Risk of hepatitis A decreased among dutch travelers to endemic regions in 2003 to 2011

We divided the number of travel-related hepatitis A cases notified in Dutch surveillance (2003–2011) by travel data obtained from an annual holiday survey to estimate the risk of hepatitis A among Dutch travelers. Of the 2,094 cases notified, 931 (44%) were imported. Morocco ( = 272, 29%), Turkey (n = 98, 11%), and Egypt (n = 87, 9%) accounted for the largest proportion of cases. Attack ratesin returnees from high or intermediate endemic regions declined from 7.5 per 100,000 travelers (95% CI 6.7–8.4) in 2003–2005 to 3.5 (95% CI 3.0–4.0) in 2009–2011 (p < 0.01). Despite the decrease in risk, vaccination remains important, and routine risk monitoring should also be considered.