Health experts in Spain are sounding the alarm over a sharp rise in hepatitis A cases among children.
The surge has prompted the Asociación Española de Pediatría (AEP) to recommend adding the vaccine to the national childhood vaccination schedule.
It is proposing routine immunisation for babies aged 12 to 15 months, alongside a catch-up programme for older unvaccinated children and teens.
In Andalucia, Malaga is emerging as one of the most affected provinces, though the trend is being seen across the region and wider Spain.
In Malaga, confirmed cases in under-15s have more than sextupled in just five years: from three cases in 2020 to 19 in 2025.
The year-on-year increase between 2024 and 2025 alone stands at 171.4%, according to public health data.
The increase is not confined to Malaga. Across Andalucía, cases in under-15s have risen from eight in 2020 to 64 in 2025, representing a 700% increase, according to figures from the regional health authorities.
Nationally, Spain remains one of the few EU countries where hepatitis A vaccination is not routinely included in the childhood calendar.
Currently, only Catalonia, Ceuta and Melilla offer systematic vaccination, with Catalonia doing so on a pilot basis.
Hepatitis A is a viral infection of the liver transmitted via the faecal-oral route, most commonly through contaminated food or water, or close contact with an infected person.
In children, the illness is often mild or even asymptomatic, but it can include symptoms such as jaundice (yellowing of the skin and eyes), abdominal pain, fever, extreme fatigue, pale stools and dark urine.
Adults typically experience more severe symptoms, and the illness can last two to four weeks or longer, depending on liver involvement. There is no specific treatment beyond rest and managing complications.
Doctors in Malaga confirm that cases that were rarely seen for decades are now appearing again in hospital emergency departments.
Specialists point to a combination of factors for the increase in cases: reduced natural exposure in recent decades (leading to lower immunity), relaxed hygiene habits, increased population movement, and the fact that many children were never vaccinated because hepatitis A was not part of the standard schedule.
While hepatitis A does not become chronic and most children recover fully – gaining lifelong immunity – experts warn that infected individuals can spread the virus unknowingly during the contagious phase.
For adults, the illness can mean weeks off work, adding to the wider social and economic impact.
