Changing travel-related global epidemiology of hepatitis A

Hepatitis A is highly endemic in many emerging cultures. Despite the availability of safe and effective vaccines and some improvements in sanitation in developing countries, hepatitis A remains a significant cause of morbidity for nonimmune travelers visiting such destinations. All are at risk, including short-term vacationers or business travelers who stay in deluxe accommodations. This may have considerable implications on public health. Hepatitis A vaccination programs for travelers have not proven to be effective, since many visitors to destinations at risk (e.g., Mexico) fail to consult health professionals prior to departure. Because ⩾50% of the US population has an anticipated lifetime risk for exposure, universal immunization against hepatitis A should be considered.