Prevalence of hepatitis A virus risk factors in a very low endemic country, Switzerland.

We aimed to estimate the population-based lifetime exposure to guidelines-based hepatitis A virus (HAV) risk factors in a country model with very low HAV endemicity. A cross-sectional survey among randomly selected residents of Switzerland aged 20-60 years was performed assessing the HAV exposure risk according to the U.S. and the Swiss guidelines. The adjusted prevalence of lifetime exposure to HAV-associated risk exceeded 80% with travel being the most important risk factor. In addition, not only the HAV vaccination coverage was low but also lack of awareness was widespread. As projections indicate a further increase in travel volume resulting imported HAV infections with subsequent transmission among the resident population are a public health concern and a universal HAV vaccination strategy for HAV should be evaluated.