Exceptionally severe hepatitis A epidemic in Hungary

According to the National Center for Public Health and Pharmacy's (NNGYK) weekly epidemiological summary,

approximately 1,600 cases of hepatitis A had been reported

by the beginning of November 2025 (week 44).

For comparison, the annual average for the period 2019–2023 was just 102 cases. The authority last provided an assessment of the situation in March and June.

We have enquired at the NNGYK about the exceptionally high number of infections in late September, and they have e-mailed us the following in response:

Cases of hepatitis A in Hungary increase cyclically every five to seven years, which can be explained by a growing susceptible population due to a lack of natural immunity, coupled with the spread of the virus.

It noted that significant epidemics occurred between 2013 and 2015, followed by an increase in cases in 2022. Several factors contributed to this:

• firstly, an increase in cases was anticipated following the low numbers recorded in previous years (2020–21);
• secondly, a new virus strain (1B instead of the previously predominant 1A) emerged.

The virus spreads through faeces from infected individuals, through close contact between people living in the same household and through the shared use of toilets in communities. It can also be contracted through water, ice or food contaminated with faecal matter, or through food that has been touched by contaminated hands. In rare cases, the virus can be transmitted sexually.

The infection is more prevalent in areas with poor hygiene practices, where water purification and clean water supplies are unavailable.

Thorough hand washing and using antiviral (virucidal) disinfectants on surfaces such as sinks, toilets, door handles and light switches can reduce the risk of spreading the infection.

It is extremely important to follow proper hygiene rules to prevent infection.

In addition, vaccines are available from pharmacies on prescription.

The chart below really tells us how exceptionally high these year's figures are.

Dr. Alíz Németh, an expert at the Hepatology Centre, says that the hepatitis A virus can cause liver inflammation. While many affected individuals are asymptomatic, others experience fatigue, weakness, nausea, diarrhoea, abdominal pain, dark urine, light or clay-coloured stools, loss of appetite, fever, itchy skin and jaundice. These symptoms usually appear about a week after infection.

The infection can be prevented by vaccination, which is available from pharmacies on prescription for a fee. Another key to prevention is good hand hygiene, since the pathogen is primarily spread through food or water contaminated with faecal matter. Infected individuals can also transmit the virus through close contact and, less commonly, through blood or sexual contact.

Hepatitis A is usually mild, with symptoms resolving within a few weeks. However, prolonged and more severe forms can occur. Unlike other types of hepatitis, it does not lead to chronic liver disease.

Even if your symptoms are mild, you should see a doctor if you suspect you have the disease, to rule out other similar conditions. There is no specific drug therapy; your body will fight off the virus itself. Most patients are advised to rest, drink plenty of fluids and avoid alcohol and other substances that put strain on the liver. Liver failure can rarely occur in the elderly, pregnant women and people with chronic diseases, which may require hospitalisation and, in severe cases, a liver transplant.

In March, Dr István Kiss, Director of the Institute of Public Health at the Faculty of Medicine of the University of Pécs, mentioned two main contributing factors: the spread of the virus due to poor hygiene conditions and unsafe drinking water, and the possibility that it was brought in by travellers from developing countries.

He emphasised that similar outbreaks occur from time to time. In the absence of proper hygiene, an infected person can pass the virus on to 8–10 other people, who can then spread it further. However, there is no need to fear a widespread national epidemic, as cases are usually confined to a few specific areas, and the necessary tools are available to stop it from spreading.

The number of severe hepatitis A cases in the Czech Republic has quadrupled compared to last year, with 2,600 cases reported by mid-November.

The Czech National Institute of Public Health (NIPH) announced on Wednesday that hepatitis has already claimed 29 lives this year, compared to two last year.

The number of cases of jaundice and related fatalities in the Czech Republic is

the highest it has been since the regime change in 1989.

Most of the victims are men. The average age is 55, and according to statistics, more than 300 of the patients are homeless, 239 are drug addicts and 34 are incarcerated individuals.

The majority of cases were registered in Prague, with 1,108 cases accounting for 42% of the total.

More than 90% of patients required hospital treatment.

So far, doctors have vaccinated more than 200,000 people, up from 66,000 last year. Each vaccine costs 1,500 Czech koruna (24,000 Hungarian forints), and two doses are required for immunity. Those affected pay for the vaccine themselves, but health insurers automatically reimburse the cost upon presentation of the invoice.