Hepatitis E virus infection in Europe: surveillance and descriptive epidemiology of confirmed cases

Esther J. Aspinall, Elisabeth Couturier, Mirko Faber, Bengü Said, Samreen Ijaz, Lara Tavoschi, Johanna Takkinen, Cornelia Adlhoch

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There is growing evidence that 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 EU/EEA.
A semi-structured survey was developed and sent to EU/EEA Member States (MS) in January 2016. The survey was divided into sections (surveillance, testing and diagnosis, and data on diagnosed cases).
The survey response rate was 97% (30/31 MS). Twenty out of 30 MS (67%) reported that they have HEV-specific surveillance systems. Twelve MS surveillance systems applied an HEV-specific case definition, which varied widely across MS. The number of reported cases of hepatitis E has increased from 500 cases per year in 2005 to 5,617 in 2015. Most of this increase was due to autochthonous cases and cannot be explained by an increase in the number of countries performing surveillance for hepatitis E. The total number of hospitalisations related to HEV infection has increased from less than 100 in 2005 to more than 1,100 in 2015.
EU/EEA MS 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 Europe-wide increase in HEV cases and hospitalisations related to HEV. The standardisation of case definitions, metadata and testing policies across the EU/EEA MS would allow a better understanding of the epidemiology and estimation of the true burden of HEV as an emerging cause of liver-related morbidity.
Original languageEnglish
Number of pages10
Issue number26
Publication statusPublished - 29 Jun 2017


  • hepatitis E
  • epidemiology
  • virology
  • Europe

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