European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden.
Euro Surveill. 2023 May;28(19). doi: 10.2807/1560-7917.ES.2023.28.19.2200575.
BackgroundEuropean Union/European Economic Area (EU/EEA) countries annually report hepatitis A (HepA) notifications to The European Surveillance System (TESSy).AimTo describe EU/EEA HepA notifications from 2010 to 2019 and identify infection drivers and surveillance improvements.MethodsWe analysed demographic, clinical and transmission information of HepA confirmed cases from TESSy. We stratified countries by population susceptibility profile and performed time-series analysis to describe trends in notification rates, sex distribution and travel history.ResultsTwenty-nine EU/EEA countries reported 139,793 HepA cases. Six eastern EU countries reported > 60% of these cases. EU/EEA notification rate during the study period was 3.2 cases per 100,000 population (range 2.7-5.6). Notifications peaked in 2014 and 2017, with marked differences in case demographic characteristics. Notification trends varied across different country susceptibility groups. In 2017, the proportion of males (74%) and case median age (31 years) increased steeply, while no changes occurred in 2014. Travel history showed seasonal case peaks following the summer. More than 47,000 hospitalisations were reported. Annual case fatality was < 0.2% for all years. Information on travel history, hospitalisation, death and mode of transmission was suboptimal.DiscussionApart from some countries in its east, the EU/EEA is characterised by low HepA incidence baseline and susceptible to recurrent large cross-border outbreaks. Analysis of European surveillance data highlighted the need for stronger prevention policies for eastern EU countries, men who have sex with men and travellers. Improving surveillance data-quality will enhance knowledge on food-borne, and travel-related exposures to inform more effective and tailored regional prevention policies.
背景
欧盟/欧洲经济区（EU/EEA）国家每年向欧洲监测系统（TESSy）报告甲型肝炎（HepA）通知。
目的
描述 2010 年至 2019 年欧盟/欧洲经济区 HepA 通知，并确定感染驱动因素和监测改进。
方法
我们分析了 TESSy 中甲型肝炎确诊病例的人口统计学、临床和传播信息。我们按人口易感性特征对国家进行分层，并进行时间序列分析，以描述通知率、性别分布和旅行史的趋势。
结果
29 个欧盟/欧洲经济区国家报告了 139793 例 HepA 病例。六个东欧国家报告了其中的>60%病例。研究期间，欧盟/欧洲经济区的通知率为每 10 万人 3.2 例（范围为 2.7-5.6）。通知在 2014 年和 2017 年达到峰值，病例人口统计学特征有明显差异。不同国家易感组的通知趋势不同。2017 年，男性（74%）和病例中位数年龄（31 岁）急剧增加，而 2014 年没有变化。旅行史显示夏季后季节性病例高峰。报告了超过 47000 例住院治疗。所有年份的年病死率均<0.2%。旅行史、住院、死亡和传播方式的信息并不完善。
讨论
除了东部的一些国家外，欧盟/欧洲经济区的甲型肝炎发病率基线较低，容易发生反复的跨境大规模暴发。对欧洲监测数据的分析强调了需要为东欧国家、男男性行为者和旅行者制定更有力的预防政策。提高监测数据质量将增强对食源性和与旅行相关暴露的了解，以便为更有效和有针对性的区域预防政策提供信息。
