003) and attitude (more intended risk-taking behavior selleckchem in travelers with prior travel experience, p < 0.001) but not on the knowledge of travelers. As a result, these (opposite) effects may cancel each other out and thus minimize the impact of this potential confounder. Another limitation of this study may be the use of CDC maps—in

which high risk countries are separated from intermediate risk countries—instead of the WHO maps, which combines intermediate-risk and high-risk countries. As a consequence, in our study, eg, Turkey was categorized as a low-to-intermediate-risk country, whereas it was an important provider of cases of imported hepatitis A, at least in the Dutch setting.15 Lastly, not all respondents belonged mutually exclusively to one risk group; this may limit the effect attributed to a certain risk profile. However, to keep the analysis straightforward and clear, we did not correct for these effects. In conclusion, the results of this questionnaire-based survey suggest that protection rates of Dutch travelers against hepatitis A increase every year in concert with a slight annual reduction in intended risk-seeking behavior. Travelers VFR and solo as well as last-minute

travelers to high-risk destinations were identified Thiazovivin cell line as the risk groups with the highest increase in relative risk for hepatitis A. These specific risk groups should be considered candidates for targeted interventions. This study was done with financial and logistic support from GlaxoSmithKline. Florfenicol Mr Michiel Vervoort is acknowledged for construction of the figure. Ms Kimberley Spong is acknowledged for English text-editing. Members of the Dutch Schiphol Airport Study Group

are: P. J. J. v G., MD, PhD (Havenziekenhuis, Rotterdam); P. G. H. M., MSc, PhD (Erasmus University, Rotterdam); Christian Hoebe, MD, PhD (GGD, Maastricht); Sietse Felix, MD (KLM Health Services, Amsterdam); P. P. A. M. v T., MD, PhD (Academic Medical Center, Amsterdam), and D. O., MD, PhD (Travel Clinic Havenziekenhuis, Rotterdam). P. J. J. v G. has received speaker’s fee and reimbursements from GlaxoSmithKline for attending symposia. D. O. has received speaker’s fee and reimbursements for attending symposia from GlaxoSmithKline and Sanofi Pasteur MSD. Other authors state they have no conflicts of interest to declare. “
“We would like to thank Drs Hagmann, Shah, and Purswani for their erudite discussion of antibody to hepatitis B core antigen (anti-HBc) and for clarifying the interpretation and management strategy of the isolated positive anti-HBc. In the context of our study on hepatitis B virus (HBV) screening practices, we did not capture additional data on the management of the opportunities presented from positive results, and we also faced lack of space in our article to provide detailed description of the optimal further evaluations.