Italy Imposes Shellfish Ban Following Hepatitis A Outbreak in Popular Tourist Region
Italian authorities have enacted an emergency ban on shellfish sales across Naples and the surrounding Campania region, following a significant outbreak of hepatitis A that has now reached 180 confirmed cases. The area is a major holiday destination for British tourists, prompting urgent warnings from health officials and travel advisory services.
Official Warnings and Case Numbers
The Foreign Office-backed Travel Health Pro website has issued a formal alert, confirming that as of March 19, there were 65 laboratory-confirmed hepatitis A cases in Campania. However, local Italian news reports indicate the total number has surged to approximately 180 cases since the beginning of the year, with the provinces of Naples and Caserta experiencing the most intense concentration of infections.
Dr Raffaele Di Sarno, head of the infectious disease emergency room at Cotugno Hospital, provided a detailed update on the situation. "We currently have 51 hospitalised patients and nine patients in the emergency room," he stated. The affected individuals are primarily aged between 30 and 40 years old, presenting with what Dr Di Sarno described as "uncomplicated hepatitis, which is not currently a cause for concern."
Immediate Regulatory Action
In response to the escalating crisis, Naples Mayor Gaetano Manfredi signed an ordinance prohibiting the consumption of raw mussels in all public establishments. This comprehensive ban extends to neighbourhood restaurants with on-site dining and businesses producing food for immediate consumption. Mayor Manfredi has also advised local residents to exercise extreme caution, particularly when consuming fruits and vegetables, which must be thoroughly washed before eating.
Similar emergency measures have been implemented by the mayors of Benevento and Forio on the island of Ischia, creating a coordinated regional response to the public health threat. The NAS Carabinieri, under Commander Alessandro Cisternino, have launched extensive inspections across Naples province, targeting eateries, fishmongers, and markets to identify any untraceable seafood or vegetable products. Collected samples are being analysed by the Portici Zooprophylactic Institute to determine contamination sources.
Expert Analysis and Historical Context
Professor Maria Triassi, a university professor of Hygiene, provided crucial insight into the outbreak's origins. "My impression is that everything originated from a batch of mussels in the Naples area," she explained. Professor Triassi noted that while the local population historically developed immunity through constant childhood exposure to endemic viruses, many residents now lack protective antibodies, making vaccination essential for prevention.
The outbreak represents a significant shift in hepatitis A patterns across Italy. National cases have been increasing since 2023, but were previously concentrated in Central-Northern regions including Lombardy, Tuscany, Emilia Romagna, and Lazio. These earlier infections were primarily linked to consumption of raw fish, berries, international travel, and sexual contact between men. The Campania outbreak marks a distinct epidemiological development, with specialists attributing it specifically to consumption of raw or inadequately cooked bivalve shellfish including mussels, clams, and oysters—staples of the regional culinary tradition.
Symptoms and Prevention Measures
Hospital admissions have documented a range of hepatitis A symptoms including fever, jaundice (yellowing of the eyes and skin), dark urine, loss of appetite, nausea, and general fatigue. Dr Cristina Mussini, national president of the Italian Society of Infectious Diseases, emphasised the importance of recognising warning signs. "Among the warning signs are changes in mental status and possible bleeding, conditions that require immediate access to the emergency room," she cautioned.
Travel Health Pro notes that while symptoms are often mild or absent in young children, the illness becomes increasingly severe with age. Recovery can take anywhere from several weeks to multiple months, though immunity following infection typically lasts for life. The health authority's Prevention Department, overseen by Tiziana Spinosa, has distributed directives to mayors across provincial municipalities requesting suspension of shellfish sales throughout the region.
In Benevento, Mayor Clemente Mastella—acting in his capacity as chairman of the health authority's Committee of Mayors—has banned all commercial premises from serving and selling raw shellfish for immediate consumption. The regional response involves coordinated efforts between the Prevention Departments of local health authorities, the Experimental Zooprophylactic Institute of Southern Italy (which conducts source inspections on mussel and shellfish production), and the technical-scientific network of the General Directorate for Health Protection.
To prevent infection, health officials recommend maintaining excellent personal hygiene and following established guidelines for food and water safety, as consumption of contaminated food or water represents the most common transmission route for travellers.
