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Bechini A, Zanobini P, Zanella B, Ancillotti L, Moscadelli A, Bonanni P, Boccalini S. Travelers' Attitudes, Behaviors, and Practices on the Prevention of Infectious Diseases: A Study for Non-European Destinations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3110. [PMID: 33803553 PMCID: PMC8002973 DOI: 10.3390/ijerph18063110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/13/2021] [Accepted: 03/15/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The aim of this study was to improve our comprehension of the attitudes, behaviors, and practices related to the health risks of travel to non-European destinations. METHODS This cross-sectional study utilized an online questionnaire disseminated through social networks. RESULTS About 79% of the respondents reported that they informed themselves or would inform themselves about travel-related health risks before departure. The most used sources of information were the Internet (52%) and health professionals (42%). Older age groups were positively associated with seeking pretravel health information (OR = 2.44, CI 95%: 1.18-5.01, in the age group 25-34 years and OR = 14.6, CI 95%: 1.77-119.50, in subjects over 65 years). Travelers visiting friends and relatives (VFRs) were less likely to seek health information (OR = 0.49; CI 95%: 0.26-0.95). About 13.9% of participants had doubts about the practice of vaccination. Those who sought information on social media had a higher probability of refusing vaccination (OR = 3.24; CI 95%: 1.02-10.19). CONCLUSIONS The data demonstrate that VFRs and the younger population are less informed about travel risks compared with other travelers. This study also revealed the importance that digital information assumes for travelers. Therefore, decisive efforts should be made to ensure that travelers can find correct and reliable information on the Web, particularly on social media.
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Affiliation(s)
- Angela Bechini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (P.Z.); (B.Z.); (L.A.); (P.B.); (S.B.)
| | - Patrizio Zanobini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (P.Z.); (B.Z.); (L.A.); (P.B.); (S.B.)
| | - Beatrice Zanella
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (P.Z.); (B.Z.); (L.A.); (P.B.); (S.B.)
| | - Leonardo Ancillotti
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (P.Z.); (B.Z.); (L.A.); (P.B.); (S.B.)
| | - Andrea Moscadelli
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy;
| | - Paolo Bonanni
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (P.Z.); (B.Z.); (L.A.); (P.B.); (S.B.)
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (P.Z.); (B.Z.); (L.A.); (P.B.); (S.B.)
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2
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Doornekamp L, GeurtsvanKessel C, Slobbe L, Te Marvelde MR, Scherbeijn SMJ, van Genderen PJJ, van Gorp ECM, Goeijenbier M. Adherence to hepatitis A travel health guidelines: A cross-sectional seroprevalence study in Dutch travelling families - The Dutch travel Vaccination Study (DiVeST). Travel Med Infect Dis 2019; 32:101511. [PMID: 31704482 DOI: 10.1016/j.tmaid.2019.101511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/14/2019] [Accepted: 11/04/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND This Dutch travel Vaccination Study (DiVeST) aimed to study adherence or compliance to Dutch travel health guidelines in travelling families and to identify risk groups to provide better advice and protection for international travellers. METHODS Between 2016 and 2018, family members who travelled to Eastern Europe or outside Europe during the preceding year were recruited via Dutch secondary schools. The vaccination status of the travellers was assessed using questionnaires and vaccination records and hepatitis A virus antibody concentrations in dried blood spot (DBS) eluates. Subgroups of travellers with lower adherence to guidelines were identified. RESULTS Of the 246 travellers that participated in this study, 155 (63%) travelled to destinations for which the HAV vaccination was recommended. Of these 155 travellers, 56 (36%) said they visited a pre-travel clinic, and 64 of them (41%) showed a valid HAV vaccination in their vaccination records. Of the 145 travellers with available DBS eluates, anti-HAV antibodies were detected in 98 (68%) of them. CONCLUSIONS We found that adherence to travel health guidelines, in terms of HAV vaccination, was suboptimal. According to our results, specific attention should be paid to children, persons visiting friends and relatives and those who travel relatively short distances.
