Czech surge in hepatitis A cases signals growing public health concern

Czechia is experiencing a significant increase in reported hepatitis A cases, raising concerns among health authorities and epidemiologists. Data from the State Health Institute shows that by July 21, 928 cases had been reported, with ten deaths—a sharp rise compared to last year’s total of 620 cases and two fatalities.

The surge already represents a roughly 50 percent increase in cases through the first half of 2024, with the year-on-year total expected to more than double. Epidemiologist and former health minister Roman Prymula described the trend as dramatic and highlighted the growing number of deaths as particularly troubling.

He emphasized that the country is approaching the threshold at which widespread vaccination typically begins. Public health officials warn that improved hygiene and vaccination remain the most effective defenses against the virus’s spread.

Hepatitis A is caused by a virus that spreads primarily through the fecal-oral route. According to infectious disease specialist Milan Trojánek, speaking to Czech Television, infected individuals shed the virus in their stool, and it can be transmitted through contaminated hands or surfaces.

The virus requires only a small infectious dose to spread, making it highly contagious in environments where people share toilets or wash facilities, such as schools, childcare centers, and camps.

“Any group using shared restrooms is at risk,” Prymula explained. He noted that the virus is hardy and can survive on surfaces for several weeks at normal temperatures, though exposure to sunlight and ultraviolet radiation can reduce its viability.

In frozen conditions, the virus may persist for years, underscoring the potential for foodborne outbreaks, as seen in a 1979 epidemic linked to frozen strawberries. That outbreak led to more than 30,000 reported cases of hepatitis A.

The virus’s long incubation period, which can extend up to 30 days, complicates efforts to control transmission. During this time, infected individuals may unknowingly spread the virus before symptoms appear.

Hepatitis A infection often begins with flu-like symptoms and can lead to jaundice—yellowing of the skin and eyes. While children typically experience mild or asymptomatic illness, adults, particularly those with chronic liver conditions or weakened health, face a greater risk of severe disease and death.

Trojánek stressed the importance of recognizing early symptoms and seeking prompt medical evaluation to rule out other causes of jaundice, such as bile duct obstruction or other liver diseases. Treatment is supportive, with a focus on monitoring and managing symptoms.

Isolation practices for patients have shifted from hospital confinement to home isolation, though rigorous disinfection of shared surfaces remains essential to prevent further spread. Schools and public facilities are advised to disinfect high-touch areas such as door handles and toilet fixtures frequently.

Vaccination plays a critical role in controlling hepatitis A outbreaks. Post-exposure vaccination can be effective in preventing illness if administered shortly after contact with an infected person. The vaccine, recommended though not mandatory in Czechia, offers nearly lifelong immunity and is particularly advised for travelers to endemic regions.