ECDC report: Ten-fold increase of hepatitis E cases in the EU/EEA between 2005 and 2015

July 11, 2017, European Centre for Disease Prevention and Control (ECDC)
Of the 30 Member States responding to the ECDC survey, 20 (67%) have hepatitis E-specific surveillance systems in place. The remaining 10 countries have no HEV-specific surveillance, but may have generic viral hepatitis surveillance. Credit: ECDC/European Centre for Disease prevention and Control

The incidence of hepatitis E virus (HEV) infection has been steadily increasing across the countries of the European Union and European Economic Area (EU/EEA) with 21 081 cases reported in the EU/EEA over the last decade.

According to data published by ECDC, the number of confirmed HEV has been increasing each year from 514 in 2005 to 5 617 cases in 2015, representing a ten-fold increase. Between 2011 and 2015 cases increased three-fold. In total, 28 deaths associated with HEV were reported from five countries between 2005 and 2015.

"Our study provides a compelling picture of hepatitis E infections and related activities across Europe. The survey findings also demonstrate a relatively mixed picture, with 20 countries having well established specific systems and testing protocols in place while the others do not conduct hepatitis E surveillance", says ECDC Chief Scientist Mike Catchpole.

"One possible explanation for the rise in reported cases over the years could be the increased awareness of and testing for hepatitis E, but dietary reasons may also play a role. When we talk about the target of eliminating viral hepatitis as a public health issue by 2030, we should also keep hepatitis E in mind."

The data show that infections were mainly locally-acquired with men and people over the age of fifty being most affected. Most infections are asymptomatic (without clinical symptoms), and in acute E cases the disease is usually mild and self-limiting. However, in some instances, the infection can be severe and may develop to a chronic state with a fatal outcome.

The proportion of people being hospitalised due to HEV infection decreased over time, more than half of the cases with known hospitalisation status were admitted or at least diagnosed in a hospital setting in 2015.

Evidence suggests that HEV is an under-recognised pathogen in high-income countries. The actual number of human infections due to HEV in Europe has been unclear, given widespread variations in clinical awareness, testing surveillance practices and a lack of published information across the majority of EU/EEA Member States.

Although HEV infection is not a reportable disease at the EU-level, 20 countries have surveillance systems in place to monitor this disease. The purpose of the ECDC survey therefore was to measure current testing, diagnosis, and surveillance for HEV in EU/EEA Member States, and to conduct a baseline assessment of available epidemiological data. It is clear from the results that reporting of cases of Hepatitis E is increasing and that better surveillance practices alongside clinical awareness would help to better understand the epidemiology of the disease and support the implementation of prevention measures. This report will now inform a wider ECDC investigation on the incidence, prevalence, and risk factors for HEV in the EU/EEA.

Common way to get HEV: consumption of raw or undercooked pork meat and liver

Additional scientific advice published today by the European Food Safety Authority (EFSA) states that the most common way to become infected with Hepatitis E virus in the EU is through the consumption of raw or undercooked pork meat and liver.

Explore further: Is Europe ready to eliminate viral hepatitis?

More information: Esther J Aspinall et al, Hepatitis E virus infection in Europe: surveillance and descriptive epidemiology of confirmed cases, 2005 to 2015, Eurosurveillance (2017). DOI: 10.2807/1560-7917.ES.2017.22.26.30561

Related Stories

Is Europe ready to eliminate viral hepatitis?

July 27, 2016
The goal for 2030: a world free of hepatitis. Currently, Europe records around 57 000 newly diagnosed acute and chronic cases of hepatitis B and C each year. On top of that, an estimated 10 million Europeans are believed ...

Gaps in hepatitis testing and monitoring programmes across the EU/EEA

May 31, 2017
The survey results suggest a wide variation in existing national testing policy and practice when it comes to hepatitis B and C - with overall limited monitoring of testing, diagnosis, and treatment across EU/EEA Member States. ...

Hepatitis C nearly triples in US in 5 years

May 11, 2017
The number of hepatitis C infections have nearly tripled in the United States in the last five years, particularly among people in their 20s, researchers said Thursday.

Vaccination: Main prevention measure to address hepatitis A outbreaks among MSM

June 15, 2017
1 173 confirmed hepatitis A cases involving three separate clusters have been reported across 15 countries of the European Union since June 2016. Several EU countries have seen large increases in hepatitis A cases in 2017 ...

Taking stock: Where does Europe stand in the elimination of hepatitis B and C?

March 2, 2017
In 2016, a regional action plan for Europe contributing to the implementation of the global viral hepatitis elimination strategy was developed by the WHO Regional Office for Europe. In an article published today in Eurosurveillance, ...

Many European countries ill-prepared to prevent and control the spread of viral hepatitis

April 23, 2015
Many countries in the World Health Organization (WHO) European Region are facing limitations in conducting chronic viral hepatitis disease surveillance, assessing the burden of disease and measuring the impact of interventions, ...

Recommended for you

Kids with rare rapid-aging disease get hope from study drug

April 24, 2018
Children with a rare, incurable disease that causes rapid aging and early death may live longer if treated with an experimental drug first developed for cancer patients, a study suggests.

Commonly prescribed heartburn drug linked to pneumonia in older adults

April 24, 2018
Researchers at the University of Exeter have found a statistical link between pneumonia in older people and a group of medicines commonly used to neutralise stomach acid in people with heartburn or stomach ulcers. Although ...

Early treatment for leg ulcers gets patients back on their feet

April 24, 2018
Treating leg ulcers within two weeks by closing faulty veins improves healing by 12 per cent compared to standard treatment, according to new findings.

Research finds new mechanism that can cause the spread of deadly infection

April 20, 2018
Scientists at the University of Birmingham have discovered a unique mechanism that drives the spread of a deadly infection.

Selection of a pyrethroid metabolic enzyme CYP9K1 by malaria control activities

April 20, 2018
Researchers from LSTM, with partners from a number of international institutions, have shown the rapid selection of a novel P450 enzyme leading to insecticide resistance in a major malaria vector.

Low-cost anti-hookworm drug boosts female farmers' physical fitness

April 19, 2018
Impoverished female farm workers infected with intestinal parasites known as hookworms saw significant improvements in physical fitness when they were treated with a low-cost deworming drug. The benefits were seen even in ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.