From February 2016 to December 2016, five EU countries reported clusters or sporadic cases associated with two different hepatitis A virus sequences. Three other countries, Spain, Italy and Germany, reported regional increases of hepatitis A in men who have sex with men (MSM) or adult male populations.
The two sequences are most likely associated with independent events and mostly associated with MSM population groups at increased risk for hepatitis A virus infection. No infected food handlers have been implicated in these events. Person-to-person sexual transmission is the most likely hypothesis for the spread of this outbreak, as a foodborne transmission would tend to result in more cases affecting the general population.
ECDC encourages Member States to raise awareness among healthcare providers, in particular those caring for MSM with regards sexually transmitted infections, about the possibility of infection with hepatitis A virus. Responsible authorities in Member States are encouraged to share microbiological and epidemiological details of new cases through Epidemic Intelligence Information System for Food- and Waterborne Diseases and Zoonoses (EPIS-FWD) for the benefit of progressing with multi-country outbreak investigations.