Hepatitis A in Europe (Update 1)

On January 2018 the European Centre for Disease Prevention and Control (ECDC) reported a large increase in hepatitis A infections in 2017 compared with previous years. These infections mostly affected men who have sex with men (MSM).

Since 29 September 2017, 22 countries (Austria, Belgium, Croatia, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Ireland, Italy, Latvia, Luxembourg, Malta, the Netherlands, Norway, Portugal, Slovenia, Spain, Sweden and the United Kingdom) reported 950 cases associated with this outbreak. The outbreak total from June 2016 to 22 December 2017 is 3 813 cases.

The total number of hepatitis A cases between January and November 2017 is 15 040, from 24 European countries. This an almost a 3.6-fold increase compared with the same period between 2012 and 2015.

Advice to travellers

• Most travellers will be at low risk of hepatitis A.
• As with all other illnesses spread by the faecal oral route, precautionary measures should be taken to avoid consumption of potentially contaminated drinks and drinking water and to ensure food is uncontaminated or cooked thoroughly.
• Personal hygiene when eating and drinking is also important including hand washing prior to eating and using clean plates, cups and utensils.

When to consider vaccination

Vaccination should be considered under the following circumstances and is dependent on the individual risk assessment

• Non immune travellers to developing countries are at most risk of infection.
• Occasionally cases have occurred in travellers staying in good quality hotel accommodation but the risk is increased for:
• those travelling to areas where they will be exposed to unsafe drinking water
• where sanitation conditions are poor
• travellers visiting friends and family
• long stay travellers.
• Men who have sex with men (MSM)

For further information see Hepatitis A.