Hepatitis A and travel abroad: a study of notifications in Birmingham

One hundred and seventy-two cases of viral hepatitis A (or 'infective hepatitis' or 'infective jaundice' judged to be viral hepatitis A) were notified in Birmingham in the 15 months from January 1990 to March 1991. Forty patients had travelled abroad in the three months prior to onset, 30 of whom had been to the Indian subcontinent. A survey of general practitioners attending to patients going abroad indicated that human normal immunoglobulin (HNIG) was rarely given to intending travellers, whereas other recommended immunisations often were. Furthermore, a sizeable proportion of travellers did not attend their general practitioners prior to departure. Interventions aimed at encouraging attendance, and the administration of HNIG prior to travel to endemic areas, could reduce the incidence of hepatitis A substantially, particularly in areas with a large population of Asian origin.