Rapid communication Open Access
Like 0


Since 14 November 2016, 38 cases of hepatitis A have been notified in Berlin; of these, 37 were male and 30 reported to have sex with men (MSM). Median age of MSM cases is 31 years (range: 24–52 years). Phylogenetic analysis revealed three distinct sequences, linking cases in Berlin to those in other German cities and to clusters recognised in other European countries in 2016.


Article metrics loading...

Loading full text...

Full text loading...



  1. Robert Koch Institut (RKI). Falldefinitionen des Robert Koch-Instituts zur Übermittlung von Erkrankungs- oder Todesfällen und Nachweisen von Krankheitserregern, Ausgabe 2015. [Case definitions of the Robert Koch Institute for the surveillance of notifiable infectious diseases in Germany, Edition 2015]. German. Available from: http://www.rki.de/DE/Content/Infekt/IfSG/Falldefinition/Downloads/Falldefinitionen_des_RKI.pdf?__blob=publicationFile
  2. Harries M, Monazahian M, Wenzel J, Jilg W, Weber M, Ehlers J, et al. Foodborne hepatitis A outbreak associated with bakery products in northern Germany, 2012. Euro Surveill. 2014;19(50):20992.  https://doi.org/10.2807/1560-7917.ES2014.19.50.20992  PMID: 25597541 
  3. National Institute for Public Health and the Environment (RIVM). Ministry of Health, Welfare and Sport. Protocol. Molecular detection and typing of VP1-2A region of Hepatitis A Virus (HAV). Bilthoven: RIVM. [Accessed 19 Jan 2017]. Available from: http://www.rivm.nl/dsresource?objectid=87925ed7-72d0-4d4f-8b53-fa309fe45b87&type=org&disposition=inline
  4. European Centre for Disease Prevention and Control (ECDC). Hepatitis A outbreaks in the EU/EEA mostly affecting men who have sex with men. Stockholm: ECDC. 19 Dec 2016. Available from: http://ecdc.europa.eu/en/publications/Publications/13-12-2016-RRA-Hepatitis%20A-United%20Kingdom.pdf
  5. Bruni R, Taffon S, Equestre M, Chionne P, Madonna E, Rizzo C, et al. Italian National Task Force on Hepatitis A. Key Role of Sequencing to Trace Hepatitis A Viruses Circulating in Italy During a Large Multi-Country European Foodborne Outbreak in 2013. PLoS One. 2016;11(2):e0149642.  https://doi.org/10.1371/journal.pone.0149642  PMID: 26901877 
  6. Mao JS, Yu PH, Ding ZS, Chen NL, Huang BZ, Xie RY, et al. Patterns of shedding of hepatitis A virus antigen in feces and of antibody responses in patients with naturally acquired type A hepatitis. J Infect Dis. 1980;142(5):654-9.  https://doi.org/10.1093/infdis/142.5.654  PMID: 6257794 
  7. Cotter SM, Sansom S, Long T, Koch E, Kellerman S, Smith F, et al. Outbreak of hepatitis A among men who have sex with men: implications for hepatitis A vaccination strategies. J Infect Dis. 2003;187(8):1235-40.  https://doi.org/10.1086/374057  PMID: 12696002 
  8. Spada E, Genovese D, Tosti ME, Mariano A, Cuccuini M, Proietti L, et al. An outbreak of hepatitis A virus infection with a high case-fatality rate among injecting drug users. J Hepatol. 2005;43(6):958-64.  https://doi.org/10.1016/j.jhep.2005.06.012  PMID: 16143420 
  9. Robert Koch Institut (RKI). Statement of the German Standing Committee on Vaccination at the RKI. Recommendations of the Standing Committee on Vaccination. (STIKO) at the Robert Koch Institute/Effective: August 2015. Epidemiol Bull. 2015;332(34). Available from: http://www.rki.de/EN/Content/infections/Vaccination/recommandations/34_2015_engl.pdf?__blob=publicationFile
  10. Faber MS, Stark K, Behnke SC, Schreier E, Frank C. Epidemiology of hepatitis A virus infections, Germany, 2007-2008. Emerg Infect Dis. 2009;15(11):1760-8.  https://doi.org/10.3201/eid1511.090214  PMID: 19891863 
  11. Victor JC, Monto AS, Surdina TY, Suleimenova SZ, Vaughan G, Nainan OV, et al. Hepatitis A vaccine versus immune globulin for postexposure prophylaxis. N Engl J Med. 2007;357(17):1685-94.  https://doi.org/10.1056/NEJMoa070546  PMID: 17947390 
  12. Robert Koch Institut (RKI). Gehäuftes Auftreten von Hepatitis-A-Erkrankungen bei Männern, die Sex mit Männern haben [Increased incidence of hepatitis A among men who have sex with men]. Epidemiol Bull. 2017;2:28. German. Available from: http://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2017/Ausgaben/02_17.pdf?__blob=publicationFile
  13. Sfetcu O, Irvine N, Ngui SL, Emerson C, McCaughey C, Donaghy P. Hepatitis A outbreak predominantly affecting men who have sex with men in Northern Ireland, October 2008 to July 2009. Euro Surveill. 2011;16(9):19808. PMID: 21392487 

Data & Media loading...

Submit comment
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error