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Robert Steffen, Hepatitis A In Travelers: The European Experience, The Journal of Infectious Diseases, Volume 171, Issue Supplement_1, March 1995, Pages S24–S28, https://doi.org/10.1093/infdis/171.Supplement_1.S24
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Abstract
Each year ∼14 million Europeans travel to developing countries in Africa, Asia, and Latin American as well as to infrequently visited countries in eastern Europe. Without protection, travelers develop symptomatic hepatitis A at the rate of 3 cases per 1000 people per month of stay. Those who eat and drink under poor hygienic conditions have an even higher risk, 20/1000/month. Studies show that hepatitis A is the most frequent vaccine-preventable disease in travelers to developing countries. Immunity to hepatitis A virus is infrequent among northern European travelers, except for those born before 1945, with a history of jaundice, or who lived for > 1 year in a developing country.