Hepatitis A in France. Epidemiological data for 2014.

In 2014, 933 cases of hepatitis A were reported (834 in mainland France, 99 in the overseas departments). In the overseas departments, 76% of cases were reported by Mayotte. For mainland France, the annual incidence rate of reported cases was 1.3 per 100,000 inhabitants.

Compared to 2013, the number of cases reported in 2014 in mainland France remained stable (834 vs. 836). Annual incidence rates in 2014 were generally similar among men (1.4 per 100,000) and women (1.3 per 100,000) but higher among those under 15 years of age (2.8 per 100,000) than in other age groups (0.9 per 100,000).

The two main risk exposures in the 2 to 6 weeks preceding the onset of the disease were a stay outside mainland France (44%) and the presence of hepatitis A cases among close contacts (35%), with 86% of these cases occurring within the family. Among the cases who had traveled outside mainland France, more than half (55%) had visited a country in the Maghreb. These results show that vaccination recommendations—vaccination of family members of a case and during a stay in an area with poor hygiene—are rarely or never followed.

The year 2014 was marked by a foodborne outbreak affecting staff and customers of a food establishment in the Hérault department (30 people affected). In addition, a large-scale European outbreak (331 confirmed cases with the same epidemic strain) linked to the consumption of frozen red berries occurred in 10 European countries, including France (3 confirmed cases in the Aisne department).

In 2014, 27% of reported cases were part of a cluster of cases investigated by Regional Health Agencies and Interregional Epidemiology Units.

Number of reported cases of acute hepatitis A by reporting region/department, France, 2014 (table)

Region/Reporting Department

2014

N = 933

Alsace

Bas-Rhin (67)

11

Haut-Rhin (68)

31

Aquitaine

Dordogne (24)

2

Gironde (33)

18

Landes (40)

2

Lot-et-Garonne (47)

1

Pyrénées-Atlantiques (64)

11

Auvergne

Allier (03)

5

Cantal (15)

Haute-Loire (43)

1

Puy-de-Dôme (63)

6

Lower Normandy

Calvados (14)

4

Manche (50)

3

Orne (61)

2

Burgundy

Côte-d'Or (21)

4

Nièvre (58)

2

Saône-et-Loire (71)

2

Yonne (89)

4

Brittany

Côtes-d'Armor (22)

2

Finistère (29)

9

Ille-et-Vilaine (35)

7

Morbihan (56)

4

Centre

Cher (18)

17

Eure-et-Loir (28)

8

Indre (36)

2

Indre-et-Loire (37)

6

Loir-et-Cher (41)

6

Loiret (45)

3

Champagne-Ardenne

Ardennes (08)

4

Aube (10)

2

Marne (51)

5

Haute-Marne (52)

Corsica

Southern Corsica (2A)

2

Upper Corsica (2B)

Overseas Departments

Guadeloupe (971)

Martinique (972)

1

French Guiana (973)

10

Reunion (974)

13

Mayotte (976)

75

Franche-Comté

Doubs (25)

7

Jura (39)

6

Haute-Saône (70)

1

Territory of Belfort (90)

1

Upper Normandy

Eure (27)

5

Seine-Maritime (76)

18

Ile-de-France

Paris (75)

33

Seine-et-Marne (77)

9

Yvelines (78)

41

Essonne (91)

8

Hauts-de-Seine (92)

26

Seine-Saint-Denis (93)

27

Val-de-Marne (94)

22

Val-d'Oise (95)

25

Languedoc-Roussillon

Aude (11)

2

Gard (30)

4

Hérault (34)

40

Lozère (48)

Pyrénées-Orientales (66)

5

Limousin

Corrèze (19)

1

Creuse (23)

Haute-Vienne (87)

6

Lorraine

Meurthe-et-Moselle (54)

7

Meuse (55)

Moselle (57)

7

Vosges (88)

2

Midi-Pyrénées

Ariège (09)

3

Aveyron (12)

1

Haute-Garonne (31)

19

Gers (32)

1

Lot (46)

2

Hautes-Pyrénées (65)

1

Tarn (81)

2

Tarn-et-Garonne (82)

1

Nord-Pas-de-Calais

Nord (59)

55

Pas-de-Calais (62)

2

Pays de la Loire

Loire-Atlantique (44)

6

Maine-et-Loire (49)

10

Mayenne (53)

9

Sarthe (72)

3

Vendée (85)

1

Picardy

Aisne (02)

7

Oise (60)

4

Somme (80)

3

Poitou-Charentes

Charente (16)

2

Charente-Maritime (17)

1

Deux-Sèvres (79)

1

Vienne (86)

1

Provence-Alpes-Côte d'Azur

Alpes-de-Haute-Provence (04)

7

Hautes-Alpes (05)

2

Alpes-Maritimes (06)

14

Bouches-du-Rhône (13)

38

Var (83)

2

Vaucluse (84)

15

Rhône-Alpes

Ain (01)

4

Ardèche (07)

2

Drôme (26)

7

Isère (38)

40

Loire (42)

24

Rhône (69)

39

Savoie (73)

6

Haute-Savoie (74)

10

Source: InVS, mandatory reporting of acute hepatitis A.

Number of reported cases of acute hepatitis A by month of diagnosis, France, 2014 (figure)

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Source: InVS, mandatory reporting of acute hepatitis A

Incidence rate of reported cases of acute hepatitis A by metropolitan department of residence, France, 2014 (map)

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Incidence rate of reported cases of acute hepatitis A by sex and age group, metropolitan France, 2014 (figure)

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Source: InVS, mandatory reporting of acute hepatitis A

Number of reported cases of acute hepatitis A by month of diagnosis and by history of travel outside metropolitan France, metropolitan France, 2014 (figure)

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Source: InVS, mandatory reporting of acute hepatitis A

Characteristics and risk exposures of reported cases of acute hepatitis A by age group, France, 2014 (table)

Characteristics and risk exposures

0–5 years N=117%1

6–15 years N=322%1

16–25 years N=158%1

26–45 years N=178%1

45 years and older N=158%1

Total N= 933%1

Clinical Jaundice (alone or associated with other nonspecific symptoms2) Symptoms2 (without jaundice) Absence of jaundice or symptoms

71 1910

76 213

80 191

83 152

62 317

75 214

Hospitalization

31

37

65

55

49

46

Risk exposures: Close contacts, Travel outside mainland France, Child under 3 years old at home, Consumption of seafood, Work/Frequentation: - facility for people with disabilities - daycare

49 40 49 8 03

47 47 40 7 41

27 52 21 14 61

27 48 34 29 23

14 27 6 34 40

35 44 31 18 42

Included in an "identified" cluster of cases

38

39

19

22

9

27

1Percentages calculated for reported cases, 2asthenia, anorexia, fever, vomiting, abdominal pain, diarrhea.

Source: InVS, mandatory reporting of acute hepatitis A.