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Communicable Disease: Infectious Hepatitis

Bhutanese Refugee Health Profile

Upon arrival in Texas, 1.3% (33/2558) of refugees screened in June 2009–May 2011 had chronic infection with hepatitis B as indicated by detectable serum hepatitis B surface antigen. 15 Of those who tested negative for hepatitis B surface antigen, 24% demonstrated hepatitis B core and/or surface antibody indicating some degree of immunity; 2.7% were positive for both hepatitis B core and surface antibodies indicating clearance of natural infection, 20% of refugees demonstrated only surface antibodies most likely due to past vaccination, and 1.4% had only positive core antibodies, most likely indicating clearance of past infection (although this can also be due to low-level chronic infection, resolving acute infection, or false positive test). It should be noted that a positive hepatitis B surface antibody may be positive if measured after the first or second dose of vaccination and does not necessarily indicate long-term immunity. Refugees generally do not receive the full hepatitis B series prior to migration.

Approximately 45% of Bhutanese refugees resettled in one large resettlement state in June 2009–May 2011 tested positive for hepatitis A antibodies, indicating previous exposure. 15 There are no data available on the prevalence of infectious hepatitis in the camps in Nepal.


  1. Texas Department of State Health Services (2009-2011), Electronic System for Health Assesment of Refugees (eShare Database).