Since 2007, medical data is more structurally collected,

and data on the country of birth of both parents GSI-IX order have been included in the data collection and entered in the database. According to the Dutch guidelines published by the National Coordination Centre for Travelers’ Health Advice (LCR), travelers to the KSA are given health recommendations in addition to the mandatory meningitis vaccination; this advice includes information about vaccinations for hepatitis A (travelers who are born and raised in countries where hepatitis A is endemic are considered immune); typhoid fever (for travel more than 2 weeks); and the trivalent diphtheria, tetanus, and poliomyelitis vaccine (dTP). Because immigrants from countries where hepatitis B virus (HBV) is endemic who now live in a country where HBV is not endemic are a specific risk group for viral hepatitis B,5 IWR-1 solubility dmso since 2009 this group has also been offered hepatitis B vaccination. Hepatitis A vaccination and updating vaccination

against dTP is recommended for every traveler that will visit a country where such diseases are endemic, including KSA. Most people in this group are born and raised in a country endemic for hepatitis A. Therefore, according to Dutch guidelines, most are considered immune, vaccination is not recommended, and uptake of hepatitis A vaccination cannot be evaluated. For dTP, travelers who have never been vaccinated, whose vaccination status is uncertain, who have received incomplete diphtheria, tetanus, or polio vaccination

series, and whose most recent vaccination has been given more than 10 years ago are advised dTP. As dTP is the most advised vaccination in this group, and because it is very rare that people choose to accept one, but reject another recommended vaccination, dTP acceptance is used as a “proxy” for the willingness to accept recommended vaccinations. Immune system In this study, all data of the Muslims who visited the PHS before travel to Mecca are extracted from the database and analyzed retrospectively. Over the years from 2001 to 2009, the characteristics are described and trends are analyzed by age, gender, duration of travel, and time of visit to the PHS before departure. For the years 2007 to 2009, predictive factors for the acceptance of advised dTP vaccination are analyzed. Factors tested are age, gender, status as first- or second-generation immigrant, number of medical disorders, and specific disease category. Statistical Package for the Social Sciences (SPSS) version 17.0.2 software program (SPSS, Inc., Chicago, IL, USA) was used to carry out all analyses. Multiple regression analyses were performed in two models. In model one, the number of disorders was analyzed; in model two, the kind of disorder was analyzed. These two models are not taken together to exclude duplicates. To calculate the risk factors for different outcomes, odds ratios (ORs) and 95% confidence intervals (CIs) were obtained. Differences with a p value equal to or lower than 0.