Hepatitis A Infections Surge in Hungary, Reaching Over 1,900 Cases

Significant Rise in Hepatitis A Cases Reported

The number of Hepatitis A infections in Hungary has seen a notable increase, with an additional 55 cases reported in the 49th week of 2025. This brings the total number of recorded infections to 1,912, according to data released by the National Centre for Public Health and Pharmacy (NNGYK). The current situation has been described as 'exceptional' by health authorities, with the incidence rate significantly surpassing the five-year median value since late 2024.

While a temporary decline was observed between mid-April and early July 2025, a continuous increase has been recorded since the second half of the summer, aligning with the typical seasonal peak for the disease. Experts from the Epidemiology and Surveillance Centre, part of Semmelweis University, suggest that the spread of the virus is primarily driven by direct or indirect human contact, rather than common transmission factors like contaminated food.

Outbreak Context and Affected Regions

The 2025 outbreak represents a substantial rise in cases, with nearly 1,600 infections registered by early November, approximately fifteen times the annual average for the period 2019–2023, which stood at 102 cases. This surge is part of a broader multi-country outbreak affecting the EU/EEA, with notable spikes also observed in Austria, Czechia, and Slovakia. A contributing factor to the increased incidence is believed to be the emergence of a new virus strain, 1B, replacing the previously predominant 1A.

Initially, the capital, Budapest, and Pest County were the most affected areas. However, the virus's spread accelerated in Borsod and Szabolcs counties during the latter half of the year. By November, the highest number of infections continued to be detected in Budapest, followed by Borsod-Abauj-Zemplen and Szabolcs-Szatmar-Bereg counties.

Transmission, Risk Factors, and Symptoms

Hepatitis A is primarily transmitted through the fecal-oral route, often via contaminated water, ice, or food, and through close personal contact with infected individuals. Poor hygiene practices, inadequate water purification, and insufficient access to clean water are significant risk factors. In rare instances, sexual transmission can also occur.

The current outbreak disproportionately affects vulnerable populations, including homeless adults, individuals who use or inject drugs, and those living in poor sanitary conditions. Cases have also been identified among members of Roma communities in neighboring countries and in pre-school facilities, impacting young children. Symptoms typically manifest after an incubation period of 15 to 50 days, averaging around four weeks, and can include fever, weakness, abdominal pain, jaundice, and dark urine. Many infections, particularly in children under six, may be asymptomatic.

Public Health Response and Prevention Measures

The NNGYK has urged healthcare professionals to maintain a high index of suspicion for Hepatitis A during diagnoses and to educate patients on prevention strategies. Key preventive measures emphasized by health authorities include:

• Thorough and frequent handwashing with soap and water.
• Maintaining good personal hygiene.
• Disinfecting surfaces such as sinks, toilets, door handles, and light switches.

Vaccination against Hepatitis A is recommended for individuals in high-risk groups and is available with a prescription for a fee. However, vaccination is provided free of charge for close contacts of confirmed Hepatitis A patients. The European Centre for Disease Prevention and Control (ECDC) has also advised targeted vaccination efforts and epidemiological investigations to contain the outbreak. While Hepatitis A is generally a mild illness that resolves within weeks and does not lead to chronic liver disease, severe cases can occur, particularly in older individuals, and have resulted in fatalities. Four adults with chronic underlying illnesses in Hungary have died due to complications from the virus.