American Board of Internal Medicine (ABIM) Certification Practice Exam

For which regions should travelers receive the hepatitis A vaccine and intramuscular immune globulin?

1. North America and Europe

2. South Asia, Africa, and South and Central America

3. Australia and New Zealand

4. Middle East and Caribbean

The correct answer is: South Asia, Africa, and South and Central America

Travelers should receive the hepatitis A vaccine and intramuscular immune globulin primarily when traveling to regions with a higher risk of hepatitis A infection. Hepatitis A is a viral infection that is often transmitted through consumption of contaminated food and water, and poor sanitation practices are more prevalent in certain areas of the world. In South Asia, Africa, and South and Central America, the incidence of hepatitis A is significantly higher due to factors such as inadequate sanitation, lack of safe drinking water, and varying levels of public health measures. Therefore, travelers to these regions are particularly advised to be vaccinated to protect themselves from this preventable disease. Vaccination is crucial, especially for individuals who may be at greater risk, such as those who are planning to stay for extended periods or who expect to have close contact with local populations. On the other hand, North America and Europe, as well as Australia and New Zealand, generally have lower rates of hepatitis A due to better sanitation and vaccination practices. Although some cases can still occur, the risk is considered minimal compared to the higher-risk areas. The Middle East and Caribbean have variable rates of infection, but they do not consistently exhibit the same level of risk that necessitates routine vaccination and immune globulin prophylaxis for all travelers