Prophylaxis against hepatitis A for travel.
OBJECTIVE
To develop a rational practice policy for prophylaxis against hepatitis A for travellers to high risk areas.


METHODS
18 Month prospective study of consecutive patients who requested prophylaxis against hepatitis A.


METHODS
Inner city general practice.


METHODS
104 Patients aged 15-61 (mean 30) assessed for risk factors for hepatitis A and put into groups depending on predictions from the risk factors of their immunity.


RESULTS
All patients were screened for antibody to hepatitis A virus. Of 52 patients with no risk factors 47 had no antibody and were thus susceptible to hepatitis A. All 27 patients with major risk factors (having been brought up in an endemic area or with a history of jaundice) were immune. Of 25 patients with minor risk factors (a history of previous travel in high risk areas, drug abuse, having lived in a squat or travelled rough, or having lived with someone who had jaundice) 12 were immune (p less than 0.001, chi 2 test).


CONCLUSIONS
All travellers requesting prophylaxis against hepatitis A should be assessed for risk factors for previous exposure to hepatitis A. Those with no risk factors could be immunised with human normal immunoglobulin without screening. The remainder should be tested for hepatitis A antibody and those found to be susceptible should be immunised.
Moore
P
P
Mawbey Brough Health, Centre, London.
Oakeshott
P
P
Logan
J
J
Law
J
J
Harris
D M
DM
D000293:Adolescent; D000328:Adult; D004198:Disease Susceptibility; D006506:Hepatitis A / Q000276:immunology / Q000517:prevention & control*; D006508:Hepatitis Antibodies / Q000032:analysis; D006507:Hepatovirus / Q000276:immunology; D006801:Humans; D007116:Immunization, Passive; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014195:Travel
D006508:Hepatitis Antibodies