Abstract
Since November 2012, there has been an increase in reported cases of hepatitis A in tourists returning from Egypt in several European countries. As of 24 April, 80 HAV cases in travellers with symptom onset after 1 November 2012 visiting different areas in Egypt have been reported. Four cases from Norway, six cases from the Netherlands and five cases from England share an identical hepatitis A viral RNA sequence. This increase in cases suggests that vaccination recommendations for travellers to hepatitis A endemic countries should be reinforced.
Highlights
The incidence of hepatitis A virus (HAV) in European countries has decreased from 15.1 in 1996 to 3.9 per 100,000 population in 2006, attributable to improved sanitary and living conditions [1,2]
HAV vaccination is generally recommended for all travellers to Egypt, funding the vaccination for tourists or including the vaccine as part of the national vaccination plan is uncommon
All other cases from Germany with available information were unvaccinated. This increase in cases reported from European travellers returning from Egypt suggests that European public health authorities should consider reinforcing HAV vaccine recommendations for tourists travelling to endemic areas, especially Egypt
Summary
The incidence of HAV in European countries has decreased from 15.1 in 1996 to 3.9 per 100,000 population in 2006, attributable to improved sanitary and living conditions [1,2]. In Denmark, Germany, the Netherlands, Norway and Sweden, age, sex, vaccination status and location of travel is submitted as part of the notification. HAV cases are excluded if they are a different genotype or have a different sequence to the outbreak strain. As of 24 April, 80 HAV cases in travellers with symptom onset after 1 November 2012 visiting different areas in Egypt have been reported (Table 2).
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