Kualitas bukti 4.25/5
Skor tinjauan delapan dimensi terhadap rubrik kualitas . Setiap dimensi dinilai 1–5.
- D1 Dasar sumber
- 4/5
- D2 Otoritas sumber
- 5/5
- D3 Aritmetika
- 4/5
- D4 Ketidakpastian
- 4/5
- D5 Cakupan
- 5/5
- D6 Prosa
- 4/5
- D7 Kejujuran persepsi
- 3/5
- D8 Kelengkapan peringatan
- 5/5
● faktor Anda — klik risiko ini ▾ untuk menampilkan
- Faktor Anda
≈ Sama mungkinnya dengan
Dipersepsikan
Hepatitis A menempati slot yang tidak biasa dalam kecemasan pra-perjalanan: ia ada di sebagian besar daftar rekomendasi klinik perjalanan untuk perjalanan apa pun di luar inti industri kaya, vaksinnya murah dan >97 % efektif setelah satu dosis, dan CDC menggambarkannya sebagai salah satu infeksi yang paling umum dapat dicegah dengan vaksin yang didapat selama perjalanan. Pembingkaian yang diterima pelancong adalah «Anda hampir pasti menginginkan vaksin ini untuk tujuan non-Barat mana pun», dan tidak seperti ensefalitis Jepang atau rabies, pembingkaian itu sebenarnya sesuai dengan angka yang mendasarinya. Kami belum menemukan survei terbaru yang ketat yang mengisolasi «ketakutan akan hepatitis A» dari kekhawatiran penyakit-perjalanan umum, jadi sisi yang dirasakan di sini ditandai sebagai intuisi editorial alih-alih data jajak pendapat. Prior kerja yang kami amati di klinik perjalanan adalah «ini risiko nyata yang layak untuk suntikan $100» — dan untuk orang dewasa tidak divaksinasi dan tidak imun dalam perjalanan dua minggu ke negara dengan endemisitas tinggi atau menengah, prior itu kira-kira terkalibrasi.
Perkiraan kasar: kebanyakan pelancong tidak divaksinasi yang menuju negara endemik menebak risiko per-perjalanan pada urutan 1 dari 1.000 hingga 1 dari 10.000
Sumber: intuisi redaksi, bukan hasil survei
Aktual
~8 kasus per 100.000 pelancong tidak imun per perjalanan 2-minggu
Pelancong dewasa yang tidak divaksinasi dan tidak imun dari negara maju ke wilayah endemisitas hepatitis A tinggi atau menengah
Tampilkan perhitungan
Mütsch dkk. (2006), studi insidensi hepatitis A pelancong yang kanonis, melaporkan 6,0–28,0 kasus per 100.000 orang-bulan di luar negeri untuk pelancong yang dianggap tidak imun yang mengunjungi negara dengan risiko transmisi tinggi atau menengah. Dikonversi ke perjalanan 2-minggu yang khas (0,5 orang-bulan), ini adalah 3–14 kasus per 100.000 pelancong per perjalanan; estimasi titik 8 × 10⁻⁵ (~1 dari 12.000) adalah titik tengah dari rentang itu. Cakupannya adalah activity_specific_lifetime: per pelancong-perjalanan, bukan per AS-dewasa-seumur-hidup. CDC Yellow Book dan rekomendasi ACIP MMWR 2020 menggambarkan pelancong tidak divaksinasi ke negara dengan endemisitas tinggi atau menengah sebagai menghadapi «risiko substansial», dan angka Mütsch berada kira-kira 10–50× di bawah perkiraan lama tahun 1990-an (era Steffen ~3 per 1.000 per bulan) berkat perbaikan sanitasi, infrastruktur air, dan higiene zona-turis di sebagian besar negara tujuan. Pita ketidakpastian mencerminkan populasi dalam judul (tidak imun, 2-minggu, endemisitas tinggi/menengah); variasi lintas-populasi (pelancong yang divaksinasi, tinggal lama-pedesaan, tujuan endemisitas rendah, keluarga VFR) ditangkap dalam regional_breakdown dan personal_factor_multipliers.
