Advances in hepatitis A prevention in travellers

The introduction of an active vaccine against hepatitis A, the most frequent of the vaccine-preventable infections in travellers, is an important contribution to travellers' health. Although theoretically the risk of exposure may be minimised by taking hygienic precautions, most travellers in practice remain at considerable risk. As compared to immunoglobulin, vaccine has the advantages of better and long-lasting protection. A double-strength vaccine has been introduced (HAVRIX, 1440 enzyme-linked immunosorbent [ELISA] units [EL.U]) and a single injection will protect from day 14 for 1 year. No significant adverse events have been reported. Questions that remain unanswered are whether travellers leaving before day 14 should receive immune globulin plus vaccine and whether very young travellers should all be immunised.