title: Risk of hepatitis B for travelers: is vaccination for all travelers really necessary?
abstract: OBJECTIVE
  Behavioral studies in travelers suggest that 33% to 76% of all travelers to hepatitis B virus (HBV)-endemic countries are at risk for HBV infection. We study the incidence and risk factors for HBV infection in travelers.
  
  
  METHODS
  Retrospective analysis of the characteristics and risk factors of all reported acute HBV patients in Amsterdam, the Netherlands, from January 1, 1992, until December 31, 2003.
  
  
  RESULTS
  The estimated incidence in travelers from Amsterdam to HBV-endemic countries is 4.5/100,000 travelers. Two thirds of these patients were immigrants who lived in Amsterdam and who had visited their friends and relatives in their country of origin. In 12 years, only three Dutch short-term tourists contracted HBV while traveling, all by heterosexual contacts.
  
  
  CONCLUSIONS
  Dutch tourists who travel to HBV-endemic countries run a very low risk of contracting HBV. Vaccination of short-term Dutch tourists is not necessary. Immigrants run a higher risk irrespective of travel or duration of travel. This group should be advised vaccination.
authors.affiliation: Public Health Service Amsterdam, Department of Infectious Diseases, Amsterdam, The Netherlands. gsonder@ggd.amsterdam.nl
authors.forename: Gerard J B
authors.initials: GJ
authors.lastname: Sonder
authors.forename: Gini G C
authors.initials: GG
authors.lastname: van Rijckevorsel
authors.forename: Anneke
authors.initials: A
authors.lastname: van den Hoek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D054242:Emigrants and Immigrants; D019353:Endemic Diseases / Q000517:prevention & control*; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D018571:Sentinel Surveillance; D014195:Travel; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D017325:Hepatitis B Vaccines