Highest in 20 years - The infection outbreak spreading across Israel

According to data from the Health Ministry's "Health Intelligence" unit, the cases primarily occurred in several regions, including Bedouin communities in the south, Jewish settlements in Samaria, and the Shuafat area in Jerusalem.

Hepatitis A, a liver infection caused by a virus, has been a concern in Israel in recent years. However, this year’s uptick is alarming, as it marks the highest incidence rate recorded since 2004. Of the 196 reported cases, about 30% were in Bedouin settlements such as Abu Qrenat and Bir al-Dahij, 26% in Jewish communities in Samaria, particularly in Itamar, and 7% in the Shuafat area in Jerusalem. Additionally, there were eight cases among Thai foreign workers in the Arava region and around Gaza. The high rate of hepatitis A infections in Samaria, where the vaccination rate is around 60%, has been linked to the outbreak.

The Ministry of Health noted that while the number of cases is on the rise, the morbidity rate in Israel remains similar to that of other Western countries. The national morbidity rate in 2024 stood at 1.96 cases per 100,000 people, which, although concerning, is consistent with rates in other developed nations.

An in-depth genomic analysis revealed two distinct outbreaks, with different sources of infection in the southern regions compared to Samaria and Jerusalem. This suggests that the outbreaks are not linked but have independently emerged in separate communities.

Vaccination remains the primary preventive measure against hepatitis A in Israel. Routine vaccinations began in 1999, with two doses administered at six months and again at two years of age. National vaccination rates are about 88% for the first dose and 85% for the second dose. However, the vaccination rate in Samaria is significantly lower, standing at just 60%, which has contributed to the increased incidence in these areas. On the other hand, vaccination rates in Bedouin communities in the south remain high, at around 90%.

Hepatitis A is caused by a virus that attacks the liver, leading to symptoms such as fever, fatigue, loss of appetite, nausea, vomiting, diarrhea, and abdominal pain. In more severe cases, acute liver failure can occur, leading to a life-threatening situation that may require a liver transplant. However, severe complications are rare, and the disease is usually not severe.

Most children under the age of five experience asymptomatic infections, but adults often develop symptoms, and complications can be more severe in this age group. The virus spreads through contaminated food or water or close contact with an infected person. There is no specific treatment for hepatitis A, and prevention through vaccination remains the most effective method to control the spread of the virus.

Professor Nadav Davidovitch from Ben-Gurion University emphasized that while there is no immediate concern of a nationwide outbreak, the increase in cases is a significant warning signal. He attributes the rise in cases to decreased vaccination rates, which have been affected by the COVID-19 pandemic, a shortage of healthcare personnel, and vaccine misinformation. Davidovitch pointed out that the same issues have contributed to drops in vaccination coverage for other diseases like pertussis and measles. He stressed the need for a national plan to address these gaps in vaccination and ensure that populations in affected areas, like Beitar Illit, receive targeted interventions.

The Ministry of Health’s call to action is clear: the recent rise in hepatitis A cases highlights the need for urgent attention to vaccination efforts and awareness campaigns. As the situation unfolds, it will be crucial to monitor and address low vaccination rates to prevent further outbreaks and protect public health across Israel.