An sudden spike in hepatitis A infection in several European countries has led to public health authorities issue urgent advisories and roll out containment strategies. The multicountry outbreak, spanning Austria, Czechia, Hungary, and Slovakia, has already infected more than 2,000 people since January 2025. The European Centre for Disease Prevention and Control (ECDC) confirmed on Friday that two genetically linked strains of the hepatitis A virus (HAV) are behind this multicountry outbreak, which alarms for ongoing community transmission and potential cross-border spillover.

Though hepatitis A is generally a preventable viral illness, its comeback in Europe is a grim reminder of how vaccination gaps, sanitation flaws, and outreach failures can prove lethal — particularly for older people and those who are vulnerable.

This outbreak, characterized by two similarly linked hepatitis A virus (HAV) strains, has not only affected local groups but also infected tourists traveling to popular tourist destinations in Europe. The problem is further complicated by reports of confirmed cross-border transmissions, with Germany reporting cases genetically associated with those in Austria and Hungary, indicating the likelihood for wider spread.

The cluster is focussed in four middle European countries: Slovakia (880), Czechia (600), Hungary (530), and Austria (87). Although all these countries have suffered the majority of the infections, cases that had the outbreak strain are also found within Germany, reflecting the virus's capacity to transcend borders via social networks and travel.

Nine fatalities have been reported to date — six in Czechia and three in Austria — underlining the potentially serious health impact of the disease, especially in older people or those with existing liver disease. The ECDC's rapid risk assessment also verifies genomic evidence of regionally linked transmissions, triggering a coordinated EU response.

What is Hepatitis A?

Hepatitis A is acute viral disease of the liver due to the hepatitis A virus (HAV). In contrast to its more persistent cousins, hepatitis B and C, hepatitis A does not result in chronic liver disease. But it can nevertheless generate full-blown disease and death—particularly among those at high risk.

The virus is mainly spread by ingestion of infected food or water, or direct contact with an infected person. HAV is found in the feces of infected individuals and is thus majorly a factor of poor sanitation and hygiene that leads to outbreaks. The illness quickly spreads in communities lacking clean water, safe food, and proper healthcare.

Contrary to hepatitis B and C, hepatitis A does not develop into chronic liver disease. Nevertheless, it may cause severe liver complications and even death in some people. Severity escalates with age. The ECDC has estimated the risk of serious illness as high in people older than 40 years and very high in individuals with pre-existing liver disease or weakened immunity.

Symptoms and Challenges in Early Detection

Not all people who get hepatitis A develop symptoms. But if symptoms do occur, they might include:

• Weakness and fatigue
• Abdominal pain and fever
• Jaundice, or yellow eyes and skin
• Clay-colored stools and dark urine
• Nausea and loss of appetite
• Diarrhea and joint pain

Since the virus takes weeks to manifest as symptoms, people may spread the virus unknowingly during incubation. That timing makes it harder to track the infections and contain possible routes of exposure.

Who Is Most at Risk?

Although anyone can get hepatitis A, there are groups that are more likely to suffer from severe illness. The ECDC states that individuals aged 40 years and older are at greater risk of developing serious complications, and the risk increases with age. Patients with existing liver disease and those who are immunosuppressed are especially at risk, as are older persons.

Social determinants also come into play. The epidemic has hit disproportionately hard among those living in homelessness, those who inject or use illicit drugs, and those living in filthy conditions or with limited healthcare access. These individuals usually do not have the resources necessary to receive vaccination or be at a hygiene standard to avoid infection.

For the population at large in the affected nations, risk is at present estimated as low to moderate. Yet, the situation is dynamic, and the risk for further transmission cannot be ruled out.

Slovakia has been struggling with hepatitis A since 2022, making it the epicenter of the current outbreak. Its 880 cases this year represent the largest burden across the affected nations. Czechia, meanwhile, has seen a significant jump in cases in 2025, including the majority of the deaths.

Even with the fewer cases reported, there have been three deaths in Austria — highlighting the fact that the virus does not have to be widespread to pose a threat. In Hungary, more than 500 cases of infection have been reported this year, leading health authorities to increase surveillance and prevention measures.

How the Virus Is Spreading?

Genetic sequencing has shown that the current outbreak is being fueled by person-to-person transmission in interconnected social networks and geographic regions. The fact that genetically similar strains were detected in Germany, where it is not an epicenter, is a testament to the ease with which the virus can travel across borders—particularly in an age of high mobility and international travel.

