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Infectious Diseases

Answer 1
  1. The patient should receive the first dose of hepatitis A vaccine and a dose of IG. Hepatitis A virus (HAV) is endemic in India, and the risk of acquiring the virus is higher among travelers staying in areas with poor hygienic conditions, such as small, rural villages. Hence, this patient should be vaccinated prior to his planned trip. Inactivated hepatitis A vaccine is safe and immunogenic. The vaccine is usually administered as a single dose followed by a booster dose 6 to 12 months later. Ideally, patients should receive both doses of the vaccine (6 months apart) prior to travel. If this is not feasible, patients should receive at least 1 dose of the vaccine 4 weeks before travel to have a significant antibody response, with the second dose completed 6 to 12 months later. Patients planning a trip to a country of high endemicity sooner than 4 weeks after the first dose of vaccine should also receive a dose of intramuscular IG at a different injection site.1

    1. Centers for Disease Control and Prevention. Prevention of hepatitis A through active or passive immunization. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 2006;55:1-23.

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