Hepatitis A in the European Union and Morocco.

The European Centre for Disease Prevention and Control (ECDC) reports a small but widespread outbreak of hepatitis A in Denmark, France, Germany, Spain, the Netherlands and the United Kingdom.

Forty-two confirmed cases were infected with one of two strains of Hepatitis A virus previously identified in Morocco. However, only 3 of these cases had a history of travel to Morocco. The rest are considered to have been infected at home.

A further 50 travel-related possible cases of hepatitis A with history of travel to Morocco are also reported.

No source of infection has been identified.

Advice to travellers

• Most travellers will to countries in Europe 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.

• All non-immune travellers to Morocco
• Non-immune travellers to developing countries are at most risk of infection.

In other European affected countries:

• 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.