Though foodborne transmission cannot be ruled out, available evidence implicates close personal contact and unsatisfactory sanitation as main movers. This underscores the pivotal role that focused prevention and swift response play in high-risk populations.

The ECDC has called on member states to carry out epidemiologic studies, expand targeted contact with high-risk groups, and improve access to vaccination. Cross-border coordination has also been highlighted by the agency, since the outbreak does not respect geography or citizenship. Strategies that are recommended include:

• Targeted vaccine campaigns among high-risk groups
• Post-exposure prophylaxis (PEP) of close contacts
• Increased sanitation and hygiene in settlements and communities
• Increased genetic testing to track spread of virus
• Public education and awareness to increase early reporting and vaccination rates

ECDC's head of One Health Unit Ole Heuer highlighted the need for increased outreach: "This outbreak is a reminder that hepatitis A infection can lead to severe illness and death, particularly in individuals with poor access to health care and basic hygiene. Vaccination and sanitation services need to reach those who are most vulnerable."

How You Can Protect Yourself?

For people, the best defense against hepatitis A is vaccination. The hepatitis A vaccine is given in two doses, usually six to twelve months apart. The CDC says getting the vaccine — or immune globulin treatment — within two weeks of infection can ward off illness. Other important prevention measures are:

• Washing hands frequently with soap and water, particularly before meals
• Drinking clean, filtered water and avoiding suspect food sources while abroad
• Not getting direct exposure to the body fluid of infected people

The CDC also advises travelers to countries with outbreaks of hepatitis A to get vaccinated before they go.

As the peak travel season for summer draws near, it's a time of vigilance for public health officials and travelers alike. Vaccination, education, and enhanced sanitation are the pillars of prevention—not only for hepatitis A, but for the countless infectious diseases that still threaten global health security.

The Trump administration is reportedly preparing to announce changes to the childhood immunisation schedule early next year, with a proposal that would recommend fewer vaccines and bring U.S. policy closer to Denmark’s model. A source familiar with the discussions told NewsNation correspondent Libbey Dean that the revised schedule, expected next year, would involve fewer shots and would be “more in line with Denmark’s vaccination schedule,” according to The Hill. This has raised an important question: what does Denmark’s vaccine schedule look like, and is it realistic for the U.S. to follow it?

Denmark Vaccine Schedule: What Is It?

Denmark runs a clearly defined childhood vaccination programme that is free and voluntary, aimed at protecting children from serious infectious diseases. Infants are given combination vaccines that cover diphtheria, tetanus, whooping cough, polio, and Haemophilus influenzae type b, along with the pneumococcal vaccine, at 3, 5, and 12 months. Children receive their first dose of the measles, mumps, and rubella (MMR) vaccine at 15 months, with a second dose at 4 years.

A booster shot for diphtheria, tetanus, whooping cough, and polio is administered at 5 years. Around the age of 12, both boys and girls are offered the HPV vaccine to reduce the risk of cancers linked to the virus. Vaccines for chickenpox, rotavirus, hepatitis A, or meningococcal disease are not routinely included in Denmark’s standard schedule, according to official guidance from the Danish Health Authority’s Childhood Vaccination Programme.

RFK Jr. Is Considering Denmark Vaccine Schedule For US

Reports suggest that the Department of Health and Human Services (HHS) is exploring additional changes to federal childhood vaccine recommendations, with a focus on aligning them more closely with those followed by other developed nations, especially Denmark, as per The Washington Post. This discussion comes after a meeting earlier this month of the CDC’s Advisory Committee on Immunization Practices (ACIP), where childhood vaccine schedules in the U.S. and Denmark were reviewed and adjustments to the U.S. schedule were made. It was followed by a memorandum from President Trump directing HHS to begin a “process to align U.S. core childhood vaccine recommendations with best practices from peer, developed countries.”

Denmark Vaccine Schedule: What Happens If the US Adopts It?

If the U.S. were to adopt Denmark’s schedule in full, it would result in fewer vaccines being recommended for children up to age 18. When comparing vaccines that are universally advised in both countries, Denmark’s programme covers protection against 10 diseases, while the U.S. schedule includes vaccines for 16 diseases, following the removal of hepatitis B from universal recommendations. The additional vaccines recommended in the U.S. address respiratory syncytial virus (RSV), rotavirus, varicella, hepatitis A, and meningococcal disease. Although the U.S. advises more childhood vaccines than many comparable countries, Denmark stands out for recommending fewer than most. Data from the European Centre for Disease Prevention and Control (ECDC) vaccine scheduler shows that none of the other 29 ECDC member countries limits its routine childhood schedule to just 10 diseases. Several countries, including Germany, Greece, Ireland, Italy, and Poland, recommend vaccines against 15 or more diseases, while Austria’s schedule covers 17 diseases, which is even more than the U.S. currently recommends.

