Methods: Cases recorded through the mandatory notification system were classified in accordance with the European case definition. Data were analyzed by population group (general population, Roma, refugees / migrants, travelers to endemic countries, and MSM).
Results: Between 2009 and 2017, 1072 cases were reported to the Department of Epidemiological Surveillance and Intervention of the Hellenic Center for Disease Control and Prevention. The median annual number of reported cases was 86 (41-277). Reported cases exceeded the expected number in 2013, 2016 and 2017. In 2013 165 cases were reported [3 times higher than the mean annual n reported for 2005-2012; 101 (61.6%) among Roma]. Three clusters were identified accounting for 50% of reported cases. Genotyping showed that clusters were due to hepatitis A virus subgenotype IA.
In 2016, after the closure of the northern borders of Greece in March, 177 cases were reported among refugees (subgenotype IB, the majority of affected of Syrian origin).
In 2017, an outbreak among men having sex with men (MSM) was recorded as part of a European HAV outbreak. 176 male cases were recorded (median age; 38 years old, range; 21-55); 81 identified themselves as MSM. Genotyping data showed linkage to identified European clusters (subgenotype IA).
Conclusion: Hepatitis A remains a significant Public Health threat in Greece. Preventive interventions should target populations with low access to health care, as well as MSM.
T. Sideroglou, None
S. Tsiodras, None
T. Georgakopoulou, None