In the European Union and European Economic Area, the majority of the nearly 27,000 newly reported hepatitis B cases were classified as chronic infections in 2017. Since 2008, this situation follows a consistent upward trend in reported chronic hepatitis B cases. According to available surveillance data for countries of the European Union and the European Economic Area (EU/EEA) for 2017, there is evidence of on-going transmission of hepatitis B and continued importation of cases to many European countries. However, incomplete data, as well as varying national surveillance systems and practices, impair more detailed epidemiological analysis of reported data.
In 2017, from 1.1 per 100,000 population, the majority of EU/EEA countries consistently reporting experienced a steady decline in newly reported acute hepatitis B infection. This occasion reflects overall global trends and is most likely a result of successful national vaccination programs: in these countries, the proportion of acute hepatitis B infections among individuals below 25 years of age dropped from 20 percent in 2008 to 12 percent in 2017. In 2008, the rate of chronic cases under 25 declined from 21 percent to 10 percent in 2017.
To understand the epidemiology of hepatitis B, transmission data are crucial. Information on the transmission mode, however, was only complete for roughly a third (29 percent) of the reported acute cases in 2017 and only 13 percent of the notified chronic cases. Hence, the data are unlikely to be fully representative, and observed trends and differences between countries are hard to interpret.
Heterosexual transmission was most commonly reported (27 percent) for the 718 acute cases with complete information, followed by nosocomial transmission (16 percent), sex between men (13 percent), non-occupational injuries (10 percent), and injecting drug use (10 percent). In 2017, Italy, Poland, and Romania accounted for 74 percent of the acute cases attributed to healthcare-associated hepatitis B infections.
Transmission from mother to child and in a healthcare setting where the information was available were the most commonly reported routes for chronic hepatitis B infection with 41 percent and 28 percent respectively. Poland reported 90 percent of chronic cases related to nosocomial transmission.
In 2017, the considerable high rate of 26,907 reported hepatitis B infections particularly chronic cases, in combination with the diversity in reported transmission routes across Europe suggested that countries need to maintain and strengthen local hepatitis prevention and control programs.
The European Action plan of the World Health Organization for the health sector response to viral hepatitis outlines ways to do this. Based on the information from the ECDC prevalence database, authorities can discover the key population groups and areas of high hepatitis prevalence for targeted efforts.
