Hepatitis A in the European Union: Responding to Challenges Related to New Epidemiological Patterns

Hepatitis A is a vaccine-preventable acute, usually self-limiting disease caused by infection with the hepatitis A virus (HAV). Transmission is usually by the faecal-oral route, including via person-to-person spread, contaminated water or food products. It has also been associated with injecting drug use and outbreaks among men having sex with men. In the European Union (EU), though figures may vary among countries, the overall incidence of hepatitis A has decreased over the last 10 years from 15.1 per 100,000 population in 1996 to 3.9 per 100,000 in 2006. This decreasing trend has been attributed to continued improved sanitary and living conditions, with reduced exposure to infection, especially in early childhood. However, reduction in circulation of HAV leads to decreased acquisition of immunity and, in the absence of universal vaccination, an accumulation of susceptible individuals. Though the total number of cases may be decreasing yearly in the EU, the articles published in this edition of Eurosurveillance indicate that hepatitis A is still an important public health issue, and highlight the need for increased awareness of both the risk of infection to the individual and the possibility of community outbreaks within a changing EU epidemiology. Eurosurveillance. 2009;14(3):1-2.