Abstract
We divided the number of travel-related hepatitis A cases notified in Dutch surveillance (2003-2011) by travel data obtained from an annual holiday survey to estimate the risk of hepatitis A among Dutch travelers. Of the 2,094 cases notified, 931 (44%) were imported. Morocco (n = 272, 29%), Turkey (n = 98, 11%), and Egypt (n = 87, 9%) accounted for the largest proportion of cases. Attack rates in returnees from high or intermediate endemic regions declined from 7.5 per 100,000 travelers (95% CI 6.7-8.4) in 2003-2005 to 3.5 (95% CI 3.0-4.0) in 2009-2011 (p < 0.01). Despite the decrease in risk, vaccination remains important, and routine risk monitoring should also be considered.
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