An outbreak of Hepatitis A linked to frozen strawberries from Egypt used by a smoothie chain has grown to include at least 119 people in eight states, federal health officials reported Friday. The report does not include an additional four cases reported in Virginia around the same time, which brings the national total to 123 infections.
The U.S. Centers for Disease Control and Prevention (CDC) said that the illnesses have led to 47 hospitalizations, with the vast majority of cases being reported in Virginia.
In August, Virginia Department of Health officials linked the growing outbreak to Tropical Smoothie Café restaurants in that state. The smoothie chain was using frozen strawberries imported from Egypt in many of the smoothies it served in its Virginia restaurants. Genetic testing showed that the illnesses in the current outbreak were caused by a strain of hepatitis A that has been associated with past outbreaks linked to frozen strawberries from Egypt.
In addition to the 94 hepatitis A cases reported in Virginia, health officials have found the same strain has sickened one person in each of the states of Arkansas, North Carolina, Oregon, and Wisconsin; 12 in Maryland; six in West Virginia; and three in New York.
“Information available at this time does not indicate an ongoing risk of hepatitis A virus infection at Tropical Smoothie Cafés,” the CDC said in an update last week, adding that it is not aware of any other restaurants or retailers that used the frozen strawberries linked to the outbreak.
Tropical Smoothie Café stopped using the Egyptian strawberries at all of its locations on Aug. 8, but new cases have emerged since then because it can take weeks for symptoms of a hepatitis A infection to appear.
Hepatitis A is a highly contagious virus that is spread by direct contact with an infected person or from an infected person to food or drink through fecal matter due to poor sanitation.
The virus causes inflammation of the liver, and the classic symptom is jaundice, which is a yellowing of the skin or the eyes. Other symptoms include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine and light-colored stools. Symptoms develop between 15-50 days after exposure to the virus, which can occur through direct contact with another person who has the infection or by consuming food or drink that has been contaminated with the virus.