Hepatitis B vaccination for international travelers to Asia

Abstract

There is a wide range in prevalence of hepatitis B virus (HBV) infection and HBV immunization programs between different regions. Hepatitis B is a vaccine preventable disease yet is still endemic in the majority of countries in Asia. Despite the decreasing global prevalence of chronic HBV infection, there is still considerable risk of HBV infection among international travelers to high endemic areas. Numbers of international travelers are expected to increase year by year; thus immunization among this cohort is a crucial preventive measure. Among international travelers to Asia, HBV immunization should be recommended for those without previous HBV vaccination who plan to travel to countries with intermediate to high prevalence of HBV, and especially for those individuals at greater risk of HBV infection; including travelers engaging in casual sex, getting a tattoo or piercing, and those having dental surgery or other medical procedures. Longer duration of travel is also associated with a greater risk of HBV infection. Travelers from low HBV prevalence countries, especially those born before implementation of universal HBV vaccination, might benefit from HBV vaccination during long-term traveling to HBV intermediate to high endemic country.

Seroepidemiology of Hepatitis Viruses and Hepatitis B Genotypes of Female Marriage Immigrants in Korea

“…These countries have achieved more than 70% coverage of completed HBV vaccination (China, 99%; Thailand, 99%; Cambodia, 97%; Vietnam, 95%; the Philippines, 79%; Uzbekistan, 82%, Mongolia, 76%). 28 29 30 31 Therefore, the prevalence of anti-HBs gradually increased in East, Southeast, and Central Asia after implementation of universal HBV vaccination program.…”

Traveler’s Infections: Overview of Hepatitis B Virus Infection

“…Transmission of HBV in travelers is through percutaneous or mucosal exposure to HBV-infected blood or bodily fluids including saliva or semen [30,31]. There are reports of transmission via sexual contact, contaminated blood and its products, and contaminated medical equipment and through sharing of infected needles and injecting apparatus [31,32].…”

The older traveller

“…Hepatitis B is one of the most common vaccine-preventable travel-associated infectious diseases. It is estimated that approximately 240 million people worldwide are infected with hepatitis B virus (HBV) and approximately 1 million people die each year from HBV-related illness [73]. The risk of acquiring HBV during the travel is relatively low (about 0.2 to 0.6 per 1000 person-months).…”

“…However, the risk of chronic HBV infection in people over 40 years of age is lower in comparison to young adults (6% vs. 8%) [76]. The hepatitis B vaccine is recommended to all unvaccinated travellers going to regions with intermediate to high prevalence of chronic hepatitis B; however, only 15-30% of international travellers had received a full vaccination course prior to travel [73]. The Swiss study showed that hepatitis B vaccination was administered significantly less often to senior travellers [5].…”