizations.
DATA EXTRACTION: Independent analysis by multiple observers.
DATA SYNTHESIS: The incidence rate for unprotected travelers, including those staying in luxury hotels, is estimated to be three per 1000 travelers per month of stay in a developing country. Persons eating and drinking under poor hygienic conditions have a rate of 20/1000 per month. This makes hepatitis A the most frequent infection in travelers that may be prevented by immunization. In many industrialized countries persons born after 1945 have an HAV antibody seroprevalence (immunity) of less than 20%. New inactivated HAV vaccines induce protective antibodies in more than 95% of recipients and offer protection estimated to last for 10 years or more, whereas protection by immune globulin lasts only 3 to 5 months.
CONCLUSIONS: Hepatitis A vaccine, or immune globulin where HAV vaccine is not available, is recommended for all nonimmune travelers visiting developing countries. Prescreening for antibodies to HAV in travelers living in countries with low prevalence is usually not necessary in persons born after 1945.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:21 September 1994
Deposited On:03 Jul 2015 14:05
Last Modified:05 Apr 2016 19:18
Publisher:American Medical Association (AMA)
ISSN:0098-7484
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1001/jama.1994.03520110065031
PubMed ID:8078167

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