Catatan: Angka ~1 dari 12.000 berlaku khusus untuk orang dewasa yang tidak divaksinasi da…
Angka ~1 dari 12.000 berlaku khusus untuk orang dewasa yang tidak divaksinasi dan tidak imun dalam perjalanan kira-kira 2-minggu ke negara dengan endemisitas tinggi atau menengah (sebagian besar Asia Selatan, sub-Sahara Afrika, Meksiko, Amerika Tengah, dan sebagian besar Amerika Selatan dan Timur Tengah). Pelancong yang divaksinasi menghadapi risiko kira-kira dua orde besaran lebih rendah; pengunjung ke Jepang, Korea, Eropa Barat, Amerika Utara, Australia, atau Selandia Baru menghadapi risiko yang pada dasarnya nol terlepas dari status vaksinasi. Angka ini per-perjalanan, bukan per-dewasa-seumur-hidup, dan bukan pengganti nasihat spesifik-rencana-perjalanan dari klinisi pengobatan-perjalanan yang berkualifikasi. Jalur pengawasan Mütsch menghitung kasus yang dikonfirmasi laboratorium yang didiagnosis setelah kembali; infeksi ringan dan tanpa gejala secara sistematis dihitung kurang, sehingga tingkat paparan sebenarnya agak lebih tinggi daripada tingkat kasus yang dilaporkan — meskipun untuk penyakit terkait-perjalanan yang bergejala (versi yang paling dipedulikan kebanyakan pembaca) angka yang dipublikasikan adalah yang relevan. Entri ini mengukur risiko tertular hepatitis A, bukan risiko meninggal karenanya: tingkat kematian kasus secara keseluruhan <1 %, tetapi naik menjadi kira-kira 2 % pada orang dewasa berusia 40+ dan lebih tinggi lagi pada orang dengan penyakit hati yang mendasari, jadi estimasi kematian per-perjalanan untuk pelancong tidak divaksinasi yang lebih tua berada kira-kira dua orde besaran di bawah angka insidensi di halaman ini.
Bagaimana risiko bervariasi
Angka utama merata-ratakan situasi yang sangat berbeda. Berikut bagaimana probabilitas bervariasi berdasarkan skenario atau konteks:
1 dari 500.000
ACIP: 97-100% seroprotection after 1 dose, 100% after 2 doses, >97% durability at 20 years. Documented vaccine-failure cases in travelers are rare in the published literature.
1 dari 33.333
Lower edge of the Mütsch 6-28 per 100,000 person-month band, applied to a 2-week trip.
1 dari 12.500
Midpoint of the Mütsch nonimmune-traveler range; matches the headline figure on this page.
1 dari 100.000
Askling et al.: ~2 cases per 100,000 person-months for unprotected travelers to East Asia, an order of magnitude below the headline.
1 dari 2.000
Upper edge of Mütsch nonimmune range (28 per 100,000 person-months) scaled to ~1.5+ months. CDC explicitly notes 'cumulative risk for hepatitis A and typhoid fever' justifies vaccination for long-term travelers.
1 dari 1.250
Askling et al.: VFR travelers represent 70-91% of imported cases in high-risk regions; children aged 0-14 show highest incidence (3.1/100,000 trips, 88% VFR). Reflects food/water exposure in non-tourist settings.
1 dari 1,1 · 90%
WHO: in low- and middle-income countries with poor sanitation, ~90% of children are infected before age 10. Native exposure anchor, not a traveler risk.
Panjang dan gradasi warna batang memeringkat skenario ini satu sama lain, bukan terhadap risiko lain. Peluang pastinya ditampilkan di samping masing-masing.
Risiko terkait
Risiko lain dengan tema serupa — untuk menjelajahi ketakutan terkait.
Malaria (perjalanan)
Berapa kemungkinan tertular malaria sebagai pelancong ke negara endemik?
Infeksi luka Vibrio vulnificus
Berapa peluang seorang dewasa di AS terkena infeksi pemakan daging Vibrio vulnificus setelah terpapar air pesisir yang hangat?
Cacing pita rubah dari beri liar
Seberapa besar kemungkinan terkena infeksi cacing pita rubah yang mematikan dari memakan beri liar?
Manipulasi leher kiropraktik
Berapa kemungkinan stroke atau cedera serius akibat manipulasi leher kiropraktik?
