Hepatitis A and E in the Mediterranean: A systematic review.

Hepatitis A (HAV) and Hepatitis E (HEV) considered to be major public health threats worldwide. Although, both infections are more common in developing countries, an increased number of HAV and HEV cases have been reported in developed countries. This systematic review analyzes epidemiological profiles of HAV and HEV in the Mediterranean countries. By using PRISMA guideline, we searched for articles from 2010 to 2020 referring HAV and HEV outbreaks from online databases: Scopus, PubMed and Springerlink. From 33265 unique publications initially captured, data was extracted from 101 articles investigating country and year of outbreak, transmission mode, vehicle of infection, mean age and sex of patients, symptoms reported, vaccination applied and diagnostic method. Our results indicate that occurrence of HAV and HEV in Mediterranean countries had increased with main transmission vehicle reported as food or water and transmission point as refugee camps. More results (countries, differences, other characteristics). Thus, public health authorities should give a priority to face up challenges regarding the prevalence of both viruses and control strategies to prevent upcoming outbreaks.