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Affiliation(s)
- Laura Doornekamp
- Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Travel Clinic, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - Corine GeurtsvanKessel
- Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Lennert Slobbe
- Travel Clinic, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Merel R Te Marvelde
- Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sandra M J Scherbeijn
- Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Perry J J van Genderen
- Travel Clinic, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Eric C M van Gorp
- Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Marco Goeijenbier
- Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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Getaz L, Casillas A, Motamed S, Gaspoz JM, Chappuis F, Wolff H. Hepatitis A immunity and region-of-origin in a Swiss prison. Int J Prison Health 2017; 12:98-105. [PMID: 27219907 DOI: 10.1108/ijph-10-2015-0033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose - The environmental and demographic characteristics of closed institutions, particularly prisons, precipitate morbidity during hepatitis A virus (HAV) outbreaks. Given the high prevalence of chronic liver disease and other risk factors in the prison setting, the purpose of this paper is to examine HAV-immunity and its associated factors in this population. Design/methodology/approach - The cross-sectional study was conducted in 2009: a serology screening for HAV IgG was carried out among 116 inmates in Switzerland's largest pre-trial prison. Other participant characteristics were collected through a structured face-to-face questionnaire with a physician. Findings - In terms of significant demographics, Africa (53.5 percent) and the Balkans/Eastern Europe (36.2 percent) were the main regions of origin; a minority of inmates were from Western Europe (6.9 percent), Latin America (2.6 percent) or Asia (0.9 percent). The authors identified hepatitis A antibody-negative serology (lack of immunity) in five out of 116 prisoners (4.3 percent, 95 percent CI 1.4-9.7). Among participants of European origin alone, five out of 50 inmates were hepatitis A antibody-negative (10 percent, 95 percent CI 3.3-21.8), whereas the 66 inmates from other all continents were hepatitis A antibody-positive (immune) (p=0.026). Originality/value - In this prison population composed of mostly African migrants, hepatitis A immunity was high. This reaffirms that region of origin is highly associated with childhood immunity against HAV. HAV vaccination should take into account a patient's area of origin and his/her risk factors for systemic complications, if ever infected. This targeted strategy would offer herd immunity, and seek out the most vulnerable individuals who are potentially at risk of new exposure in this precarious setting.
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Affiliation(s)
- Laurent Getaz
- Division of Penitentiary Medicine and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Alejandra Casillas
- Division of Penitentiary Medicine and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Sandrine Motamed
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Jean-Michel Gaspoz
- Division of Primary Care Medicine, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Francois Chappuis
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Hans Wolff
- Division of Penitentiary Medicine and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
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Torresi J, Steffen R. Redefining priorities towards graded travel-related infectious disease research. J Travel Med 2017; 24:4359791. [PMID: 29088486 DOI: 10.1093/jtm/tax064] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Indexed: 01/01/2023]
Abstract
Our knowledge of the health problems and infections encountered by international travellers has evolved considerably in the past decades. The growth of global networks such as the GeoSentinel Surveillance network, TropNet Europe, EuroTravNet and networks based in North America have provided valuable information on the frequency of a wide array of travel-related diseases and accidents, including details on the destination of travel and trends over time. The information gained from these network studies has provided important data for the practice of travel medicine and in some instances for the development of practice guidelines. However, network data due to a lack of denominators usually cannot serve as a basis for a GRADE approach to guideline development. Although epidemiological network studies will continue to serve an important role in travel medicine we encourage an additional strong focus towards translational scientific research questions and towards the broader use of novel techniques to obtain more accurate epidemiological analyses to address the many unanswered questions in our field.
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Affiliation(s)
- Joseph Torresi
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Robert Steffen
- Epidemiology, Biostatistics and Prevention Institute, Division of Communicable Diseases, WHO Collaborating Centre for Travellers' Health, University of Zurich, Zurich, Switzerland.,Division of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas School of Public Health, Houston, TX, USA
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Tsankova GS, Todorova TT, Ermenlieva NM, Popova TK, Tsankova DT. Epidemiological Study of Hepatitis A Infection in Eastern Bulgaria. Folia Med (Plovdiv) 2017; 59:63-69. [PMID: 28384115 DOI: 10.1515/folmed-2017-0005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 08/09/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Hepatitis A virus (HAV) infection is an acute, self-limited liver disease transmitted usually through the faecal-oral route via person-to-person contact. Bulgaria has intermediate HAV endemicity with higher susceptibility among adults and recurrent outbreaks. AIM As HAV infection is strongly related to human movements and represents a significant risk to travelers and migrants, as well as to local population receiving these groups, we set out to analyze the epidemiological data on hepatitis A in five of the largest tourist border regions of Bulgaria located in its eastern part: Varna, Shumen, Dobrich, Burgas and Yambol. MATERIALS AND METHODS We reviewed retrospectively all reported cases of acute hepatitis A in the eastern regions of Bulgaria over a 7-year period between 2008 and 2014. RESULTS A total of 2879 newly infected patients were registered during the study period, the number varying widely: from 190 cases in 2014 to 923 in 2012. The average incidence of HAV was higher in the south-eastern regions than in the northeastern regions (55.30%000 vs 15.04%000 respectively, p < 0.0001). The most affected age group in all regions was the 5-9-year olds (p < 0.0001) and males were significantly more susceptible to HAV (p = 0.02). CONCLUSION Hepatitis A is still a major public health problem in Bulgaria; there is a significant difference in the incidence of the disease between the regions in the south-east and those in the north-east and between the different age groups and sexes.