Every country follows its own process when setting vaccine recommendations, shaped by its specific circumstances. Childhood immunisation schedules are built over years by reviewing available evidence and weighing factors such as healthcare systems, insurance coverage, public health infrastructure, and national priorities. This explains why vaccine schedules vary across countries, and so far, no developed nation has based its decisions solely on what another “peer” country does.

Importantly, Denmark’s approach is not based on a different interpretation of vaccine science or effectiveness. Instead, Danish health authorities prioritise recommending vaccines that significantly lower the risk of death or serious illness in children. For instance, while rotavirus infections do occur among children in Denmark, they rarely result in death or long-term harm in a setting with universal healthcare access, strong medical systems, and lower inequality than in the U.S. By contrast, neighbouring countries such as Norway and Finland do include the rotavirus vaccine in their routine schedules, as does the U.S., where before the vaccine was introduced, rotavirus caused an estimated 2.7 million infections each year, leading to 55,000 to 70,000 hospitalisations and 20 to 60 deaths among children under five.

Delhi yet again woke up to a thick smog blanketed Saturday morning. The AQI stood at 380 for the city, which puts it under the 'very poor' category, as of 7am, according to the Central Pollution Control Board (CPCB). Several parts of the city also recorded with in the 'severe' limits of air pollution, with multiple stations recording AQI above 400. These areas include Anand Vihar and Sarai Kale Khan recorded 428 AQI, ITO recorded 429, Akshardham recorded 420, Ashok Vihar recorded 407, and Rao Tularam Marg recorded 403.

While GRAP Stage IV is enforced in the capital to combat the pollution problem, amid this, Minister of State for Environment and Climate Change Kriti Vardhan Singh told the Rajya Sabha on Thursday that there is no direct correlation between higher Air Quality Index or AQI levels and lung diseases. He said that there is no "conclusive data" to establish such a link. However, he did say that air pollution is one of the "triggering factors" for respiratory ailments and associated diseases.

Read: AQI Explained: It’s Not Temperature, As Delhi CM Says, Here’s What the Air Quality Index Really Means

What Do Doctors And Research Say On The Link of Lung Diseases And Air Pollution

"Lung cancer is no longer a smoker’s but a breather’s disease," said Dr Arvind Kumar, chairman, Lung Transplant, Chest Surgery and Oncosurgery at Medanta, Gurugram, as reported by The Indian Express. He treated a 31-year-old patient from Ghaziabad with lung cancer, who had never smoked in her life.

Read: Lung Cancer No Longer A Smoker's Disease, It's A Breather's Disease: Story Of A 31-year-old Non-smoker NCR Woman Who Had Stage 2 Lung Cancer

"Younger non-smokers are being diagnosed. And there are as many women as men. This indicates that lung cancer is no longer a smoker’s but a breather’s disease. While we talk of particulate matter, the ambient air in the urban environment is full of carcinogenic gases. And this is emerging as a real threat to everybody," the doctor said.

Dr Shivanshu Raj Goyal, a pulmonologist and Associate Director Pulmonary Medicine at MAX Healthcare in Gurugram and Delhi, in an Instagram video said that breathing this toxic air is equivalent to smoking 20 cigarettes in a day. The doctor starts his video with a rather strong statement, "At present, no one in Delhi-NCR is a non-smoker."

The doctor also states that on an average, a person breathes around 20,000 times in a day, so it means we are inhaling the toxic air at least 20,000 times a day.

As per a 2017 study titled Pulmonary Health Effects of Air Pollution, it is clear that lung cancer could be exacerbated due to exposure to a variety of environmental air pollutants with greatest effects due to particulate matter (PM), ozone, and nitrogen oxides.

Also Read: Lancet Study Estimates 15 Lakh Annual Air Pollution Deaths in India; Centre Calls Data 'Inconclusive'

As per Action on Smoking and Health (ASH), a cigarette contains nicotine, and tar, which is composed of chemicals like benzene, benzopyrene, and the gas includes carbon monoxide, ammonia, dimethyl nitrosamine, cadmium, formaldehyde, hydrogen cyanide and acrolein. Some of these marked irritant properties are also carcinogen, meaning, it can cause cancer.

