Volume 24, Number 6—June 2018
Research
Hepatitis E in Long-Term Travelers from the Netherlands to Subtropical and Tropical Countries, 2008–2011
Floortje Elfrink
, Femke W. Overbosch, Janke Schinkel, Gerrit Koen, and Gerard J.B. Sonder
, Femke W. Overbosch, Janke Schinkel, Gerrit Koen, and Gerard J.B. Sonder
Table 2
Attack rates and incidence of seroconversions in HEV antibody levels for 515 long-term travelers to subtropical and tropical countries, the Netherlands, December 2008–September 2011*
| Characteristic | Travelers at risk | HEV seroconversions | Attack rate, % (95% CI) | Person-weeks of travel | Incidence/1,000 person-weeks (95% CI) | ||
|---|---|---|---|---|---|---|---|
| Univariable analysis |
|||||||
| IRR (95% CI) | p value | ||||||
| Total |
515 |
19 |
3.7 (2.4–5.7) |
10,715 |
1.8 (1.1–2.8) |
||
| Median age, y (IQR) |
25 (23–29) |
26 (22–31) |
|||||
| Sex | |||||||
| F | 335 (65) | 9 | 2.7 (1.4–5.0) | 6,795 | 1.3 (0.7–2.5) | 1.0 | 0.16 |
| M |
180 (35) |
10 |
5.6 (3.0–9.9) |
3,920 |
2.6 (1.4-4.7) |
1.9 (0.8–4.7) |
|
| Region of birth | |||||||
| Western | 506 (98.3) | 19 | 3.8 (2.4–5.8) | ||||
| Nonwestern |
9 (1.7) |
0 |
NA |
||||
| Purpose of travel | |||||||
| Holiday | 324 (62.9) | 10 | 3.1 (1.7–5.6) | 6,556 | 1.5 (0.8–2.8) | 1.0 | 0.54 |
| Work or study | 184 (35.7) | 8 | 4.3 (2.2–8.3) | 3,970 | 2.0 (1.0–4.0) | 1.3 (0.5–3.3) | |
| VFR |
7 (1.4) |
1 |
14.3 (2.6–51.3) |
1,885 |
5.3 (0.9–29.4) |
3.5 (0.4–27.0) |
|
| Primary region of travel | |||||||
| Southeast Asia and Oceania | 172 (33.4) | 5 | 2.9 (1.2–6.6) | 3,543 | 1.4 (0.6–3.3) | 1.0 | 0.57 |
| South America | 148 (28.7) | 5 | 3.4 (1.5–7.7) | 3,211 | 1.6 (0.7–3.6) | 1.1 (0.3–3.8) | |
| Sub-Saharan Africa | 94 (18.3) | 2 | 2.1 (0.6–7.4) | 1,972 | 1.0 (0.3-3.7) | 0.7 (0.1–3.7) | |
| Southern Asia | 47 (9.1) | 3 | 6.4 (2.2–17.2) | 898 | 3.3 (1.1–9.8) | 2.4 (0.6–9.9) | |
| Central America and Caribbean | 37 (7.2) | 3 | 8.1 (2.8–21.3) | 754 | 4.0 (1.4–11.6) | 2.8 (0.7–11.8) | |
| Asia, other |
17 (3.3) |
1 |
5.9 (1.0–27.0) |
336 |
3.0 (0.5–16.7) |
2.1 (0.2–18.1) |
|
| Travel duration, wk | |||||||
| 12–16 | 189 (36.7) | 6 | 3.2 (1.5–6.8) | NA | |||
| 17–24 | 190 (36.9) | 7 | 3.7 (1.8–7.4) | NA | |||
| 25–52 |
136 (26.4) |
6 |
4.4 (2.0–9.3) |
NA |
|||
| Hospital admission | |||||||
| No | 484 (94) | 18 | 3.7 (2.4–5.8) | 10,032.5 | 1.8 (1.1–2.8) | 1.0 | 0.84 |
| Yes | 31 (6) | 1 | 3.2 (0.6–16.2) | 682.5 | 1.5 (0.3–8.2) | 0.8 (0.11–6.11) | |
*Values are no. (%) except as indicated. HEV, hepatitis E virus; IQR, interquartile range; IRR, incidence rate ratio; NA, not applicable; VFR, visiting friends and relatives.
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