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Affiliation(s)
- Gabriela St Tsankova
- Department of Preclinical and Clinical Sciences, Faculty of Pharmacy, Medical University of Varna, 3 Bregalnica St., 9000 Varna
| | - Tatina T Todorova
- Department of Preclinical and Clinical Sciences, Faculty of Pharmacy, Medical University of Varna, 3 Bregalnica St., 9000 Varna
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6
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[Vaccinations and prophylaxis: what to consider]. MMW Fortschr Med 2016; 158 Suppl 1:38-42. [PMID: 27259901 DOI: 10.1007/s15006-016-8325-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Heywood AE, Nothdurft H, Tessier D, Moodley M, Rombo L, Marano C, De Moerlooze L. Pre-travel advice, attitudes and hepatitis A and B vaccination rates among travellers from seven countries†. J Travel Med 2016; 24:taw069. [PMID: 27738112 PMCID: PMC5063019 DOI: 10.1093/jtm/taw069] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND Knowledge about the travel-associated risks of hepatitis A and B, and the extent of pre-travel health-advice being sought may vary between countries. METHODS An online survey was undertaken to assess the awareness, advice-seeking behaviour, rates of vaccination against hepatitis A and B and adherence rates in Australia, Finland, Germany, Norway, Sweden, the UK and Canada between August and October 2014. Individuals aged 18-65 years were screened for eligibility based on: travel to hepatitis A and B endemic countries within the past 3 years, awareness of hepatitis A, and/or combined hepatitis A&B vaccines; awareness of their self-reported vaccination status and if vaccinated, vaccination within the last 3 years. Awareness and receipt of the vaccines, sources of advice, reasons for non-vaccination, adherence to recommended doses and the value of immunization reminders were analysed. RESULTS Of 27 386 screened travellers, 19 817 (72%) were aware of monovalent hepatitis A or combined A&B vaccines. Of these 13 857 (70%) had sought advice from a healthcare provider (HCP) regarding combined hepatitis A&B or monovalent hepatitis A vaccination, and 9328 (67%) were vaccinated. Of 5225 individuals eligible for the main survey (recently vaccinated = 3576; unvaccinated = 1649), 27% (841/3111) and 37% (174/465) of vaccinated travellers had adhered to the 3-dose combined hepatitis A&B or 2-dose monovalent hepatitis A vaccination schedules, respectively. Of travellers partially vaccinated against combined hepatitis A&B or hepatitis A, 84% and 61%, respectively, believed that they had received the recommended number of doses. CONCLUSIONS HCPs remain the main source of pre-travel health advice. The majority of travellers who received monovalent hepatitis A or combined hepatitis A&B vaccines did not complete the recommended course. These findings highlight the need for further training of HCPs and the provision of reminder services to improve traveller awareness and adherence to vaccination schedules.
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Affiliation(s)
- Anita E Heywood
- School of Public Health and Community Medicine, Faculty of Medicine, UNSW Australia, Level 3, Samuels Building, Sydney 2052, Australia
| | | | - Dominique Tessier
- Family Medicine, Groupe Sante Voyage, Quebec, Canada Unité Hospitalière de Recherche, d'enseignement et de soins sur le sida, CHUM, University of Montreal, Montreal, Canada
| | | | - Lars Rombo
- Centre for Clinical Research, Sormland County Council and Uppsala University, Eskilstuna, Sweden
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Sane J, MacDonald E, Vold L, Gossner C, Severi E. Multistate foodborne hepatitis A outbreak among European tourists returning from Egypt--need for reinforced vaccination recommendations, November 2012 to April 2013. ACTA ACUST UNITED AC 2015; 20. [PMID: 25655054 DOI: 10.2807/1560-7917.es2015.20.4.21018] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- J Sane
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, the Netherlands
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9
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[Vaccinations for international travelers]. Internist (Berl) 2014; 55:246, 248-50, 252-4, 256-8. [PMID: 24519704 DOI: 10.1007/s00108-013-3365-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Vaccinations are a prominent part of health preparations before international travel. They can avoid or significantly reduce the risk of numerous infectious diseases. Until recently, vaccination against yellow fever was the only obligatory vaccination. However, according to updated international health regulations, other vaccinations and prophylactic measures may be required at entry from certain countries. For all routine vaccinations as recommended in Germany, necessary revaccination and catch-up of missed vaccinations should be administered before travel. At most destinations the risk of infection is higher than in Germany. Hepatitis A vaccine is generally recommended for travelers to areas of increased risk, polio vaccine for all destinations where eradication is not yet confirmed (Asia and Africa). The indications for other travel vaccines must take into consideration travel destination and itinerary, type and duration of travel, individual risk of exposure as well as the epidemiology of the disease to be prevented. Several vaccines of potential interest for travel medicine, e.g., new vaccines against malaria and dengue fever, are under development.
