The timing is awkward. With Easter lunch just around the corner – traditionally based on fish, especially in the South – the Istituto Superiore di Sanità has published a bulletin that leaves no room for indifference and which tells how cases of hepatitis A in Italy have been constantly growing for over a year, with March 2026 marking a new peak.
The official data: the SEIEVA photograph
The situation is captured by the SEIEVA surveillance system – Integrated Epidemiological System of Acute Viral Hepatitis, coordinated by the ISS alongside the PREMAL surveillance of the Ministry of Health. The numbers are clear: in 2025, 631 cases of hepatitis A were reported, compared to 443 the previous year. The annual peak was reached in September, with 89 reports. Then a temporary decline, until December.
In the first three months of 2026 the curve began to rise again. In March there were around 160 cases with onset of symptoms – a figure still in the consolidation phase, but indicative of a further acceleration.
The prevailing trigger factor is clearly identified: the consumption of seafood. In the first three months of 2026, 262 cases reported this exposure as a risk factor, compared to 43 in the same period of 2024. A figure that is worth almost six times as much.
The ISS bulletin also reports a second growing line of transmission: the sexual route between men who have relationships with other men (MSM), which in 2025 represented 23.1% of total cases.
The most affected regions
The geographical concentration is clear. Campania, Lazio and Puglia are the three regions that fuel the bulk of the epidemic, Campania, in particular, already recorded 154 cases from the beginning of the year to March 20, 2026. In Naples, the Cotugno Hospital managed dozens of hospitalizations in the month of March alone. The ASL Lecce has strengthened prevention measures by reporting that, in just three months of 2026, the cases in the province were already equal to the four recorded in the whole of 2025. In Latina the contagion spread in parallel with that of Campania. The mayor of Gaeta has signed an ordinance that prohibits the serving of raw seafood in all public establishments in the province.
As noted in the aforementioned report, the Ministry of Health has activated a working group involving the ISS, regional prevention services and zooprophylactic institutes, with particular attention to the shellfish supply chain.
How it is transmitted and how it is recognized
Hepatitis A is caused by the HAV virus, with fecal-oral transmission: it is contracted by ingesting contaminated food or water, but also through direct contact with infected people. The incubation period varies between 15 and 50 days, a time window that often makes it difficult to trace the contaminated food.
Symptoms in the acute phase include fever, nausea, vomiting, intense tiredness, loss of appetite, dark urine, and jaundice. The virus does not become chronic, as the immune system eliminates it, and in the vast majority of cases the course is benign. Severe forms remain rare, but the risk increases in subjects with previous liver disease and in the elderly.
Freezing does not inactivate the virus. Cooking at over 85°C for at least one minute is the only safe method to eliminate it from shellfish. The blast chiller — used in the preparation of sushi — is not sufficient.
Tips for the holidays
According to the bulletin of the Istituto Superiore di Sanità, vaccination is recommended for close contacts of confirmed cases, for those who regularly consume raw shellfish and for travelers heading to areas with a high prevalence of the virus. The next few weeks, with the holiday peak and the traditional fish-based Easter lunch, will be decisive in understanding whether the infection curve continues its rise or begins to stabilize.