Whereas Air Pollution contains pollutants like particulate matter PM 10 and PM 2.5, ozone, nitrogen dioxide, carbon monoxide, cadmium and sulfur dioxide. Air pollution, which is often a byproduct of combustion or released from vehicle exhaust also contain formaldehyde, benzopyrene, and benzene. As per the World Health Organization (WHO), the pollutants contain carcinogens, and the outdoor air pollution is in fact classified as Group 1 carcinogen.

Read: Breathing Delhi's Toxic Air Is Like Smoking 20 Cigarettes A Day

Common Chemicals We Inhale When We Breathe Delhi's Toxic Air And When We Smoke A Cigarette

Carbon Monoxide: a poisonous, flammable gas that is colorless, odorless, tasteless, and slightly less dense than air.

Benzene: a colorless and highly flammable liquid with a sweet smell, and is partially responsible for the aroma of gasoline.

Cadmium: a soft, silvery-white metal (atomic number 48) that is toxic and naturally found in the environment, but human activities have increased its levels. It is used in products like batteries, pigments, and coatings, and exposure can occur through tobacco smoke, contaminated food, and occupational inhalation. Cadmium is a known human carcinogen that can damage the kidneys and bones.

Formaldehyde: a colorless, flammable gas with a strong odor, whose exposure could cause cancer.

Benzopyrene: a group of organic compounds known as polycyclic aromatic hydrocarbons. It is a colorless crystalline solid found in sources like cigarette smoke, coal tar and is a known carcinogen that can cause cancer and other health problems like skin rashes and bronchitis, and exposure requires medical attention for any symptoms.

H3N2 flu is spreading in Canada, and hospitalization has nearly doubled up. The Health Canada data shows that influenza is up by almost 30 per cent. The week ending December 13, Canada saw 11,646 new cases of flu, which equals to 27.7 per cent of all tests conducted in the country were positive. Now, as compared to the week before, there is an increase of 71 per cent, which saw 6,799 new cases and a positivity rate of 20.2 per cent.

The hospitalization rate has also gone up from 3.6 people per 10,000 of the population to 6.2 in this week. The number of reported outbreaks is now up from 91 to 186 and 44 regions across 11 provinces and territories reported influenza.

Which Flu Strain Is Hitting Canada Hard?

Doctors explain that subclade K enhances the ability of the virus to slip through our immune protection. However, it does not mean that vaccination offers no protection against the flu. In fact, experts and doctors have been emphasizing the need to get yourself vaccinated to help you protect from the worst effects of the virus.

“If you look at deaths and severe illness with flu, the vast majority both in adults and in children are unvaccinated,” said Dr Fahad Razak, internal medicine physician and professor at the University of Toronto.

“Yes, you may get sick, even if you are vaccinated, it’s that the severity, the chance that you’re going to end up in hospital and worst-case scenario in the ICU or die does seem to be significantly protected against by being vaccinated.”

Health Canada too noted that vaccination can prevent anyone infected with influenza from developing any further complications.

Are Any Other Countries Impacted?

UK and US are among the other countries impacted with the subclade K or the super flu. The National Health Service (NHS), UK, has already sent out a 'flu jab SOS' to vulnerable people.

NHS has confirmed that the super flu is circulating in England this year, and due to less immunity, it is making it easier to spread across people. The UK Health Security Agency (UKHSA) has urged people to get a flu jab. As per the early data, this year's vaccine has offered good protection despite the new strain.

Daniel Elkeles, chief executive of NHS Providers, said that the major concern is that H3N2 is associated with a more severe illness and superflu could be "a very nasty strain of flu". He said that UK could be experiencing a "tidal wave" of illness.

The main strain circulating this winter is a drifted H3N2 variant, which the UKHSA says has left the community with “less natural immunity.” H3N2 strains tend to cause more serious illness in older adults than H1N1 strains and are linked to higher hospitalizations and deaths. This pattern adds further strain to the NHS during the winter months.

How To Know If It Is Flu Or COVID?

Dr Rupa Parmar, a GP and medical director at Midland Health tells The Mirror, that shortness of breath could be a key symptom that could differentiate between the two.

Dr Parmar highlights that it is a key indicator for COVID. "Shortness of breath is rare in both a cold and the flu, but as COVID more so affects the lungs due to inflammation, it is a common symptom."

The NHS website supports her advice, noting that breathlessness is a symptom more often tied to Covid, not the flu or a common cold. This kind of breathing difficulty is usually associated with infections like Covid or respiratory syncytial virus (RSV).