Predictors of travel-related hepatitis A and B among native adult Danes: a nationwide case-control study

Ulla Schierup Nielsen; Reimar Wernich Thomsen; Susan Cowan; Carsten Schade Larsen; Eskild Petersen

doi:10.1016/j.jinf.2011.12.013

Predictors of travel-related hepatitis A and B among native adult Danes: a nationwide case-control study

Ulla Schierup Nielsen, Reimar Wernich Thomsen, Susan Cowan, Carsten Schade Larsen, Eskild Petersen

Research output: Contribution to journal › Journal article › Research › peer-review

11 Citations (Scopus)

Abstract

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.

Original language	English
Journal	Journal of Infection
Volume	64
Issue number	4
Pages (from-to)	399-408
Number of pages	10
ISSN	0163-4453
DOIs	https://doi.org/10.1016/j.jinf.2011.12.013
Publication status	Published - Apr 2012
Externally published	Yes

Keywords

Adolescent
Adult
Aged
Case-Control Studies
Denmark/epidemiology
Female
Hepatitis A/epidemiology
Hepatitis A Vaccines/therapeutic use
Hepatitis B/epidemiology
Hepatitis B Vaccines/therapeutic use
Humans
Immunization/standards
Male
Middle Aged
Practice Guidelines as Topic
Predictive Value of Tests
Risk Factors
Sensitivity and Specificity
Time Factors
Travel
Young Adult

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title = "Predictors of travel-related hepatitis A and B among native adult Danes: a nationwide case-control study",

abstract = "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.",

keywords = "Adolescent, Adult, Aged, Case-Control Studies, Denmark/epidemiology, Female, Hepatitis A/epidemiology, Hepatitis A Vaccines/therapeutic use, Hepatitis B/epidemiology, Hepatitis B Vaccines/therapeutic use, Humans, Immunization/standards, Male, Middle Aged, Practice Guidelines as Topic, Predictive Value of Tests, Risk Factors, Sensitivity and Specificity, Time Factors, Travel, Young Adult",

author = "Nielsen, {Ulla Schierup} and Thomsen, {Reimar Wernich} and Susan Cowan and Larsen, {Carsten Schade} and Eskild Petersen",

year = "2012",

month = apr,

doi = "10.1016/j.jinf.2011.12.013",

language = "English",

volume = "64",

pages = "399--408",

journal = "Journal of Infection",

issn = "0163-4453",

publisher = "W. B. Saunders Company",

number = "4",

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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

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 -

Predictors of travel-related hepatitis A and B among native adult Danes: a nationwide case-control study

Abstract

Keywords

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