Since September last year municipal health service GGD Amsterdam noticed an increase of hepatitis A among homosexual and bisexual men. There's also been an increase of hepatitis A diagnoses in this group in the rest of the Netherlands and elsewhere in Europe. Men who have sexual intercourse with other men are advised to get vaccinated against hepatitis A and B viruses, Blik op Nieuws reports. 

After years of no hepatitis A diagnoses in Amsterdam, there has been 13 since September 2016, all in gay or bisexual men. GGD Amsterdam believes the disease was spread through sexual contact. 

An outbreak of hepatitis A started in February 2016, according to the newspaper. The disease was then diagnosed in several European countries including the United Kingdom, Germany, Italy and Spain. 

Hepatitis A causes acute liver inflammation. The virus spreads through feces of people infected with it. It can therefore spread via the toilet or through sexual contact. Symptoms include nausea, fatigue, lack of appetite and fever. Feces may turn lighter in color and urine darker. The whites of the eyes and skin may turn jaundiced.