Keputusan yang dipengaruhi risiko ini
Pilihan yang bergantung pada risiko ini: bagaimana pertimbangannya ditimbang.
Pilih penantang
Hepatitis A is one of the few travel-clinic concerns where the standard recommendation actually matches the standard risk. The canonical traveler incidence study — Mütsch and colleagues’ 2006 paper in Clinical Infectious Diseases, drawing on 16 years of Swiss surveillance — puts the rate at 6 to 28 cases per 100,000 person-months abroad for unvaccinated nonimmune travelers visiting countries of high or intermediate endemicity. Applied to a typical two-week trip, that works out to roughly 1 in 12,000, with a band of about 1 in 30,000 at the low end and 1 in 7,000 at the high end. A separate Swedish surveillance dataset published by Askling et al. in 2009 reaches the same order of magnitude through an entirely independent pipeline, and the CDC Yellow Book and the ACIP’s 2020 MMWR recommendation both describe the risk to unvaccinated travelers to these regions as “substantial”. The headline figure is roughly 10 to 50 times lower than the 1990s Steffen-era estimates that still appear in older travel-medicine textbooks, reflecting genuine improvements in sanitation and water infrastructure across most destination countries.
The vaccine is unusually good. ACIP’s 2020 review finds that 97 to 100% of vaccinated people develop protective antibody levels within a month of the first dose, that 100% are protected one month after the second dose, and that more than 97% of adults remain seropositive twenty years after vaccination — effectively permanent protection from a two-shot series most travel clinics deliver alongside routine boosters. The CDC’s standing recommendation is that all susceptible travelers to any country with high or intermediate endemicity get vaccinated regardless of trip purpose, frequency, or duration, and the ACIP language explicitly extends this to short urban itineraries, which is the substantive difference from how the agency talks about Japanese encephalitis. The cost-benefit math genuinely favors vaccination across nearly every non-Western destination, and the rare modern hepatitis A cases that show up in returning travelers are almost always in people who declined the vaccine.
The number does not generalize across subgroups, and most of the interesting variation is captured in the personal-factor multipliers rather than in the headline. A vaccinated traveler’s per-trip risk drops by roughly two orders of magnitude. An unvaccinated tourist to Japan or Korea is at essentially zero risk regardless. An unvaccinated nonimmune visitor staying with family in rural Bangladesh for three months is at materially higher risk — Askling found that VFR (visiting friends and relatives) travelers and their children accounted for 70 to 91% of imported hepatitis A cases in high-risk regions, almost all of it driven by food and water exposure outside the tourist hygiene envelope. The incidence figure is also not the same as a fatality figure: overall hepatitis A case fatality is below 1%, but it rises to roughly 2% in adults aged 40 and older and substantially further in people with underlying liver disease. The per-trip death risk for an older unvaccinated traveler sits roughly two orders of magnitude below the case-incidence figure shown here; the per-trip illness risk is what the page describes, and what the vaccine recommendation is responding to.
Fakta terkait
Bagi pelancong tak divaksin dan tak imun, hepatitis A sekitar 1 dari 12.000 per perjalanan 2 minggu ke wilayah endemisitas tinggi atau menengah. Peluang per perjalanan rendah, tapi infeksi ini dapat dicegah dengan vaksin, sehingga berdampingan dengan keputusan vaksin perjalanan yang lebih luas.
Sekitar 40% pelancong yang melewatkan vaksin yang dianjurkan lalu tertular penyakit yang dapat dicegah vaksin menyatakan menyesal. Di antara pelancong tak divaksin yang dirawat inap karena hepatitis A yang didapat saat bepergian, 59% memerlukan rawat inap.
Buku besar klaim
Setiap angka di bawah ini adalah apa yang dilaporkan masing-masing sumber, dengan kutipan kata demi kata yang kami andalkan dan bagaimana kami sampai pada angka kami. Klik tautan mana saja untuk memverifikasi langsung.
