Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of Viral Hepatitis, Epidemiology and Surveillance Branch, Atlanta, GA, USA.
J Travel Med. 2015 May-Jun;22(3):174-8. doi: 10.1111/jtm.12186. Epub 2015 Jan 24.
Although hepatitis A virus (HAV) infection is preventable through vaccination, cases associated with international travel continue to occur. The purpose of this study was to examine the frequency of international travel and countries visited among persons infected with HAV and assess reasons why travelers had not received hepatitis A vaccine before traveling.
Using data from sentinel surveillance for HAV infection in seven US counties during 1996 to 2006, we examined the role of international travel in hepatitis A incidence and the reasons for patients not being vaccinated.
Of 2,002 hepatitis A patients for whom travel history was available, 300 (15%) reported traveling outside of the United States. Compared to non-travelers, travelers were more likely to be female [odds ratio (OR) = 1.74 (95% confidence interval [95% CI], 1.35, 2.24)], aged 0 to 17 years [OR = 3.30 (1.83, 5.94)], Hispanic [OR = 3.69 (2.81, 4.86)], Asian [OR = 2.00 (1.06, 3.77)], and were less likely to be black non-Hispanic [OR = 0.30 (0.11, 0.82)]. The majority, 189 (61.6%), had traveled to Mexico. The most common reason for not getting pre-travel vaccination was "Didn't know I could [or should] get shots" [100/154 (65%)].
Low awareness of HAV vaccination was the predominant reason for not being protected before travel. Different modes of traveler education could improve prevention of hepatitis A. To highlight the risk of infection before traveling to endemic countries including Mexico, travel and consulate websites could list reminders of vaccine recommendations.
尽管甲型肝炎病毒（HAV）感染可以通过疫苗接种来预防，但与国际旅行相关的病例仍在不断发生。本研究旨在研究感染 HAV 的人群中国际旅行的频率和旅行国家，并评估旅行者在旅行前未接种甲型肝炎疫苗的原因。
利用 1996 年至 2006 年期间美国七个县的甲型肝炎监测数据，我们研究了国际旅行在甲型肝炎发病率中的作用以及患者未接种疫苗的原因。
在 2002 名提供旅行史的甲型肝炎患者中，有 300 名（15%）报告有出国旅行史。与非旅行者相比，旅行者更有可能是女性[比值比（OR）=1.74（95%置信区间[95%CI]，1.35，2.24）]，年龄在 0 至 17 岁[OR=3.30（1.83，5.94）]，西班牙裔[OR=3.69（2.81，4.86）]，亚裔[OR=2.00（1.06，3.77）]，而非西班牙裔黑人的可能性较小[OR=0.30（0.11，0.82）]。大多数人（189 人，61.6%）前往墨西哥旅行。未接种旅行前疫苗的最常见原因是“不知道我可以[或应该]接种疫苗”[154 人中有 100 人（65%）]。
在旅行前未得到保护的主要原因是对甲型肝炎疫苗接种的认识不足。通过不同的旅行者教育模式可以改善甲型肝炎的预防。为了在前往包括墨西哥在内的流行国家旅行前强调感染风险，旅行和领事馆网站可以列出疫苗接种建议的提醒。
