Risk of Hepatitis B for Travelers: Is Vaccination for All Travelers Really Necessary?

Authors

  • Gerard J.B. Sonder MD, PhD,

    Corresponding author
    1. Public Health Service Amsterdam, Department of Infectious Diseases, Amsterdam, The Netherlands
    2. LCR, National Coordination Centre for Travellers Health Advice, Amsterdam, The Netherlands
    3. Academic Medical Center, Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Amsterdam, The Netherlands
    Search for more papers by this author
  • Gini G.C. Van Rijckevorsel MD, MPH,

    1. Public Health Service Amsterdam, Department of Infectious Diseases, Amsterdam, The Netherlands
    2. LCR, National Coordination Centre for Travellers Health Advice, Amsterdam, The Netherlands
    Search for more papers by this author
  • Anneke Van Den Hoek MD, PhD

    1. Public Health Service Amsterdam, Department of Infectious Diseases, Amsterdam, The Netherlands
    2. Academic Medical Center, Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Amsterdam, The Netherlands
    Search for more papers by this author

Gerard J.B. Sonder, MD, PhD, Public Health Service Amsterdam, Department of Infectious Diseases, Nieuwe Achtergracht 100, 1018WT Amsterdam, The Netherlands. E-mail: gsonder@ggd.amsterdam.nl

Abstract

Objectives Behavioral studies in travelers suggest that 33% to 76% of all travelers to hepatitis B virus (HBV)–endemic countries are at risk for HBV infection. We study the incidence and risk factors for HBV infection in travelers.

Methods Retrospective analysis of the characteristics and risk factors of all reported acute HBV patients in Amsterdam, the Netherlands, from January 1, 1992, until December 31, 2003.

Results The estimated incidence in travelers from Amsterdam to HBV-endemic countries is 4.5/100,000 travelers. Two thirds of these patients were immigrants who lived in Amsterdam and who had visited their friends and relatives in their country of origin. In 12 years, only three Dutch short-term tourists contracted HBV while traveling, all by heterosexual contacts.

Conclusions Dutch tourists who travel to HBV-endemic countries run a very low risk of contracting HBV. Vaccination of short-term Dutch tourists is not necessary. Immigrants run a higher risk irrespective of travel or duration of travel. This group should be advised vaccination.

Ancillary