Transmission of hepatitis A continues in Europe.
From 1 January 2016 to 27 September 2017 there have been 11 212 cases in 19 EU/EEA countries: Austria, Belgium, Denmark, Estonia, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Malta, the Netherlands, Norway, Portugal, Slovenia, Spain, Sweden and the United Kingdom.
These figures contain cases from an outbreak of hepatitis A that began in June 2016 and in which men who have sex with men (MSM) have been particularly visible. It is likely that infection is under-reported. Latvia reported cases in 2016. Outside Europe, Israel has reported cases linked to the outbreak in 2016 and 2017.
Recommendations for Travellers
Hepatitis A is spread by the faecal-oral route and most travellers to the affected areas of California will be at low risk of infection.
Prevention is focused on food and water precautions and practising meticulous hand and personal hygiene to reduce the risk of hepatitis A infection. Detailed risk management advice can be found via following links:
Vaccination is recommended if you are visiting areas where drinking water may be unsafe and where hygiene and sanitation is poor. Men who have sex with men are at higher risk of hepatitis A infection. There are various brands of hepatitis A vaccine available: Avaxim, Havrix Monodose, Havrix Junior Monodose and Vaqta Paediatric.
Hepatitis A vaccine is also available in a preparation that combines it with hepatitis B vaccine: Ambirix, Twinrix and Twinrix Paediatric and a preparation that combines it with typhoid vaccine: Hepatyrix and ViATIM.
For further information see Hepatitis A.