Hepatitis A in France. Epidemiological data for 2015.

In 2015, 743 cases of hepatitis A were reported (701 in mainland France, 42 in the overseas departments). In the overseas departments, 52% of cases were reported by Mayotte. For mainland France, the annual incidence rate of reported cases was 1.1 per 100,000 inhabitants.

Compared to 2014, the number of cases reported in 2015 in mainland France decreased by 19% (834 vs. 701). The decrease in the number of cases was observed in 13 out of 22 regions and affected all age groups except those over 45 years of age (no change between the two years).Annual incidence rates in 2015 were generally similar among men (1.2/100,000) and women (1.1/100,000) but higher among those under 15 (3.1/100,000) than in other age groups (0.9/100,000).

The two main risk exposures in the 2 to 6 weeks preceding the onset of the disease were a stay outside mainland France (42%) and the presence of hepatitis A cases in the immediate environment (42%), with 77% of these cases occurring within the family circle. Among cases who had traveled outside mainland France, nearly half (47%) had visited a country in the Maghreb. These results support the implementation of vaccination recommendations, including vaccination of family members of a case and during travel to areas with poor sanitation.

In 2015, 33% of reported cases were part of a cluster investigated by Regional Health Agencies and Interregional Epidemiology Units.

The year 2015 was marked by two clusters of cases. A first cluster of 9 cases in the Landes region, 8 of which involved an identical strain never before identified in France, closely related to a strain endemic in Japan and to strains from Southeast Asia and the Pacific. Despite a thorough investigation, the source of contamination was not identified. A second cluster occurred in a town in Ille-et-Vilaine, with 17 cases occurring within a short timeframe, 13 of which were among students and staff at four schools.

Number of reported cases of acute hepatitis A by region/reporting department, France, 2015 (table)

Region/Reporting Department

2015

N = 743

Alsace

Bas-Rhin (67)

8

Haut-Rhin (68)

14

Aquitaine

Dordogne (24)

8

Gironde (33)

6

Landes (40)

9

Lot-et-Garonne (47)

Pyrénées-Atlantiques (64)

3

Auvergne

Allier (03)

1

Cantal (15)

2

Haute-Loire (43)

Puy-de-Dôme (63)

4

Lower Normandy

Calvados (14)

4

Manche (50)

Orne (61)

Burgundy

Côte-d'Or (21)

2

Nièvre (58)

1

Saône-et-Loire (71)

7

Yonne (89)

2

Brittany

Côtes-d'Armor (22)

10

Finistère (29)

2

Ille-et-Vilaine (35)

22

Morbihan (56)

3

Centre

Cher (18)

6

Eure-et-Loir (28)

5

Indre (36)

1

Indre-et-Loire (37)

4

Loir-et-Cher (41)

7

Loiret (45)

3

Champagne-Ardenne

Ardennes (08)

2

Aube (10)

1

Marne (51)

7

Haute-Marne (52)

1

Corsica

Southern Corsica (2A)

Upper Corsica (2B)

3

Overseas Departments

Guadeloupe (971)

1

Martinique (972)

French Guiana (973)

5

Reunion (974)

14

Mayotte (976)

22

Franche-Comté

Doubs (25)

8

Jura (39)

3

Haute-Saône (70)

Territory of Belfort (90)

1

Upper Normandy

Eure (27)

3

Seine-Maritime (76)

10

Ile-de-France

Paris (75)

22

Seine-et-Marne (77)

5

Yvelines (78)

9

Essonne (91)

10

Hauts-de-Seine (92)

7

Seine-Saint-Denis (93)

22

Val-de-Marne (94)

6

Val-d'Oise (95)

18

Languedoc-Roussillon

Aude (11)

1

Gard (30)

6

Hérault (34)

25

Lozère (48)

1

Pyrénées-Orientales (66)

3

Limousin

Corrèze (19)

1

Creuse (23)

Haute-Vienne (87)

3

Lorraine

Meurthe-et-Moselle (54)

25

Meuse (55)

Moselle (57)

4

Vosges (88)

3

Midi-Pyrénées

Ariège (09)

Aveyron (12)

Haute-Garonne (31)

9

Gers (32)

Lot (46)

Hautes-Pyrénées (65)

2

Tarn (81)

Tarn-et-Garonne (82)

16

Nord-Pas-de-Calais

Nord (59)

158

Pas-de-Calais (62)

19

Pays de la Loire

Loire-Atlantique (44)

9

Maine-et-Loire (49)

4

Mayenne (53)

1

Sarthe (72)

2

Vendée (85)

1

Picardy

Aisne (02)

2

Oise (60)

8

Somme (80)

3

Poitou-Charentes

Charente (16)

Charente-Maritime (17)

4

Deux-Sèvres (79)

2

Vienne (86)

4

Provence-Alpes-Côte d'Azur

Alpes-de-Haute-Provence (04)

1

Hautes-Alpes (05)

Alpes-Maritimes (06)

11

Bouches-du-Rhône (13)

23

Var (83)

2

Vaucluse (84)

10

Rhône-Alpes

Ain (01)

2

Ardèche (07)

3

Drôme (26)

5

Isère (38)

10

Loire (42)

3

Rhône (69)

23

Savoie (73)

12

Haute-Savoie (74)

8

Source: InVS, mandatory reporting of acute hepatitis A.

Number of reported cases of acute hepatitis A by month of diagnosis, France, 2015 (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, 2015 (map)

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Incidence rate of reported cases of acute hepatitis A by sex and age group, metropolitan France, 2015 (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, 2015 (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, 2015 (table)

Characteristics and risk exposures

0–5 years N=88%1

6–15 years N=242%1

16–25 years N=117%1

26–45 years N=132%1

45 years and older N=164%1

Total N= 743%1

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

54 2323

80 182

82 180

72 207

49 3318

69 229

Hospitalization

20

44

58

51

47

45

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

62 46 43 1 05

61 48 37 8 20

37 50 27 3 13

33 42 28 19 32

12 24 6 35 21

42 42 28 14 21

Included in an "identified" cluster of cases

53

51

26

25

9

33

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

Source: InVS, mandatory reporting of acute hepatitis A.