国际旅行者中的急性甲型肝炎：2008-2020 年 GeoSentinel 分析。

Acute hepatitis A in international travellers: a GeoSentinel analysis, 2008-2020.

机构信息

Bureau of Infectious Disease and Laboratory Services, Massachusetts Department of Public Health, Boston, MA, USA.

Department of Medicine, Massachusetts General Hospital and Harvard Medical School.

出版信息

J Travel Med. 2022 Mar 21;29(2). doi: 10.1093/jtm/taac013.

DOI:10.1093/jtm/taac013

PMID:35134210

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9383360/

Abstract

BACKGROUND

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.The main objective was to describe the demographic and travel characteristics of international travellers infected with hepatitis A during travel.

METHODS

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.

RESULTS

Among 254 travellers with hepatitis A (185 confirmed and 69 probable), the median age was 28 years (interquartile range: 19-40), 150 (59%) were male, and among 54 travellers with information available, 53 (98%) were unvaccinated. The most common reasons for travel included tourism (n = 120; 47%) and visiting friends or relatives (VFR; n = 72; 28%). About two-thirds of VFR travellers with hepatitis A (n = 50; 69%) were younger than 20 years old. Hepatitis A was acquired most frequently in South-Central Asia (n = 63; 25%) and sub-Saharan Africa (n = 61; 24%), but 16 travellers (6%) acquired hepatitis A in regions with low endemicity including Western Europe (n = 7; 3%), the Caribbean (n = 6; 2%) and North America (n = 3; 1%). Median duration from illness onset to GeoSentinel site presentation was ~7 days (interquartile range : 4-14 days). Among 88 travellers with information available, 59% were hospitalized.

CONCLUSIONS

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.

摘要

背景

非免疫的国际旅行者有感染甲型肝炎的风险。虽然建议未接种疫苗的旅行者前往甲型肝炎病毒高或中度流行地区时接种甲型肝炎疫苗，但并非所有人都遵守这一建议。本研究的主要目的是描述在旅行期间感染甲型肝炎的国际旅行者的人口统计学和旅行特征。

方法

从 2008 年 1 月至 2020 年 12 月，从 GeoSentinel 监测网络数据库中获取旅行者感染甲型肝炎的确诊病例（分子检测阳性）和疑似病例（单一 IgM 检测阳性的症状性个体）的相关数据。我们分析了感染旅行者的人口统计学和旅行特征。

结果

在 254 例甲型肝炎旅行者（185 例确诊，69 例疑似）中，中位年龄为 28 岁（四分位距：19-40 岁），150 例（59%）为男性。在 54 例有信息可查的旅行者中，53 例（98%）未接种疫苗。旅行的主要原因包括旅游（n=120；47%）和探亲访友（n=72；28%）。大约三分之二的甲型肝炎 VFR 旅行者（n=50；69%）年龄小于 20 岁。甲型肝炎最常发生在中南亚（n=63；25%）和撒哈拉以南非洲（n=61；24%），但有 16 名旅行者（6%）在低流行地区感染了甲型肝炎，包括西欧（n=7；3%）、加勒比（n=6；2%）和北美（n=3；1%）。从发病到 GeoSentinel 站点就诊的中位时间约为 7 天（四分位距：4-14 天）。在 88 例有信息可查的旅行者中，59%住院。