title: The risk of viral hepatitis A, B, C, and E among North American missionaries.
abstract: The seroprevalence and incidence of hepatitis A, B, C, and E virus infection were determined among North American missionaries (n = 328) serving in various geographic locations between 1967 and 1984. The mean age of subjects at entry into the study was 39.7 years (range 5-73 years); 65% were female; 89% had lived outside the United States before the study began. Seventy-eight percent of subjects served in sub-Saharan Africa during the study. At initial evaluation, 50.9% of the subjects had antibodies to hepatitis A virus (total anti-HAV), 8.5% to hepatitis B virus core antigen (total anti-HBc), 0.6% to hepatitis C virus (total anti-HCV by second-generation immunoblot assay), and 0% to hepatitis E virus (IgG anti-HEV). After an average period of service of 7.3 years (2,396 person-years total), 5.8% of the missionaries seroconverted to anti-HAV, 5.5% to anti-HBc, 0.6% to anti-HCV, and 0% to anti-HEV. This study indicates a relatively low risk of hepatitis C and E virus infection among missionaries while confirming the previously reported high risk of hepatitis A and B virus infection. Hepatitis A and B vaccination is recommended for long-term travelers to developing countries.
authors.affiliation: Instituto de Lengua Espanola, San Jose, Costa Rica.
authors.forename: R D
authors.initials: RD
authors.lastname: Smalligan
authors.forename: W R
authors.initials: WR
authors.lastname: Lange
authors.forename: J D
authors.initials: JD
authors.lastname: Frame
authors.forename: P O
authors.initials: PO
authors.lastname: Yarbough
authors.forename: D L
authors.initials: DL
authors.lastname: Frankenfield
authors.forename: K C
authors.initials: KC
authors.lastname: Hyams
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000368:Aged; D002648:Child; D003906:Developing Countries; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology*; D006508:Hepatitis Antibodies / Q000097:blood; D006509:Hepatitis B / Q000453:epidemiology*; D006526:Hepatitis C / Q000453:epidemiology*; D016751:Hepatitis E / Q000453:epidemiology*; D016752:Hepatitis E virus / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D066189:Missionaries; D009656:North America / Q000208:ethnology; D015995:Prevalence; D008921:Religious Missions; D012307:Risk Factors
chemical_list: D006508:Hepatitis Antibodies