The exact mechanism by which infection is acquired is unclear, but is likely to involve the associated lifestyle and possibly the use of shared equipment such as bongs. The number of cases in travellers to endemic areas is of concern. All were isolated cases and all but four had another risk factor. There were 4 cases attributed to oysters from the Wallis Lakes in New South Wales, but no other food-borne cases were identified. In conclusion, we have identified a number of important risk factors for HAV infection in North Queensland.
Vaccination also needs to be further considered for some indigenous groups.
Acknowledgements We thank Dr. Jeffrey Hanna, Public Health Physician, TPHU for his supervision of the surveillance program and for assisting with the preparation of this report. Author references 1. Public Health Registrar, Tropical Public Health Unit, Cairns, Queensland Health, PO Box 1103, Cairns, Queensland, 4870. Tropical Public Health Unit, Mackay, Queensland Health, PO Box 688, Mackay, Queensland, 4740. Torres Strait and Northern Peninsula Area District Health Service, Queensland Health, PO Box 39, Thursday Island Queensland, 4875.