Travellers put themselves at risk of hepatitis A

Helen Barratt London

Many people travelling to developing countries this summer could unwittingly put themselves in danger of infection with the hepatitis A virus, the European Travel Health Advisory Board has warned. Researchers interviewed 600 travellers at major European airports, and their findings, presented to the third European Conference on Travel Medicine, suggest that most people do not consider themselves at risk of contracting the virus. Also, 40% of travellers do not seek any medical advice before making a trip abroad.

The World Health Organization recommends that travellers from developed countries should receive the hepatitis A vaccine before travelling to the developing world. The uptake of the vaccine is poor, however, and experts at the conference estimated that, in Germany alone, more than 8000 cases and 51 deaths from hepatitis A could be prevented if guidelines were followed.

Hepatitis A is the most common travellers' infection that is preventable by vaccine, and, although it is rarely fatal, infected people are unwell for several months. It is transmitted primarily via the faeco-oral route; the survey suggests that about 40% of travellers to destinations where they are at risk did not plan to avoid drinking local water, and only 20% planned to take precautions such as peeling or cooking fresh fruit.

The infection occurs worldwide, but areas of high risk include Central and South America, Africa, and southern Asia, where sanitary conditions are poor and the safety of drinking water is not well controlled. Although people travelling to rural areas are at particularly high risk of infection, in practice, most cases occur in travellers in resorts and good quality hotels.

Professor Robert Steffen, of the University of Zurich's Institute of Social and Preventive Medicine and director of the World Health Organization Collaborating Centre for Travellers' Health, said, "The results of this survey... have at last allowed us to quantify an important public health problem, namely travel related hepatitis A."



studentBMJ 2002;10:215-258 July ISSN 0966-6494