title: Risk of hepatitis A decreased among Dutch travelers to endemic regions in 2003 to 2011.
abstract: We divided the number of travel-related hepatitis A cases notified in Dutch surveillance (2003-2011) by travel data obtained from an annual holiday survey to estimate the risk of hepatitis A among Dutch travelers. Of the 2,094 cases notified, 931 (44%) were imported. Morocco (n = 272, 29%), Turkey (n = 98, 11%), and Egypt (n = 87, 9%) accounted for the largest proportion of cases. Attack rates in returnees from high or intermediate endemic regions declined from 7.5 per 100,000 travelers (95% CI 6.7-8.4) in 2003-2005 to 3.5 (95% CI 3.0-4.0) in 2009-2011 (p < 0.01). Despite the decrease in risk, vaccination remains important, and routine risk monitoring should also be considered.
authors.affiliation: National Institute for Public Health and the Environment, Bilthoven, The Netherlands; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
authors.forename: Jussi
authors.initials: J
authors.lastname: Sane
authors.forename: Rita
authors.initials: R
authors.lastname: de Sousa
authors.forename: Wilfrid
authors.initials: W
authors.lastname: van Pelt
authors.forename: Mariska
authors.initials: M
authors.lastname: Petrignani
authors.forename: Linda
authors.initials: L
authors.lastname: Verhoef
authors.forename: Marion
authors.initials: M
authors.lastname: Koopmans
mesh_terms: D062665:Epidemiological Monitoring; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology*; D022362:Hepatitis A Vaccines / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009426:Netherlands; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D014195:Travel / Q000706:statistics & numerical data*; D014611:Vaccination
chemical_list: D022362:Hepatitis A Vaccines