{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:30:25Z","timestamp":1790742625214,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T00:00:00Z","timestamp":1643846400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100011094","name":"Public Health Agency of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011094","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011015","name":"ISTM","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011015","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U50CK00189"],"award-info":[{"award-number":["U50CK00189"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Non-immune international travellers are at risk of acquiring hepatitis A. Although hepatitis A vaccination is recommended for unvaccinated travellers to high or intermediate hepatitis A virus endemicity, compliance with this recommendation is not universal.<\/jats:p>\n                  <jats:p>The main objective was to describe the demographic and travel characteristics of international travellers infected with hepatitis A during travel.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Available data on travellers with confirmed (positive molecular test) or probable (symptomatic individuals with a single positive IgM test) hepatitis A diagnosed during and after travel from January 2008 to December 2020 were obtained from the GeoSentinel Surveillance Network database. We analysed demographic and travel characteristics of infected travellers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 254 travellers with hepatitis A (185 confirmed and 69 probable), the median age was 28\u00a0years (interquartile range: 19\u201340), 150 (59%) were male, and among 54 travellers with information available, 53 (98%) were unvaccinated. The most common reasons for travel included tourism (n\u2009=\u2009120; 47%) and visiting friends or relatives (VFR; n\u2009=\u200972; 28%). About two-thirds of VFR travellers with hepatitis A (n\u2009=\u200950; 69%) were younger than 20\u00a0years old. Hepatitis A was acquired most frequently in South-Central Asia (n\u2009=\u200963; 25%) and sub-Saharan Africa (n\u2009=\u200961; 24%), but 16 travellers (6%) acquired hepatitis A in regions with low endemicity including Western Europe (n\u2009=\u20097; 3%), the Caribbean (n\u2009=\u20096; 2%) and North America (n\u2009=\u20093; 1%). Median duration from illness onset to GeoSentinel site presentation was ~7\u00a0days (interquartile range : 4\u201314\u00a0days). Among 88 travellers with information available, 59% were hospitalized.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Despite availability of highly effective vaccines, travellers still acquire hepatitis A, even when traveling to low-endemicity destinations. Providing pre-departure hepatitis A vaccine to susceptible travellers is crucial to reducing travel-associated hepatitis A and should be offered to all travellers as part of the pre-travel consultation, regardless of destination.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jtm\/taac013","type":"journal-article","created":{"date-parts":[[2022,1,29]],"date-time":"2022-01-29T04:42:24Z","timestamp":1643431344000},"source":"Crossref","is-referenced-by-count":26,"title":["Acute hepatitis A in international travellers: a GeoSentinel analysis, 2008\u20132020"],"prefix":"10.1093","volume":"29","author":[{"given":"Oluwafemi","family":"Balogun","sequence":"first","affiliation":[{"name":"Bureau of Infectious Disease and Laboratory Services, Massachusetts Department of Public Health, Boston, MA, USA"},{"name":"Department of Medicine, Massachusetts General Hospital and Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Brown","sequence":"additional","affiliation":[{"name":"Travelers\u2019 Health Branch, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina M","family":"Angelo","sequence":"additional","affiliation":[{"name":"Travelers\u2019 Health Branch, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha S","family":"Hochberg","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA"},{"name":"Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth D","family":"Barnett","sequence":"additional","affiliation":[{"name":"Section of Pediatric Infectious Diseases, Department of Pediatrics, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Ambra","family":"Nicolini","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Ospedale Policlinico San Martino-IRCCS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilmir","family":"Asgeirsson","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Karolinska University Hospital and Karolinska Institutet"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin P","family":"Grobusch","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, PO Box 22660, Amsterdam, The Netherlands 1100DD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Leder","sequence":"additional","affiliation":[{"name":"Victorian Infectious Diseases Service (VIDS), Royal Melbourne Hospital, Melbourne, Australia Infectious Disease Epidemiology Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Salvador","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Chen","sequence":"additional","affiliation":[{"name":"Mount