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Maltezou HC, Patrinos S, Veneti L, Gkolfinopoulou K, Pavli A, Mellou K, Sideroglou T, Spilioti A, Georgakopoulou T. Ηepatitis A and enteric fever in Greece, 2004-2011: a cross-sectional analysis. Travel Med Infect Dis 2013; 12:143-8. [PMID: 24201038 DOI: 10.1016/j.tmaid.2013.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 09/26/2013] [Accepted: 10/09/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND In Greece the number of international travellers has increased significantly the past decade. AIM 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.
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Affiliation(s)
- Helena C Maltezou
- Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, 3-5 Agrafon Street, Athens 15123, Greece.
| | - Stavros Patrinos
- Department for Epidemiological Surveillance, Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Labrini Veneti
- Department for Epidemiological Surveillance, Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Kassiani Gkolfinopoulou
- Department for Epidemiological Surveillance, Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Androula Pavli
- Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, 3-5 Agrafon Street, Athens 15123, Greece
| | - Kassiani Mellou
- Department for Epidemiological Surveillance, Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Theologia Sideroglou
- Department for Epidemiological Surveillance, Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Athina Spilioti
- Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, 3-5 Agrafon Street, Athens 15123, Greece
| | - Theano Georgakopoulou
- Department for Epidemiological Surveillance, Hellenic Center for Disease Control and Prevention, Athens, Greece
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Multicentric evaluation of new commercial enzyme immunoassays for the detection of immunoglobulin M and total antibodies against hepatitis A virus. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2011; 18:1391-4. [PMID: 21653739 DOI: 10.1128/cvi.00403-10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A multicentric clinical study was conducted on representative sera from 1,738 European and U.S. subjects for the evaluation of new anti-hepatitis A virus enzyme immunoassays from Bio-Rad Laboratories. Comparison with reference DiaSorin S.p.A. tests confirmed the good performance of Bio-Rad assays (99.85% and 99.47% overall agreement in detecting total antibodies and IgM, respectively).
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13
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Jilg W. [Vaccines against viral hepatitis A to E. What do we have, what effect can they have?]. ACTA ACUST UNITED AC 2011; 40:36-43. [PMID: 21194080 DOI: 10.1002/pauz.201100398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Wolfgang Jilg
- Institut für Medizinische Mikrobiologie und Hygiene, Universität Regensburg, Franz-Josef-Strauß-Allee 11, D-93053 Regensburg.
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Stoycheva M, Vatev N, Petrov A, Venchev C, Atanasova M. Epidemiological Study of Hepatitis A in Plovdiv Region—Bulgaria, 2005-2008. ACTA ACUST UNITED AC 2011. [DOI: 10.4236/wjv.2011.14017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Defining infections in international travellers through the GeoSentinel surveillance network. Nat Rev Microbiol 2009; 7:895-901. [PMID: 19881521 PMCID: PMC7097479 DOI: 10.1038/nrmicro2238] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
International travellers are often exposed to a wide range of infections, most of which are a reflection of common diseases in the destination country. The consequences of acquiring such infections are serious and can be associated with substantial morbidity and mortality. Attempting to define the range of infections and the risk factors that are associated with acquiring them during travel to different regions worldwide will provide an evidence base for the development and implementation of effective preventative interventions. This Science and Society article focuses on the valuable function served by the GeoSentinel surveillance network in defining the range of infections in travellers.