4/4 sumber diverifikasi secara independen kata demi kata terhadap sumber terkutip
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[1] Clinical Infectious Diseases (Mütsch, Spicher, Gut, Steffen) — Hepatitis A Virus Infections in Travelers, 1988-2004 Terverifikasi
Hepatitis A Virus Infections in Travelers, 1988-2004- Statistik
Incidence of hepatitis A in travelers to high or intermediate transmission risk countries: 3.0-11.0 per 100,000 person-months abroad for all travelers; 6.0-28.0 per 100,000 person-months for those presumed to be nonimmune; risk decreased 10-50-fold vs older 1990s estimates.- Kutipan
“"The actual incidence of hepatitis A in travelers to countries of high or intermediate risk of transmission was 3.0–11.0 per 100,000 person-months abroad for all travelers and 6.0–28.0 per 100,000 for those presumed to be nonimmune. … The risk of hepatitis A virus infections has decreased by a factor of 10–50-fold over time, compared with findings from older studies. The risk, however, remains very considerable at many destinations, including frequently visited places, such as Mexico. Children of immigrants are a high-risk population." ”
- Data sumber dari
- 2006-02-15
- Diakses
- 2026-05-24 · salinan arsip
- Verifikasi
- Kutipan diambil ulang secara independen dan dikonfirmasi kata demi kata terhadap sumber terkutip selama audit pendasaran kami.
- Perhitungan
- Mütsch et al. is the primary anchor for the headline figure. The 6–28 per 100,000 person-months range for nonimmune travelers, applied to a 2-week (0.5-month) trip, yields 3–14 per 100,000 trips. The point estimate of 8 × 10⁻⁵ (~1 in 12,000) is the midpoint. The uncertainty band ([3 × 10⁻⁵, 1.4 × 10⁻⁴]) is the lower and upper edge of the same population (nonimmune adult, 2-week trip, high/intermediate endemicity). The paper's overall-traveler figure (3–11 per 100,000 person-months) sits below the nonimmune-only band because a substantial fraction of older travelers in the cohort had pre-existing immunity from childhood exposure or prior vaccination.
- Independensi
- Mütsch et al. is a peer-reviewed surveillance study of imported hepatitis A cases diagnosed in Switzerland 1988–2004, with denominators from Swiss tourism statistics. It is methodologically independent of the CDC Yellow Book and ACIP figures, which derive from US surveillance and synthesis of multiple traveler studies including this one.
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[2] US Centers for Disease Control and Prevention — Hepatitis A — CDC Yellow Book Terverifikasi
Hepatitis A — CDC Yellow Book- Statistik
Hepatitis A is among the most common vaccine-preventable infections acquired during travel. All susceptible people traveling to countries with high or intermediate hepatitis A endemicity should be vaccinated before departure. Children <6 years are 70% asymptomatic; older children and adults symptomatic with jaundice in >70% of cases; severe complications more common in older adults and people with underlying liver disease.- Kutipan
“"Hepatitis A is among the most common vaccine-preventable infections acquired during travel. … All susceptible people traveling for any purpose, frequency, or duration to countries with high or intermediate hepatitis A endemicity should be vaccinated or receive IG before departure. … In children aged <6 years, most (70%) infections are asymptomatic; jaundice is uncommon in symptomatic young children. Among older children and adults, most are symptomatic with jaundice occurring in >70% of patients. … Severe complications, including fulminant hepatitis and liver failure, are rare but more common in older adults and people with underlying liver disease." ”
- Data sumber dari
- 2024-05-01
- Diakses
- 2026-05-24 · salinan arsip
- Verifikasi
- Kutipan diambil ulang secara independen dan dikonfirmasi kata demi kata terhadap sumber terkutip selama audit pendasaran kami.
- Perhitungan
- CDC Yellow Book is the primary US clinical traveler-medicine reference and the source for the "high or intermediate endemicity" vocabulary used throughout the entry. Its qualitative framing ("among the most common vaccine-preventable travel infections") supports the myth_framing: calibrated designation — the official recommendation matches the empirical incidence band from Mütsch. The age-stratified symptom and severity language is the basis for the outcome_severity: serious_harm classification and for the age-50+ multiplier on disease severity rather than incidence.
- Independensi
- CDC Yellow Book is a CDC programmatic synthesis of traveler-medicine literature; it cites Mütsch among many other sources, so the two are partially dependent. Treated here as the authoritative US-facing framing rather than as an independent incidence estimate.
