Hepatitis A in Western Balkans and Türkiye, 2015–2024
Key facts
- Of the seven Western Balkans and Türkiye countries, four reported hepatitis A data throughout the 2015–2024 period (Albania, Montenegro, North Macedonia, and Serbia), of which two (Montenegro and North Macedonia) reported case-based data.
- Average notification rates in the Western Balkans and Türkiye were lower than the EU/EEA average, apart from the year 2019.
- The highest notification rates in the Western Balkans and Türkiye were in children between 5–14 years of age. This is similar to what is observed in EU/EEA countries.
- A higher notification rate was observed in males in the Western Balkans and Türkiye, especially in the 25–44 year old age group. Although this is similar to EU/EEA countries, the high notification rate in this group was more pronounced in the EU/EEA.
Introduction
This report provides a summary of disease data provided to the European Centre for Disease Prevention and Control by the Western Balkans (Albania, Bosnia and Herzegovina, Kosovo*, Montenegro, North Macedonia, and Serbia) and Türkiye between 2015 and 2024.
Hepatitis A is an inflammation of the liver caused by the hepatitis A virus. In children, hepatitis A virus infection is often asymptomatic or mild. In adults, the onset of illness is usually abrupt, characterised by fever, malaise, and abdominal discomfort. Jaundice is the predominant symptom. Very severe disease is unusual, but the infection can lead to acute liver failure and death, particularly in the elderly and patients with liver disease. Symptoms may last from one or two weeks or for months.
The hepatitis A virus is highly transmissible and has an average incubation period of four weeks, ranging from two to six weeks. Transmission most often occurs via the faecal-oral route through contaminated food and water or via person-to-person contact (e.g. among household contacts, sexual contacts, daycare centres or schools). A vaccine against Hepatitis A infection is available.
*This designation is without prejudice to positions on status, and is in line with UNSCR 1244 and the ICJ Opinion on the Kosovo Declaration of Independence.
Methods
This report is based on data for 2015–2024 retrieved from EpiPulse cases on 22 March 2026.
EpiPulse cases is an online portal for European public health authorities and partner organisations for the collection, analysis and dissemination of data on communicable diseases.
A subset of the data used for this report is available through ECDC’s online Surveillance atlas of infectious diseases.
At the time of their latest upload, four countries used EU case definitions: Montenegro, North Macedonia, and Serbia used the EU 2018 case definition and Bosnia and Herzegovina used an unspecified EU case definition; The remaining three reporting countries used unspecified or other case definitions.
Reporting hepatitis A was compulsory and comprehensive in all countries. In most countries, cases were reported by physicians and laboratories. In Montenegro, only physicians reported cases.
Data Quality
Of the seven Western Balkans and Türkiye countries, four reported hepatitis A data throughout the 2015–2024 period (Albania, Montenegro, North Macedonia, and Serbia), of which two (Montenegro and North Macedonia) reported case-based data.
Reporting completeness for basic demographics and case classification was good, with information available for more than 80% of cases reported between 2019–2024.
Reporting Completeness
Reporting completeness for Hepatitis A of Western Balkans and Türkiye, 2015–2024
Source: Country reports.
Reported data type: A = Aggregated, C = Case-based.
Data Completeness
Data completeness of Hepatitis A cases by country and year, Western Balkans and Türkiye, EU/EEA, 2015–2024
Source: Country reports.
Completeness percentage is percentage of entries where value is entered.
Epidemiology
Over the 2015–2024 period, the overall number of cases reported by the Western Balkans and Türkiye decreased from more than 1 000 cases in 2025 to approximately 100 and fewer since 2020. This decrease was in part driven by Türkiye not reporting cases since 2018. Of the 58 cases reported for 2024, 51 (88%) were reported by Serbia.
Average notification rates in the Western Balkans and Türkiye were lower than the EU/EEA average, apart from in 2019. North Macedonia had the highest notification rate reported over the period, with 10.4 cases per 100 000 population in 2019.
Confirmed Hepatitis A cases and rates per 100 000 population by country and year, by Western Balkans and Türkiye, and EU/EEA, 2015–2024
Location | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Number | Rate | Number | Rate | Number | Rate | Number | Rate | Number | Rate | Number | Rate | Number | Rate | Number | Rate | Number | Rate | Number | Rate | |
Albania | 98 | 3.4 | 24 | 0.8 | 17 | 0.6 | 0 | 0 | 5 | 0.2 | 5 | 0.2 | 1 | 0 | 2 | 0.1 | 1 | 0 | 1 | 0 |
Bosnia and Herzegovina | NDR | NRC | NDR | NRC | NDR | NRC | NDR | NRC | NDR | NRC | NDR | NRC | NDR | NRC | NDR | NRC | NDR | NRC | 2 | 0.1 |
Kosovo | NDR | NRC | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | NDR | NRC | NDR | NRC | NDR | NRC | NDR | NRC | 0 | 0 |
Montenegro | 9 | 1.4 | 43 | 6.9 | 52 | 8.4 | 7 | 1.1 | 1 | 0.2 | 1 | 0.2 | 1 | 0.2 | 49 | 7.9 | 2 | 0.3 | 1 | 0.2 |
North Macedonia | 154 | 7.4 | 17 | 0.8 | 27 | 1.3 | 72 | 3.5 | 215 | 10.4 | 54 | 2.6 | 4 | 0.2 | 12 | 0.7 | 5 | 0.3 | 3 | 0.2 |
Serbia | 84 | 1.2 | 103 | 1.5 | 100 | 1.4 | 113 | 1.6 | 115 | 1.7 | 17 | 0.2 | 8 | 0.1 | 44 | 0.6 | 23 | 0.3 | 51 | 0.8 |
Türkiye | 707 | 0.9 | 411 | 0.5 | 471 | 0.6 | NDR | NRC | NDR | NRC | NDR | NRC | NDR | NRC | NDR | NRC | NDR | NRC | NDR | NRC |
Western Balkans and Türkiye | 1 052 | 1.2 | 598 | 0.6 | 667 | 0.7 | 192 | 1.3 | 336 | 2.3 | 77 | 0.6 | 14 | 0.1 | 107 | 0.9 | 31 | 0.3 | 58 | 0.3 |
European Union / European Economic Area | 11 980 | 2.7 | 11 782 | 2.7 | 24 692 | 5.6 | 14 758 | 3.4 | 8 162 | 1.9 | 4 280 | 1 | 3 810 | 0.9 | 4 502 | 1 | 6 050 | 1.4 | 12 568 | 2.8 |
Source: Country reports.
NDR: No data reported.
NRC: No rate calculated.
Confirmed cases per 100 000 population by country, Western Balkans and Türkiye, 2015–2024
2015
Number of cases
Rate per 100 000
2016
Number of cases
Rate per 100 000
2017
Number of cases
Rate per 100 000
2018
Number of cases
Rate per 100 000
2019
Number of cases
Rate per 100 000
2020
Number of cases
Rate per 100 000
2021
Number of cases
Rate per 100 000
2022
Number of cases
Rate per 100 000
2023
Number of cases
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