Hepatitis A outbreak continues in Czechia

According to news reports, the number of cases of hepatitis A continues to rise in Czechia.

A surge in cases was first reported in March this year and over 2000 cases have now been reported (to October 2025). This compares with 676 in 2024.  The number of cases is likely much higher given the illness can be mild and go unreported.

Prague is particularly affected with more than 40% of cases. There have been twenty-six deaths.  Government officials have linked the outbreak to areas of poor environmental sanitation.

Hepatitis A is not included in the childhood immunization schedule in Czechia.

A multi-state outbreak including Czechia and Slovakia was reported by European Centre for Prevention and Control in June this year.

How does Hepatitis A spread and who's at risk?

Hepatitis A is transmitted through contaminated food or water and is common in areas where water and environmental sanitation are poor.  Czechia is a high-income country, and an outbreak of this magnitude would be considered unusual.

Most adults in low and low middle-income countries have already acquired the disease in childhood and are immune for life. They are usually unaware of exposure, as the disease can have no symptoms in young children.

The illness is likely to be more severe as an adult with some studies showing a 3% mortality rate over 40 years. It can take many months to fully recover from the effects of the disease.

The disease can be severe in those who are immune suppressed or those with pre-existing health issues

Advice for Australian travellers

Travellers from countries like Australia and New Zealand are unlikely to have natural immunity to the disease and are generally advised to consider vaccination if travelling to risk areas.

The recent surge of hepatitis A across several European countries, including Czechia, highlights that even high income destinations are not immune from outbreaks. This raises an important question about whether hepatitis A vaccination should be considered more routinely for travellers - Is it time to reconsider hepatitis A vaccination for travellers in 2025?

Vaccination is a recommended childhood immunization in the United States. It has been for several years.

In Australia it is recommended and funded for Aboriginal and Torres Strait islands children living in the Northern Territory, Queensland, South Australia and Western Australia but not for the wider childhood immunisation program. Hopefully this will change in the future.

The hepatitis A vaccine has been available in Australia since 1994.  It should not be confused with Hepatitis B vaccination which was first offered in the 1980’s.

Hepatitis A vaccination and protection

Two doses of hepatitis A vaccine given 6 months apart will provide good protection for many years. The first dose is often given prior to a trip and then the booster dose 6 to 12 months later.

The vaccine can be given from 12 months of age, but consideration might also be offered to children aged 6-12 months visiting high risk locations (Africa, Indian subcontinent etc). While the disease is likely to be mild (not all) in this age group, there is a possibility they can return infected and start an outbreak in a childcare centre or school.

The vaccine is also available as a combination with hepatitis B. This vaccine is called Twinrix. This is usually given as a course 0, 1 and 6 months.  If the traveller is intending to be away for a lengthy period, a rapid course of the vaccine can be given at 0,1 and 3 weeks. A booster dose should be given after 12 months for long term protection.

Gammaglobulin - an older form of protection

Hepatitis A protection has also been offered in the form of an antibody.  It is called gammaglobulin and was the mainstay of protection for travellers to high-risk areas prior to the introduction of the vaccine.  It is not a vaccine and is rarely given now.

Gammaglobulin provided short term protection for 3-6 months. It would have prevented many cases of hepatitis A in backpackers travelling in India and Nepal and was still being used in the late 90’s. It should not be confused with vaccination.

Hepatitis A cases in Australia

One hundred and eighty-six cases of hepatitis A have been reported in Australia year to date (August 31, 2025).

Just 28 cases were recorded for a similar period in 2021 – when Australia’s borders were closed!

It is never too late to give a hepatitis A vaccination prior to travel!