28 September 2011

Hepatitis A outbreak in Estonia

Estonia has reported an increase in hepatitis A cases in 2011 with a notable peak since August 2011. As of 26 September, a total of 62 cases of hepatitis A have been reported, including 13 new cases in the week 19 - 25 September. Viljandi county has reported the majority of cases (44 ), with many of the other cases from Tartu (Tartumaa), Pärnu (Pärnumaa), Harju (Harjumaa) and Rapla (Raplamaa), epidemiologically linked to Viljandi county [1-2].

It is expected that additional cases will continue to occur, as the incubation period for hepatitis A ranges from 15 to 50 days [3 - 4].

The Health Board of Estonia is currently investigating the potential sources for hepatitis A [3]. Estonian health authorities are encouraging hepatitis A vaccination for residents who are at particular risk of hepatitis A [2, 5].

Advice for travellers

Hepatitis A occurs worldwide. Hepatitis A is a viral disease that causes inflammation of the liver. The disease is transmitted through contaminated food or water, or direct contact with faeces in situations of poor hygiene or during certain sexual practices.

The incidence of hepatitis A in the Baltic region, including Estonia, has decreased since the 1990s. The last major outbreak of hepatitis A in Estonia was reported in 1998 (989 cases) [6].

The risk for most travellers to Estonia is considered to be low. All travellers to Estonia should practise strict food and water hygiene, and those to Viljandi county can consider hepatitis A vaccination.

Further information on health risks for travellers to Estonia can be found on the NaTHNaC Country Information Page.

References

1. A Co-operation Project for Communicable Disease Control in Northern Europe (EpiNorth). EpiWatch: Epidemic Intelligence in Northern Europe. Update on the outbreak of hepatitis A in Estonia. 20 September 2011. [Accessed 28 September 2011]. Available at:

http://www.epinorth.org/eway/default.aspx?pid=230&trg=Main

Area_5260&MainArea_5260=5340:0:15,3019:1:0:0:::0:0

2. Health Board of Estonia. Overview of the Estonian week 38. 26 September 2011. [In Estonian]. [Accessed 28 September 2011]. Available at:

http://www.terviseamet.ee/info/uudised/u/artikkel/kollatove-levikust-eestis-38-nadalal.html

3. Health Board of Estonia. Overview of the Estonian week 37. 19 September 2011. [In Estonian]. [Accessed 28 September 2011]. Available at:

http://www.terviseamet.ee/info/uudised/u/artikkel/ulevaade-kollatovest-eestis-37-nadala-seisuga.html

4. Viljandi County Government. All forces are directed at the Viljandi county to prevent hepatitis A. 12 September 2011. [In Estonian]. [Accessed 28 September 2011]. Available at:

http://www.viljandimaa.ee/?mod=news&id=2108&c=10

5. Health Board of Estonia. Vaccination against hepatitis A. 27 September 2011. [In Estonian]. [Accessed 28 September 2011]. Available at:

http://www.terviseamet.ee/info/uudised/u/artikkel/a-viirushepatiidi-vastasest-vaktsineerimisest.html

6. European Health for All Database (HFA-DB). Morbidity, Disability and Hospital discharges.  [Accessed 28 September 2011]. Available at:

http://data.euro.who.int/hfadb/

Links

NaTHNaC Health Information Sheet on hepatitis A

Health Protection Agency information on hepatitis A