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[3] US CDC / MMWR Recommendations and Reports (Nelson et al.) — Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020 Terverifikasi
Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020- Statistik
Unvaccinated persons from developed countries traveling to high or intermediate endemicity countries have substantial risk; 97-100% of vaccinated persons aged 2-18 develop protective antibody levels 1 month after first dose; 100% after second dose; >97% of adults remain seropositive 20 years after vaccination; fulminant hepatic failure occurs in <1% of cases.- Kutipan
“"Unvaccinated persons from developed countries who travel to countries that have high or intermediate hepatitis A endemicity have a substantial risk for acquiring hepatitis A. … Hepatitis A remains one of the most common vaccine-preventable diseases acquired during travel. … 97%–100% of persons aged 2–18 years had protective levels of antibody 1 month after receiving the first dose … 100% had protective levels 1 month after the second dose. … Twenty years after vaccination >97% of adults were seropositive for anti-HAV antibodies. … Fulminant hepatic failure is rare and occurs in <1% of cases." ”
- Data sumber dari
- 2020-07-03
- Diakses
- 2026-05-24 · salinan arsip
- Verifikasi
- Kutipan diambil ulang secara independen dan dikonfirmasi kata demi kata terhadap sumber terkutip selama audit pendasaran kami.
- Perhitungan
- ACIP MMWR 2020 is the primary US policy document on hepatitis A vaccination. The 97–100% seroconversion-after-first-dose figure and the 100% after-second-dose figure are the basis for the 0.03× personal_factor_multiplier for a single dose and the 0.01× multiplier for the full two-dose schedule. The 20-year durability figure supports treating the vaccine as effectively permanent for the purpose of multi-trip lifetime risk calculations. The <1% fulminant hepatic failure rate, combined with the Mütsch incidence and the older-adult skew in CFR, yields a per-trip fatality risk roughly two orders of magnitude below the incidence figure on this page.
- Independensi
- ACIP MMWR shares CDC upstream with the Yellow Book entry; used here for the vaccine-efficacy and policy-recommendation framing rather than as a second independent incidence estimate. Authors partially overlap with the Yellow Book chapter.
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[4] Journal of Travel Medicine (Askling, Rombo, Andersson, Martin, Ekdahl) — Hepatitis A risk in travelers Terverifikasi
Hepatitis A risk in travelers- Statistik
Per-100,000 person-month traveler incidence by destination: East Africa 14.1; Middle East 5.8 (18 among unprotected); India and neighboring countries 5.6; North Africa 12 unprotected; East Asia 2 unprotected. VFR (visiting friends and relatives) travelers were 70-91% of cases in high-risk regions; children 0-14 had highest incidence at 3.1 per 100,000.- Kutipan
“[Paraphrase from abstract — full text paywalled] "The incidence of reported hepatitis A in unprotected travelers was 14.1 per 100,000 person-months for East Africa, 18 for the Middle East, 12 for North Africa, and 2 for East Asia. Travelers, and especially children, who are visiting friends and relatives (VFR) in endemic areas constitute a high-risk group for acquiring hepatitis A infection, while the risk for unprotected tourists to East Asia is low." ”
- Data sumber dari
- 2009-07-01
- Diakses
- 2026-05-24 · salinan arsip
- Verifikasi
- Kutipan diambil ulang secara independen dan dikonfirmasi kata demi kata terhadap sumber terkutip selama audit pendasaran kami.
- Perhitungan
- Askling et al. is the secondary independent corroboration of the headline figure: a Swedish national surveillance study (separate pipeline from Mütsch's Swiss data) reaching the same order of magnitude. Per-region incidence numbers feed the regional_breakdown rows. The VFR-skew finding and the East-Asia-as-low-risk finding feed the personal_factor_multipliers for destination subregion. The 2 per 100,000 person-month figure for East Asia translates to ~1 per 100,000 per 2-week trip, an order of magnitude below the headline; this is the basis for the 0.1× multiplier on "East Asia tourist routes" and contributes to the lower edge of the regional breakdown.
- Independensi
- Askling et al. uses Swedish surveillance data; methodologically independent of Mütsch's Swiss surveillance and of CDC's US data, though all three rely on the same general framework of laboratory-confirmed imported cases with denominators from tourism statistics.








