Does hepatitis a pose a significant health risk to recreational water users?

In recent years recreational water use in the UK has increased dramatically and it has been estimated that more than twenty million people use the British coastline annually. In addition, there has been a marked increase in the number of people who use inland water e.g. lakes, reservoirs, rivers and canals. The ready availability of the wet suit has altered the public use of recreational water in several ways in the UK. Longer periods of immersion are now becoming normal with year-round activity now common not just during the accepted bathing season of May-September. Further factors that raise the importance of health implications are the growth of sports which involve intimate contact with water: surfing, windsurfing and boogie boarding. The raised public awareness of environmental issues in general makes health risk assessment a prime concern. Hepatitis A virus infection is transmitted by the faecal-oral route and this study compares two groups of water users, surfers and inland windsurfers. Saliva samples were tested for total antibody to hepatitis A as this indicates the immune status of the individual. All participants completed a questionnaire that elicited concomitant risk factors for previous exposure to hepatitis A. A calculated Odds Ratio of 3.03 and a Chi square of 5.3 with a probability of P = 0.02 was obtained when the non-immunised surfers were compared with the non-immunised windsurfers. This shows a statistical correlation between surfing and exposure to hepatitis A virus. It is recommended that surfers should be offered vaccination in order that they are protected from the risk of acquiring hepatitis A. They should also be given the opportunity to make a considered decision about the risks of acquiring hepatitis A recreationally.