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Costas L, Vilella A, Trilla A, Serrano B, Vera I, Roldán M, Sancho MP, Bayas JM, Gascón J, Costa J. Vaccination strategies against hepatitis A in travelers older than 40 years: an economic evaluation. J Travel Med 2009; 16:344-8. [PMID: 19796106 DOI: 10.1111/j.1708-8305.2009.00320.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND In recent years, the number of travelers aged >40 years who acquire hepatitis A while traveling has increased. Therefore, there is a need to review hepatitis A vaccination protocols in travelers. The aims of the study were to assess immunity levels to hepatitis A virus (HAV) in international travelers >40 years and to determine the least costly immunization strategy. METHODS A serological examination of HAV antibodies in 427 international travelers aged >40 years traveling endemic zones was carried out. The prevalence of antibodies in each age group was assessed. The costs of two preventive strategies, direct vaccination of all subjects (independent of the immune status) or screening and subsequent vaccination of susceptible subjects were compared. The critical value of prevalence (CVP) (the value at which the costs for the two strategies are equal) was calculated. RESULTS Total prevalence of HAV antibodies was 78.9% [95% confidence interval (CI): 74.8-82.5] and was 80.0% (95% CI: 73.8-85.2) in men and 77.9% (95% CI: 71.9-83.2) in women. There was a positive association with age. In the 40 to 49, 50 to 59, 60 to 69, and 70 to 95 years age groups, the prevalence rates were 62.6 (95% CI: 53.8-71.5), 76.8 (95% CI: 70.0-82.7), 91.7 (95% CI: 85.2-95.6), and 97.5% (95% CI: 87.4-99.6), respectively. The CVP was 58.4% using two doses of vaccine. CONCLUSIONS The CVP was lower than the prevalence rate found in our international travelers. Therefore, we recommend systematic screening for HAV antibodies before selective vaccination of international travelers aged >40 years traveling to hepatitis A endemic zones.
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Affiliation(s)
- Laura Costas
- Preventive Medicine and Epidemiology Department, Hospital Clinic/IDIBAPS, Barcelona, Spain.
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17
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Abstract
BACKGROUND Traveling to highly endemic areas for hepatitis A is increasing while the immunization level in travelers has been shown to be low in the countries studied. METHODS In this population-based study, we have estimated the incidence rate of travel-related hepatitis A during 1997 to 2005 by use of the Swedish notification system of communicable diseases and an ongoing national database on travel patterns. We have also acquired airport-based immunization data from 2007. RESULTS During the study period, 636 cases of travel-related hepatitis A were notified. Traveling to East Africa was associated with the highest incidence rate (14.1 cases/100,000 person months), followed by the Middle East (5.8/100,000 person months), and India with neighboring countries (5.6/100,000 person months). Visiting Friends and Relatives (VFR) travelers represented 83, 91, and 70% of the cases to these three regions. By age-group, the highest incidence was found in children 0 to 14 years (3.1/100,000 travelers) where 88% of the cases were VFR travelers. Incidence rate in unprotected travelers to East Asia, North Africa, and the Middle East was 2, 12, and 18 cases/100,000 person months, respectively. In 2007, 79% of the travelers were immunized against hepatitis A. CONCLUSIONS We conclude that travelers, and especially children, who are VFR in endemic areas constitute a high-risk group for acquiring hepatitis A infection, while the risk for unprotected tourists to East Asia is low.
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Affiliation(s)
- Helena H Askling
- Department of Medicine/Unit for Infectious Diseases, Solna, Karolinska Institute, Karolinska University Hospital, S-17176 Stockholm, Sweden.
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Kyrka A, Tragiannidis A, Cassimos D, Pantelaki K, Tzoufi M, Mavrokosta M, Pedeli X, Athanassiadou F, Hatzimichael A, Konstantopoulos A, Kafetzis D, Papaevangelou V. Seroepidemiology of hepatitis A among Greek children indicates that the virus is still prevalent: Implications for universal vaccination. J Med Virol 2009; 81:582-7. [PMID: 19235841 DOI: 10.1002/jmv.21434] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A national cross-sectional seroprevalence survey was conducted in order to evaluate the current seroepidemiology of hepatitis A among 1,383 children, aged 0-14 years, residing in Greece. Stratification of the study population was conducted according to age and area of residence. Sera from study participants were tested for the presence of anti-HAV IgG antibodies. Immigrant children, as well as children residing in rural areas, had lower immunization rates. Among unvaccinated children, the seroprevalence rate of anti-HAV was 17.1%. Nationality was shown to have a marginally significant effect since non-immunized immigrant children had a higher seroprevalence rate (22.4% vs. 15.9%, OR = 1.52, P = 0.064). Significant differences between geographic areas for both vaccination coverage and natural immunity were observed. The study findings indicate that hepatitis A is prevalent in Greece and therefore universal infant hepatitis A immunization should be implemented.
