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Hepatitis B

Disease Description: Hepatitis B is caused by the hepatitis B virus (HBV). The clinical manifestations of HBV infection range in severity from no symptoms to fulminant hepatitis. Signs and symptoms of hepatitis B may include fever, malaise, anorexia, nausea, and abdominal discomfort, followed within a few days by jaundice (1). The incubation period of hepatitis B averages 120 days (range 45-160 days).

Risk to Travelers: The risk of HBV infection for international travelers is generally low, except for certain travelers in countries where the prevalence of chronic HBV infection is high or intermediate (Map). Modes of HBV transmission in areas with high or intermediate prevalence of chronic HBV infection that are important for travelers to consider are contaminated injection and other equipment used for health care-related procedures and blood transfusions from unscreened donors. Unprotected sex and sharing illegal drug injection equipment are also risks for HBV infection in these areas.

Prevention - Vaccine: Hepatitis B vaccination should be administered to all unvaccinated persons traveling to areas with intermediate to high levels of endemic HBV transmission (i.e., with hepatitis B surface antigen [HBsAg] prevalence >2%) (see Map). The vaccine is usually administered as a three-dose series on a 0-, 1-, and 6-month schedule.

Vaccine Adverse Effects: Hepatitis B vaccines have been shown to be very safe for persons of all ages. Pain at the injection site (3%-29%) and elevated temperature (1%-6%) are the most frequently reported side effects among vaccine recipients.

Vaccine Contraindications: These vaccines should not be administered to persons with a history of hypersensitivity to any vaccine component, including yeast.

Vaccine Booster Recommendations: For children and adults whose immune status is normal, booster doses of vaccine are not recommended after completion of the primary series.

 

Information adapted from CDC Health Information for International Travel (the Yellow Book), http://www.cdc.gov/travel/yellowbook/2010/table-of-contents.htm