VOL: 102, ISSUE: 30, PAGE NO: 45
Jane Zuckerman, MBBS, MD, FRCPath, FIBiol, FFPHM, FFTM
director, Academic Centre for Travel Medicine and Vaccines and WHO Collaborating Centre for Travel Medicine; and director, Royal Free Travel Health Centre, London
Travellers need to be made more aware of the risk of contracting hepatitis B while abroad, suggest the results of a multi-centre, pan-European travel health survey (Zuckerman, 2006).
The eight-centre study, which involved over 4,000 respondents from Belgium, Finland, Germany, Italy, The Netherlands, Spain, Sweden and the UK, showed that, in the past five years, 23% of people from the UK had travelled to a destination where hepatitis B is endemic (as defined by the World Health Organization), and had stayed there for three nights or more.
Of all those surveyed who had travelled to those destinations, 66% could not recall receiving a hepatitis B vaccination.
The key message from the survey is that because of the unpredictability of incidents while abroad, many travellers may inadvertently be putting themselves at risk of contracting hepatitis B through, for example, accidents or illness that may require medical treatment. This could, for example be through the use of non-sterile medical equipment or the administration of blood or body fluids that could be contaminated with the virus.
The survey showed that of all those travelling to a hepatitis B-endemic country, 24% were at an increased risk of exposure to hepatitis B because of situations arising where blood-borne viruses could be transmitted:
- Of the 30% of all travellers surveyed who fell ill, 55% had not received a hepatitis B vaccination;
- 6% of UK travellers had been involved in an accident or incident that required medical treatment;
- 5% of UK travellers had had a tattoo in an endemic country;
- 8% of UK travellers had had sex with a person they met in an endemic country.
The survey also highlighted dangers for ‘health tourists’: 3% of travellers had visited a hepatitis-B endemic country specifically for the purpose of having a medical procedure such as dental work or eye surgery, but 65% of those travelling for ‘health tourism’ were not vaccinated against the virus.
While 90% of travellers to a hepatitis B-endemic country had sought advice regarding vaccinations before departure, 50% of respondents across all countries participating in the survey had not had the risk factors for contracting hepatitis B explained to them by a healthcare professional in their country of residence.
As increasing numbers of travellers today visit hepatitis B-endemic areas for business, pleasure or the new phenomenon of health tourism, it is imperative that travel medicine practitioners advise travellers on the potential risks of contracting hepatitis B and on its long-term effects on their health.
In addition, travel medicine practitioners should offer safe behaviour strategies that can be undertaken to minimise the risk of exposure, and explain that vaccination is available to afford protection.
For further information on the B-Free campaign please telephone 020 7053 6020.
Zuckerman, J.N. (2006) Understanding the Risk of Hepatitis B to Travellers: Findings of a 2006 European Survey. Presentation at the North European Conference on Travel Medicine, Edinburgh, June 7-10. www.nectm.com/Abstract_Files/GSK.doc.