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Affiliation(s)
- A Kyrka
- 2nd Department of Pediatrics, University of Athens Medical School, "A. Kyriakou" Children's Hospital, Goudi, Athens, Greece
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Nielsen US, Larsen CS, Howitz M, Petersen E. Hepatitis A among Danish travellers 1980-2007. J Infect 2008; 58:47-52. [PMID: 19059649 DOI: 10.1016/j.jinf.2008.10.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2008] [Revised: 10/27/2008] [Accepted: 10/28/2008] [Indexed: 10/21/2022]
Abstract
The authors present a descriptive study on hepatitis A among Danish travellers in the period 1980-2007 based on data from a large survey among 26,640 Danes regarding travel habits, as well as national surveillance and population data. There are five messages to be read from the results: (1) The incidence of hepatitis A is declining at most destinations worldwide. (2) Reported incidence rates tend to overestimate the risk for the average tourist because they include immigrants visiting friends and family in the country of origin. (3) The immunization strategy in Denmark (leaving it up to the individual traveller to seek advice and pay for the immunization) seems to work well for most Danish travellers as 75% travelled immune. (4) Danes travel very frequently to hepatitis A endemic areas and will spend on average 6 months in endemic areas from the age of 18 till 79. (5) 80% of all incident cases 2002-2006 were immigrants or children of immigrants. The immunization strategy is not effective in this group. In conclusion, the risk of acquiring hepatitis A abroad is low for the average ethnic Danish tourist, while it is high in immigrants and their children. Thus, special focus on this group of travellers is warranted.
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Affiliation(s)
- Ulla Schierup Nielsen
- Department of Infectious Diseases, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark.
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20
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Tsai NCS, Holck PS, Wong LL, Ricalde AA. Seroepidemiology of hepatitis B virus infection: analysis of mass screening in Hawaii. Hepatol Int 2008; 2:478-85. [PMID: 19669323 DOI: 10.1007/s12072-008-9103-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2008] [Accepted: 09/14/2008] [Indexed: 12/26/2022]
Abstract
BACKGROUND Although hepatitis B seroprevalence has been studied extensively in California and New York, detailed information for other high-risk areas in the United States is lacking. To study current prevalence and risk for hepatitis B virus (HBV) infection in Hawaii, we analyzed cross-sectional data from Hawaii residents screened between July 2003 and April 2006. METHODS We retrospectively reviewed the screening records of 3,989 participants recruited at health fairs and clinics. Prevalence and risk factors for HBV infection were estimated using univariate and multivariate logistic regression models. RESULTS Total prevalence of hepatitis B surface antigen (HBsAg) was 3.6%. Gender, age, and ethnicity were independently associated with HBsAg seropositivity. In a multivariate logistic regression model, males were at increased risk for HBsAg compared with females (odds ratio [OR] = 1.53, 95% confidence interval [CI]: 1.09-2.16) and persons aged 70 years or older were less likely to test positive than those younger than 30 (OR = 0.25, 95% CI: 0.11-0.61). In addition, multivariate ORs of HBsAg seropositivity were 3.24 (95% CI: 1.04-10.09), 4.13 (95% CI: 1.66-10.29), and 7.47 (95% CI: 2.52-22.11) for Vietnamese, Chinese, and Pacific Islanders, respectively, compared with Whites. CONCLUSIONS This study furthers current knowledge of HBV epidemiology in areas with large populations of high-risk immigrants and demonstrates the relevance of screening programs for hepatitis B.
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Affiliation(s)
- Naoky C S Tsai
- Liver Center, Hawaii Medical Center, 2230 Liliha Street, 2MA, Honolulu, HI, 96817, USA,
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Risk and Burden Associated With the Acquisition of Viral Hepatitis A and B in the Corporate Traveler. J Occup Environ Med 2008; 50:935-44. [DOI: 10.1097/jom.0b013e3181808096] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Weinke T, Güthoff W, Liebold I. [Vaccination for travel]. PHARMAZIE IN UNSERER ZEIT 2008; 37:72-77. [PMID: 18081050 DOI: 10.1002/pauz.200700253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- Thomas Weinke
- Klinikum Ernst von Bergmann, Medizinische Klinik, Gastroenterologie, Infektiologie, Pneumologie, Charlottenstr. 72, 14467 Potsdam.
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