Trends and risk factors for hepatitis A in NSW, 2000-2009: the trouble with travel.

AIM To analyse trends in hepatitis A notifications and information on exposure to risk factors, in particular international travel, collected through routine surveillance in NSW. METHODS Hepatitis A notification data for the period 2000-2009 were extracted from the Notifiable Diseases Database and analysed by age group, gender, area of residence and exposure risk factors, including travel, food eaten and contact with other possible infectious cases. RESULTS The notification rate for hepatitis A in NSW fell from 3.0 cases per 100000 population in 2000 to 1.4 cases per 100000 population in 2009. Notification rates were highest among people aged 20-24 years and residents of metropolitan Sydney. Travel to a country where hepatitis A is endemic was a risk exposure identified in 43% of cases. CONCLUSION International travel to highly endemic countries continues to be the most common risk factor for hepatitis A infection notified in NSW despite recommendations that travellers be vaccinated prior to travel to these areas.