Trends and risk factors for hepatitis A in NSW, 2000–2009: the trouble with travelEvan Freeman A B D , Siranda Torvaldsen B , Sean Tobin C , Glenda Lawrence B and C. Raina MacIntyre B
A NSW Public Health Officer Training Program, NSW Ministry of Health
B School of Public Health and Community Medicine, The University of New South Wales
C Communicable Diseases Branch, NSW Ministry of Health
D Corresponding author. Email: firstname.lastname@example.org
NSW Public Health Bulletin 23(8) 153-157 https://doi.org/10.1071/NB11036
Published: 21 September 2012
Aim: To analyse trends in hepatitis A notifications and information on exposure to risk factors, in particular international travel, collected through routine surveillance in NSW. Methods: Hepatitis A notification data for the period 2000–2009 were extracted from the Notifiable Diseases Database and analysed by age group, gender, area of residence and exposure risk factors, including travel, food eaten and contact with other possible infectious cases. Results: The notification rate for hepatitis A in NSW fell from 3.0 cases per 100 000 population in 2000 to 1.4 cases per 100 000 population in 2009. Notification rates were highest among people aged 20–24 years and residents of metropolitan Sydney. Travel to a country where hepatitis A is endemic was a risk exposure identified in 43% of cases. Conclusion: International travel to highly endemic countries continues to be the most common risk factor for hepatitis A infection notified in NSW despite recommendations that travellers be vaccinated prior to travel to these areas.
References Brotherton J, Wang H, Schafer A, Quinn H, Menzies R, Lawrence G, et al. Vaccine preventable diseases and vaccination coverage in Australia, 2003 to 2005. Commun Dis Intell 2007; 31 S1–152.
 World Health Organization. Hepatitis A. WHO/CDS/CSR/EDC/2000.7 Available at: http://www.who.int/csr/disease/hepatitis/HepatitisA_whocdscsredc2000_7.pdf (Cited 12 December 2011).
 American Public Health Association. Heyman DL, editor. Control of communicable diseases manual (19th Edition). Washington DC: American Public Health Association; 2008.
 Stokes ML, Ferson MJ, Young LC. Outbreak of hepatitis among homosexual men in Sydney. Am J Public Health 1997; 87 2039–41.
| Outbreak of hepatitis among homosexual men in Sydney.CrossRef | 1:STN:280:DyaK1c%2Fptlehug%3D%3D&md5=110f3e043540fbfe38ab643e684ee40eCAS |
 Delpech VC, Thackway SV, Young L, Pontivivo G, Smedley E, Morgan K, et al. Hepatitis A in south-eastern Sydney 1997–1999: continuing concerns for gay men and an outbreak among illicit drug users. Commun Dis Intell 2000; 24 203–6.
| 1:STN:280:DC%2BD3cvptl2ntA%3D%3D&md5=3a2f6777d9fd72261819c5fa6f94d22dCAS |
 Amin J, Gilbert G, Escott R, Heath T, Burgess M. Hepatitis A epidemiology in Australia: national seroprevalence and notifications. Med J Aust 2001; 174 338–41.
| 1:STN:280:DC%2BD3M3ltVCjsw%3D%3D&md5=dec9ba36779a2a60de21469c737778c5CAS |
 Health Canada. A review of provincial/territorial strategies for hepatitis A pre- and post-exposure prophylaxis. Can Commun Dis Rep 2005; 31: 197–205. Available at: www.phac-aspc.gc.ca/publicat/ccdr-rmtc/05vol31/dr3124e-eng.php (Cited 12 December 2011).
 Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC). Update: Prevention of hepatitis A after exposure to hepatitis A virus and in international travelers. Updated recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 2007; 56 1080–4.
 Ward K, McAnulty J. Hepatitis A: who in NSW is most at risk of infection? NSW Public Health Bull 2008; 19 32–5.
| Hepatitis A: who in NSW is most at risk of infection?CrossRef |
 National Health and Medical Research Council. Australian Immunisation Handbook. 9th Ed. Canberra: Commonwealth of Australia; 2008.
 NSW Health. Control guidelines. Hepatitis A. National Guidelines for Public Health Units. Last updated: 1 October 2009. Available at: www.health.nsw.gov.au/factsheets/guideline/hepa.html (Cited 12 December 2011).
 OzFoodNet Working Group OzFoodNet quarterly report. 1 October to 31 December 2009. Commun Dis Intell 2010; 34 59–67.
 Zwar N, Streeton CL., Travel Health Advisory Group Pretravel advice and hepatitis A immunization among Australian travelers. J Travel Med 2007; 14 31–6.
| Pretravel advice and hepatitis A immunization among Australian travelers.CrossRef |
 Advisory Committee on Immunization Practices (ACIP). Fiore AE, Wasley A, Bell BP. Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2006; 55(RR-7): 1–23. Available at: http://www.cdc.gov/mmwr/PDF/rr/rr5507.pdf (Cited 12 December 2011).
 Menzies R, Turnor C, MacIntyre PB. Vaccine preventable diseases and vaccination coverage in Aboriginal and Torres Strait Islander people, Australia, 2003 to 2006. Commun Dis Intell 2008; 32 S2–67.
 MacIntyre CR, Burgess M, Isaacs D, McIntyre PB, Menzies R, Hull B. Epidemiology of severe hepatitis A in Indigenous Australian children. J Paediatr Child Health 2007; 43 383–7.
| Epidemiology of severe hepatitis A in Indigenous Australian children.CrossRef |
 Australian Bureau of Statistics. 3401.0 – Overseas Arrivals and Departures, Australia, Jun 2010. Table 7. Short-term movement, resident departures – selected destinations: trend. Available at: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/3401.0Jun%202010?OpenDocument (Cited 12 December 2011).
 Scheifele DW, Serres G, Gilca V, Duval B, Milner R, Ho M, et al. A nationwide survey of past hepatitis A infections among Canadian adults. Vaccine 2010; 28 5174–8.
| A nationwide survey of past hepatitis A infections among Canadian adults.CrossRef |
 Duval B, De Serre G, Shadmani R, Boulianne N, Pohani G, Naus M., et al. A population-based comparison between travelers who consulted travel clinics and those who did not. J Travel Med 2003; 10 4–10.
| A population-based comparison between travelers who consulted travel clinics and those who did not.CrossRef |