Hepatitis A among Danish travellers 1980-2007

The authors present a descriptive study on hepatitis A among Danish travellers in the period 1980-2007 based on data from a large survey among 26,640 Danes regarding travel habits, as well as national surveillance and population data. There are five messages to be read from the results: (1) The incidence of hepatitis A is declining at most destinations worldwide. (2) Reported incidence rates tend to overestimate the risk for the average tourist because they include immigrants visiting friends and family in the country of origin. (3) The immunization strategy in Denmark (leaving it up to the individual traveller to seek advice and pay for the immunization) seems to work well for most Danish travellers as 75% travelled immune. (4) Danes travel very frequently to hepatitis A endemic areas and will spend on average 6 months in endemic areas from the age of 18 till 79. (5) 80% of all incident cases 2002-2006 were immigrants or children of immigrants. The immunization strategy is not effective in this group. In conclusion, the risk of acquiring hepatitis A abroad is low for the average ethnic Danish tourist, while it is high in immigrants and their children. Thus, special focus on this group of travellers is warranted.