Hepatitis E in the EU/EEA, 2005-2015

Hepatitis E in the EU/EEA, 2005–2015: Baseline assessment of testing, diagnosis, surveillance and epidemiology

Hepatitis E virus (HEV) is one of the leading causes of acute viral hepatitis worldwide. HEV genotype 3 (GT3) predominates in high-income countries: transmission is usually zoonotic and has been linked to the consumption of contaminated pork or shellfish products. Infection may be asymptomatic or cause an acute self-limiting hepatitis, but may become chronic in a small number of cases, particularly among those who are immunosuppressed or who have pre-existing liver disease. Risk factors for symptomatic or complicated infection include being male, being of an older age, and having pre-existing liver disease. The number of human infections due to HEV in Europe is currently unclear, given widespread variations in awareness, testing, and surveillance activities, and a lack of published information across the majority of European Union/European Economic Area (EU/EEA) Member States. However, there is emerging evidence that HEV is an under-recognised pathogen in highincome countries, and that the incidence of HEV infection has been steadily increasing over the last decade. The purpose of this study was to assess current testing, diagnosis, and surveillance for HEV in EU/EEA Member States, and to conduct a baseline assessment of available epidemiological data. This assessment will inform a wider ECDC investigation on the incidence, prevalence, and risk factors for HEV in the EU/EEA.