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Brief by Carol A. Kemper, MD, FACP
Source: Teitelbaum P. J Travel Med. 2004;11:102-106.
About 4-28% of cases of hepatitis A occur in travelers. This estimated risk has let to recommendations for hepatitis A vaccination (HAV). Teitelbaum assessed the annual incidence of acute HAV infection in Canadian travelers from 1996 to 2001. During that time, Canadians logged ~36 million days/year of travel to developing countries with an average incidence of HAV infection of 6.15 per 100,000 people. Based on these data, ~1 in 3000 travelers are at risk for HAV infection if they spent 1 month traveling in a developing country—considered the usual duration of such travel. Obviously this risk may vary, depending on the types of activity and the country visited. Extrapolating from these figures (based on USD figures for HAV vaccine), about $360,000 of vaccine would be administered to prevent a single HAV infection in travelers to developing countries. I bet the Canadian Health Care System is trying to decide if the expense is worth it.
Dr. Kemper is Clinical Associate Professor of Medicine, Stanford University, Division of Infectious Diseases; Santa Clara Valley Medical Center, Santa Clara, Calif.