Hepatitis B may be transmitted to visitors and expatriate residents in endemic areas in a number of ways. Sexual transmission is highly efficient, as is percutaneous transmission from needle-sharing, blood transfusion, injections or other invasive procedures with unsterile medical or dental equipment, traditional medical procedures such as acupuncture, or tattooing.
Medical personnel working in endemic areas are at especially high risk.
Immunization will provide protection for at least 10 years. Because of the prolonged incubation period of hepatitis B. protection will be afforded to most travellers even if only the first dose is given prior to travel, provided that the subsequent doses are given upon return. Prevaccination screening to determine immune status is generally not cost-effective in people from industrialized countries, but may be in people from developing countries who have a high probability of having had asymptomatic infection during childhood.