Hepatitis E virus infection in Europe: Surveillance and descriptive epidemiology of confirmed cases, 2005 to 2015

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Hepatitis E virus (HEV) is an under-recognised cause of acute hepatitis in high-income countries. The purpose of this study was to provide an overview of testing, diagnosis, surveillance activities, and data on confirmed cases in the European Union/European Economic Area (EU/EEA). A semi-structured survey was developed and sent to 31 EU/EEA countries in February 2016, 30 responded. Twenty of these countries reported that they have specific surveillance systems for HEV infection. Applied specific case definition for HEV infection varied widely across countries. The number of reported cases has increased from 514 cases per year in 2005 to 5,617 in 2015, with most infections being locally acquired. This increase could not be explained by additional countries implementing surveillance for HEV infections over time. Hospitalisations increased from less than 100 in 2005 to more than 1,100 in 2015 and 28 fatal cases were reported over the study period. EU/EEA countries are at different stages in their surveillance, testing schemes and policy response to the emergence of HEV infection in humans. The available data demonstrated a Europewide increase in cases. Standardised case definitions and testing policies would allow a better understanding of the epidemiology of HEV as an emerging cause of liver-related morbidity.

Original languageEnglish
Issue number26
Publication statusPublished - 29 Jun 2017

Bibliographical note

Funding Information:
The authors are grateful to Zdenka Man??kov? (Czech Republic), Daniela Schmid (Austria), Elisabeth Kanitz (Austria), Kremena Parmakova (Bulgaria), Galina Zagrbneviene (Lithuania), Thor Gudnason (Iceland), Pierre Weicherding (Luxembourg) and Tanya Melillo (Malta) for providing the country data. Sharon J Hutchinson and David J Goldberg from Glasgow Caledonian University, Glasgow, UK and Gill Hawkins from Health Protection Scotland, NHS National Services Scotland, Glasgow, the United Kingdom, supported with their expert knowledge during the study. We thank Erika Duffell, Ettore Severi and Dragoslav Domanovic from ECDC for their critical review of the questionnaire. We would also like to acknowledge the support of Sally Baylis and Harry Dalton, members of ECDC?s expert group in the development of the questionnaire; J?rgen Wenzel, National Virus Reference Laboratory, Germany and Joanne O?Gorman, National Virus Reference Laboratory, Ireland, for information on laboratory testing. This study was conducted as part of the ECDC-funded project, Hepatitis B, C, and E in the EU/EEA: monitoring and testing activities, ID 5132, European Centre for Disease Prevention and Control.

Publisher Copyright:
© 2017, European Centre for Disease Prevention and Control (ECDC). All rights reserved.


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