Every year towards the end of the peak travel season in late summer and autumn, an accumulation of hepatitis A diseases occurs in Germany. Only a vaccination can protect against hepatitis A.
The RKI (Robert Koch Institute) reported a total of 929 cases in 2009
(2008: 1073). In about half of the cases, the infection is introduced from abroad, followed by a wave of infections acquired here, which continue into the spring. The countries of origin are mainly the popular holiday destinations around the Mediterranean such as Turkey, Italy, Spain and North Africa (Tunisia, Egypt, Algeria), but also Eastern Europe as well as Mexico, South America, South and Southeast Asia.
Hepatitis A is usually transmitted via contaminated food or drinking water, but also directly by human-to-human contact. Above all, the consumption of mussels and shellfish, so popular in southern countries, is highly risky. Studies from Mediterranean countries showed that up to 40% of seafood products were infected with hepatitis A viruses. In Egypt, 271 German holidaymakers were infected with contaminated orange juice in a hotel in 2005.
In children, the disease usually proceeds without symptoms or mildly. Elderly people and those with a damaged liver are threatened by a severe disease. Healthy adults suffer from inflammation of the liver, which is accompanied by general weakness and fatigue, typical of viral infections. It can lead to protracted disease progressions. Fortunately, chronic forms such as hepatitis B and C do not exist. Therapy is not available; only the symptoms (fever, aching limbs, etc.) can be treated.
Whereas in countries with poor hygiene, the population in children is already almost 100% infected. In Germany many older people over the age of 60 still do have immunity against hepatitis A, but only 2-5% of the next generation is still protected.
Since the vaccination is being well tolerated and the virus is already spread in the holiday countries “on the doorstep”, the Hepatitis A vaccination is recommended for travelers who are “east of the Oder and south of the Alps”.
The vaccines against hepatitis A are already approved for children from 12 months and older. They are administered in two doses at intervals of 6-12 months. Since the protection builds up within ten days, but the incubation period of hepatitis A is 20-40 days, the vaccination is also possible as a so-called “last-minute vaccination” on the day before departure. Vaccination protection lasts up to 25 years, presumably for life.
Since the endemic areas for hepatitis A and B are the same, combined vaccinations against both infections should also be considered. Two vaccinations at intervals of 4 weeks before the start of the journey and a third after 6 months are necessary.