TY - JOUR
T1 - Predictors of travel-related hepatitis A and B among native adult Danes
T2 - a nationwide case-control study
AU - Nielsen, Ulla Schierup
AU - Thomsen, Reimar Wernich
AU - Cowan, Susan
AU - Larsen, Carsten Schade
AU - Petersen, Eskild
N1 - Copyright © 2011 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
PY - 2012/4
Y1 - 2012/4
N2 - OBJECTIVES: To assess journey length and other predictors of travel-related acute hepatitis A (HAV) and B (HBV) virus infection among native Danes and determine the sensitivity and specificity of current pre-travel vaccination guidelines.METHODS: A nationwide case-control study was perfomed involving 60 Danes with HAV and 14 with HBV who acquired hepatitis in non-western countries from 2000 to 2010. Non-immune travellers from a nationwide survey (1188 HAV and 1709 HBV) served as controls.RESULTS: The odds ratios (ORs) for HAV and HBV increased with increasing journey length (p<0.0001). However, 90% of HAV and 62% of HBV cases travelled for less than 4 weeks, and the daily infection rate did not increase with journey length; rather, for HAV it decreased. Increasing age (p<0.0001) and journeys to Africa (OR 6.1 (3.2-11)) raised the risk of acute HAV. Travelling alone or with friends as compared to travelling with a partner/family (OR: 15 (3.2-134)) strongly predicted HBV risk. Danish vaccination guidelines had HAV/HBV sensitivities of 86%/31%, and specificities of 27%/95%, respectively. Incidence rates were 12.8 (HAV) and 10.2 (HBV) per 100,000 non-immune travel months, and acute disease severity affected HAV and HBV cases equally.CONCLUSIONS: These results may support revision of current pre-travel vaccination guidelines.
AB - OBJECTIVES: To assess journey length and other predictors of travel-related acute hepatitis A (HAV) and B (HBV) virus infection among native Danes and determine the sensitivity and specificity of current pre-travel vaccination guidelines.METHODS: A nationwide case-control study was perfomed involving 60 Danes with HAV and 14 with HBV who acquired hepatitis in non-western countries from 2000 to 2010. Non-immune travellers from a nationwide survey (1188 HAV and 1709 HBV) served as controls.RESULTS: The odds ratios (ORs) for HAV and HBV increased with increasing journey length (p<0.0001). However, 90% of HAV and 62% of HBV cases travelled for less than 4 weeks, and the daily infection rate did not increase with journey length; rather, for HAV it decreased. Increasing age (p<0.0001) and journeys to Africa (OR 6.1 (3.2-11)) raised the risk of acute HAV. Travelling alone or with friends as compared to travelling with a partner/family (OR: 15 (3.2-134)) strongly predicted HBV risk. Danish vaccination guidelines had HAV/HBV sensitivities of 86%/31%, and specificities of 27%/95%, respectively. Incidence rates were 12.8 (HAV) and 10.2 (HBV) per 100,000 non-immune travel months, and acute disease severity affected HAV and HBV cases equally.CONCLUSIONS: These results may support revision of current pre-travel vaccination guidelines.
KW - Adolescent
KW - Adult
KW - Aged
KW - Case-Control Studies
KW - Denmark/epidemiology
KW - Female
KW - Hepatitis A/epidemiology
KW - Hepatitis A Vaccines/therapeutic use
KW - Hepatitis B/epidemiology
KW - Hepatitis B Vaccines/therapeutic use
KW - Humans
KW - Immunization/standards
KW - Male
KW - Middle Aged
KW - Practice Guidelines as Topic
KW - Predictive Value of Tests
KW - Risk Factors
KW - Sensitivity and Specificity
KW - Time Factors
KW - Travel
KW - Young Adult
U2 - 10.1016/j.jinf.2011.12.013
DO - 10.1016/j.jinf.2011.12.013
M3 - Journal article
C2 - 22227464
SN - 0163-4453
VL - 64
SP - 399
EP - 408
JO - Journal of Infection
JF - Journal of Infection
IS - 4
ER -