Auburn Hospital, Cambridge, MA, and Harvard Medical School, Boston, 02115, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Odolini","sequence":"additional","affiliation":[{"name":"University Division of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9427-5237","authenticated-orcid":false,"given":"Marta","family":"D\u00edaz-Men\u00e9ndez","sequence":"additional","affiliation":[{"name":"National Referral Unit for Imported Tropical Diseases, Tropical & Travel medicine Unit, Infectious Diseases Department, La Paz- Carlos III University Hospital-IdiPAZ, Paseo de la Castellana, 261 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Gobbi","sequence":"additional","affiliation":[{"name":"Department of Infectious-Tropical Diseases and Microbiology (DITM), IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley A","family":"Connor","sequence":"additional","affiliation":[{"name":"Weill 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MacLean Centre for Tropical Diseases, McGill University Health Centre, 1001 Decarie Blvd, Montreal, H4A 3J1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davidson H","family":"Hamer","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA"},{"name":"Department of Global Health, Boston University School of Public Health, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,2,3]]},"reference":[{"key":"2022032516120830600_ref1","doi-asserted-by":"crossref","first-page":"589","DOI":"10.12998\/wjcc.v6.i13.589","article-title":"Update on global epidemiology of viral hepatitis and preventive strategies","volume":"6","author":"Jefferies","year":"2018","journal-title":"World J Clin Cases"},{"key":"2022032516120830600_ref2","article-title":"The global prevalence of hepatitis A virus infection and susceptibility: a systematic review","author":"Jacobsen","year":"2009","journal-title":"Health Stud Fac Publ"},{"key":"2022032516120830600_ref3","doi-asserted-by":"crossref","first-page":"68","DOI":"10.4254\/wjh.v4.i3.68","article-title":"Hepatitis A: epidemiology and prevention in developing countries","volume":"4","author":"Franco","year":"2012","journal-title":"World J Hepatol"},{"key":"2022032516120830600_ref4","doi-asserted-by":"crossref","DOI":"10.1101\/cshperspect.a031716","article-title":"Globalization and the changing epidemiology of hepatitis A virus","volume":"8","author":"Jacobsen","year":"2018","journal-title":"Cold Spring Harb Perspect Med"},{"key":"2022032516120830600_ref5","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1111\/j.1708-8305.2009.00307.x","article-title":"Hepatitis A risk in travelers","volume":"16","author":"Askling","year":"2009","journal-title":"J Travel Med"},{"key":"2022032516120830600_ref6","author":"Global Hepatitis Report","year":"2017"},{"key":"2022032516120830600_ref7","doi-asserted-by":"crossref","DOI":"10.15585\/mmwr.mm6743a5","article-title":"Update: recommendations of the advisory committee on immunization practices for use of hepatitis a vaccine for postexposure prophylaxis and for Preexposure prophylaxis for international travel","volume":"67","author":"Nelson","year":"2018","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022032516120830600_ref8","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.puhe.2018.09.017","article-title":"Changes to country-specific hepatitis a travel vaccination recommendation for UK travellers in 2017\u2014responding to a vaccine shortage in the national context","volume":"168","author":"Petersen","year":"2019","journal-title":"Public Health"},{"key":"2022032516120830600_ref9","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-018-34927-1","article-title":"Hepatitis A virus infections, immunisations and demographic determinants in children and adolescents, Germany","volume":"8","author":"Michaelis","year":"2018","journal-title":"Sci Rep"},{"key":"2022032516120830600_ref10","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: a systematic analysis for the global burden of disease study 2019","volume":"396","author":"Vos","year":"2020","journal-title":"The Lancet"},{"key":"2022032516120830600_ref11","volume-title":"Compendium of WHO and Other UN Guidance on Health and Environment","author":"World Health Organization","year":"2021"},{"key":"2022032516120830600_ref12","doi-asserted-by":"crossref","first-page":"2968","DOI":"10.1001\/jama.286.23.2968","article-title":"Control of hepatitis A through routine vaccination of children","volume":"286","author":"Averhoff","year":"2001","journal-title":"JAMA"},{"key":"2022032516120830600_ref13","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1111\/j.1708-8305.2010.00457.x","article-title":"Pre-travel health advice-seeking behavior among US international travelers departing from Boston Logan International Airport","volume":"17","author":"LaRocque","year":"2010","journal-title":"J Travel Med"},{"key":"2022032516120830600_ref14","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/j.1708-8305.2006.00088.x","article-title":"Travel health advisory group. 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