BMJ 1995;310:533 (25 February)

Letters

Travel prophylaxis

EDITOR,--Pierre van Damme and colleagues and E Walker support the findings of our study that high risk travellers should be selectively immunised, but they disagree about other issues. The aim of our study was to provide a framework in which policy related to travel prophylaxis could be explored in the context of the NHS.1

While acknowledging that underreporting occurs, we used a correction factor of 50%. This factor includes adjustment for diseases with short incubation periods, such as malaria and typhoid, which may well present abroad. In the case of hepatitis A, the incidence in British residents is similar to that used in other studies,2 3 and we believe that it is realistic. Had we used a lower estimate of the prevalence of hepatitis A antibody, this would have implied a larger body of susceptible travellers for the same number of cases, as defined by laboratory and clinical reports (a higher . . . [Full text of this article]


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