title: Ηepatitis A and enteric fever in Greece, 2004-2011: a cross-sectional analysis.
abstract: BACKGROUND
  In Greece the number of international travellers has increased significantly the past decade.
  
  
  OBJECTIVE
  To study the impact of international travels on the epidemiology of hepatitis A and enteric fever in Greece.
  
  
  METHODS
  We studied cases of hepatitis A and enteric fever notified through the National Surveillance System from January 1, 2004 through December 31, 2011.
  
  
  RESULTS
  A total of 921 cases of hepatitis A and 106 cases of enteric fever were notified; of them, 88 (9.5%) and 46 (43.4%) were travel-associated, respectively. Travellers returning from Eastern Europe and the Middle East accounted for most imported cases of hepatitis A (37 (43.5%) and 14 (16.5%) cases, respectively). The Indian subcontinent was the prevalent area of acquisition of travel-associated enteric fever, followed by the Middle East (35 (83.3%) and 4 (9.5%) cases, respectively). Foreign-born travellers accounted for 43 (48.8%) and 39 (86.6%) cases of travel-associated hepatitis A and enteric fever, respectively. Children <15 years accounted for 65.1% of hepatitis A cases and 7.7% among foreign-born travellers. Greek Roma accounted for 270 (29.3%) of all hepatitis A cases notified.
  
  
  CONCLUSIONS
  International travels have a significant impact on the epidemiology of enteric fever in Greece, affecting mainly foreign travellers. Hepatitis A carries a significant burden of morbidity among Greek travellers and children of foreign nationality. There is a need to improve travel medicine services for travellers travelling to developing countries.
authors.affiliation: Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, 3-5 Agrafon Street, Athens 15123, Greece. Electronic address: helen-maltezou@ath.forthnet.gr.
authors.forename: Helena C
authors.initials: HC
authors.lastname: Maltezou
authors.affiliation: Department for Epidemiological Surveillance, Hellenic Center for Disease Control and Prevention, Athens, Greece.
authors.forename: Stavros
authors.initials: S
authors.lastname: Patrinos
authors.affiliation: Department for Epidemiological Surveillance, Hellenic Center for Disease Control and Prevention, Athens, Greece.
authors.forename: Labrini
authors.initials: L
authors.lastname: Veneti
authors.affiliation: Department for Epidemiological Surveillance, Hellenic Center for Disease Control and Prevention, Athens, Greece.
authors.forename: Kassiani
authors.initials: K
authors.lastname: Gkolfinopoulou
authors.affiliation: Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, 3-5 Agrafon Street, Athens 15123, Greece.
authors.forename: Androula
authors.initials: A
authors.lastname: Pavli
authors.affiliation: Department for Epidemiological Surveillance, Hellenic Center for Disease Control and Prevention, Athens, Greece.
authors.forename: Kassiani
authors.initials: K
authors.lastname: Mellou
authors.affiliation: Department for Epidemiological Surveillance, Hellenic Center for Disease Control and Prevention, Athens, Greece.
authors.forename: Theologia
authors.initials: T
authors.lastname: Sideroglou
authors.affiliation: Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, 3-5 Agrafon Street, Athens 15123, Greece.
authors.forename: Athina
authors.initials: A
authors.lastname: Spilioti
authors.affiliation: Department for Epidemiological Surveillance, Hellenic Center for Disease Control and Prevention, Athens, Greece.
authors.forename: Theano
authors.initials: T
authors.lastname: Georgakopoulou
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006115:Greece / Q000453:epidemiology; D006506:Hepatitis A / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D014195:Travel / Q000706:statistics & numerical data*; D057236:Travel Medicine; D014435:Typhoid Fever / Q000453:epidemiology* / Q000821:virology*; D055815:Young Adult
keywords: Enteric fever; Greece; Hepatitis A; Imported; Travel-associated