The Infectious Diseases Unit, Shaare-Zedek Medical Center, Jerusalem, Israel.
J Travel Med. 2013 Jul-Aug;20(4):232-6. doi: 10.1111/jtm.12039. Epub 2013 May 15.
Acute hepatitis is a well-described cause of morbidity and sporadic mortality in travelers. Data regarding the epidemiology of hepatitis in travelers are lacking. The aim of this study is to describe the epidemiology of acute viral hepatitis among travelers returning from tropical countries, with particular attention to enterically transmitted hepatitis.
This study is a prospective observational study of ill-returned travelers who presented at two travel medicine clinics in Israel between the years 1997 and 2012. Data of patients with acute hepatitis were summarized. Only travelers were included, immigrants and foreign workers were excluded.
Among 4,970 Israeli travelers who were seen during this period, 49 (1%) were diagnosed with acute hepatitis. Among them, hepatitis E virus (HEV) was the etiology in 19 (39%) cases and hepatitis A virus (HAV) was the etiology in 13 (27%) cases, demonstrating that 65% of all cases were due to enterically transmitted hepatitis. Acquiring acute hepatitis B (two cases) or acute hepatitis C (one case) was uncommon (6.1%). In 27% of the cases, no diagnosis was determined. Fifty-five percent of cases were imported from the Indian subcontinent, with a predominance of HEV infection (84%). A significant male predominance was seen in all groups regardless of etiology. Pre-travel consultation was documented in only 7% of those with vaccine preventable hepatitis (hepatitis A & B) compared to 89% in those with hepatitis E.
Enterically transmitted hepatitis is the main causes of viral hepatitis among travelers. HEV is an emerging disease and has become the most common hepatitis among Israeli travelers. Although an efficacious vaccine has been developed, no licensed HEV vaccine is yet available. Although hepatitis A vaccine is highly efficacious, safe, and easily available, there is a stable number of HAV cases.
急性肝炎是旅行者发病率和散发性死亡率的一个已知病因。关于旅行者肝炎的流行病学数据尚缺乏。本研究旨在描述从热带国家返回的旅行者中急性病毒性肝炎的流行病学，特别关注肠道传播的肝炎。
本研究为前瞻性观察性研究，研究对象为 1997 年至 2012 年间在以色列两家旅行医学诊所就诊的患病旅行者。总结急性肝炎患者的数据。仅纳入旅行者，不包括移民和外国工人。
在这段时间就诊的 4970 名以色列旅行者中，有 49 人（1%）被诊断为急性肝炎。其中，19 例（39%）为戊型肝炎病毒（HEV）病因，13 例（27%）为甲型肝炎病毒（HAV）病因，表明 65%的所有病例均由肠道传播的肝炎引起。乙型肝炎（2 例）或丙型肝炎（1 例）急性感染较为少见（6.1%）。27%的病例未确定病因。55%的病例从印度次大陆输入，以 HEV 感染为主（84%）。无论病因如何，所有组均显示出显著的男性优势。在有疫苗可预防的肝炎（甲型和乙型肝炎）的病例中，仅有 7%的人进行了旅行前咨询，而在有戊型肝炎的病例中，89%的人进行了旅行前咨询。
肠道传播的肝炎是旅行者中病毒性肝炎的主要病因。HEV 是一种新兴疾病，已成为以色列旅行者中最常见的肝炎。虽然已开发出有效的疫苗，但尚无获得许可的 HEV 疫苗。虽然甲型肝炎疫苗具有高效、安全和易于获得的特点，但仍有稳定数量的 HAV 病例。
