Between 1 November 2012 and 30 April 2013, 15 confirmed cases of hepatitis A virus infections and 89 probable cases, all with subgenotype IB, have been reported in 14 EU/EFTA countries. All cases have a travel history to Egypt.
Due to the fact that 15 of these cases, identified in three different countries, have identical ribonucleic acid (RNA) sequences, a multistate outbreak has been confirmed with exposure occurring in that country.
Preliminary epidemiological investigations in the affected countries do not definitively point to any particular source of infection. Taking this into consideration, unimmunised EU/EFTA citizens travelling to Egypt, and particularly to the Red Sea region, may still be exposed. Further cases of hepatitis A are likely to be reported in the affected countries, with the possibility of additional Member States reporting cases linked to the outbreak.
Vaccination recommendations should be highlighted to those travelling to areas where hepatitis A is endemic. Member States should consider vaccination of all contacts of cases following their national guidance.
ECDC and the European Commission, in cooperation with the affected countries and the World Health Organization, will continue to closely monitor this event and will update the risk assessment as soon as new relevant information becomes available. In addition, all the European stakeholders will keep collaborating with the Egyptian authorities to investigate the source of infection.
Rapid Risk Assessment: Outbreak of hepatitis A virus infection in travellers returning from Egypt