Travel-related hepatitis B: risk factors and prevention using an accelerated vaccination schedule.
Rates of global travel and tourism are increasing dramatically, especially to regions with medium or high endemicity for hepatitis A and B, such as Asia, Africa, Latin America, and the Middle East. International travelers to these areas should be protected against both hepatitis A and B, regardless of their anticipated length of stay. However, many travelers depart within weeks of planning their trip (too late to complete the accelerated 0-, 1-, 2-month regimen for hepatitis B), and a majority of those traveling depart without being vaccinated. Although extended-stay travelers are at high risk for hepatitis B, short-stay travelers also are at risk. The most commonly encountered risk factors for travel-related hepatitis B are casual sexual activity with a new partner, medical and dental care abroad, and in the expatriate community, adoption of children who are hepatitis B carriers. Although efficacy studies of accelerated schedules for hepatitis B immunization have not been conducted, the results of immunogenicity studies in healthy volunteers who received an accelerated, 3-dose regimen on a 0-,7-, and 21-day schedule suggest that excellent, rapid, and long-term protection will be conferred. More data are needed to assess the efficacy of accelerated schedules in persons aged >40 years and to determine whether a fourth dose of hepatitis B vaccine is needed in all age groups.
Keystone
Jay S
JS
Centre for Travel and Tropical Medicine, Toronto General Hospital, University of Toronto, Toronto, Canada. jay.keystone@utoronto.ca
D006509:Hepatitis B / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D007115:Immunization Schedule; D012307:Risk Factors; D014195:Travel; D014611:Vaccination / Q000379:methods*