More than 2,000 people across four European countries popular among tourists are confirmed to have hepatitis A virus (HAV), and nine have died, prompting the European Centre for Disease Prevention and Control (ECDC) to issue an urgent travel warning.

 

In response to the multicountry outbreak, the ECDC issued a Rapid Risk Assessment to evaluate the public health risk. The assessment reported a significant increase in HAV across the Czechia, Hungary, Slovakia and Austria in 2025, totaling 2,097 cases.

 

This year, Slovakia reported 880 HAV cases, and Hungary reported 530. Czechia confirmed 600 HAV cases, mostly among young children, including three deaths. Austria recorded 87 cases and three deaths, already exceeding its 2024 total, according to the assessment.

 

HAV is a liver disease primarily spread from one person to another when the feces of someone with HAV get into another person’s mouth. Even trace amounts of feces too hard to see can cause an infection. This can occur in the following ways: 

  • Eating food—particularly food that is raw or not thoroughly cooked (shellfish, for example)—that has been handled or prepared by someone who has hepatitis A;
  • Drinking water or ice that contaminated with feces;
  • Close personal contact with a person infected with the virus;
  • Using contaminated water for intravenous drug use;
  • Engaging in oral-anal sex (“rimming”) with someone who has HAV.

 

The ECDC confirms cross-border transmission and underscores the need for public health action.

 

“This outbreak reminds us that hepatitis A can cause serious illness and death, especially among people with limited access to health care and basic hygiene,” Ole Heuer, DVM, PhD, head of unit disease programs at ECDC, said in the release. “We need to strengthen outreach, provide access to vaccination in groups more likely to be exposed and ensure basic sanitation, especially in response to the increase in cases.  More than health measures, they are equity measures.”

 

The best way to prevent HAV is to be vaccinated. Two HAV vaccines are available: Havrix and Vaqta. Both vaccines require two injections, usually administered six months apart. What’s more, getting the vaccine within two weeks of suspected HAV exposure may help prevent sickness.

 

Even if you haven’t been vaccinated against HAV, you can take the following steps to prevent infection:

  • Avoid water that could be contaminated with fecal matter;
  • Avoid undercooked or raw shellfish;
  • Always wash your hands with soap and water after using the bathroom or changing a diaper and before preparing and eating food;
  • Use a latex barrier—such as a dental dam—for oral-anal sex.

 

To learn more, click #Hepatitis A or #Europe. There, you’ll see headlines such as “Scaling Up Hepatitis A and B Vaccination Among LGBTQ People,” “Top Risk Factors for Hepatitis A Include Drug Use, Unstable Housing” and “Many People Forgo Hepatitis A Vaccine Despite Its Ability to Prevent Death.”