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Biological Health Hazard – Hepatitis A (HAV) Outbreak (public health threat): U.S. (9 States)


October 17. 2016
Outbreak News Today

In a follow-up on the multistate hepatitis A outbreak linked to frozen strawberries used in smoothies at Tropical Smoothie Café locations prior to August 8, the Centers for Disease Control and Prevention (CDC) reported this week updated data on the outbreak.

As of October 17, 2016, 134 people with hepatitis A have been reported from nine states: Arkansas (1), California (1), Maryland (12), New York (3), North Carolina (1), Oregon (1), Virginia (107), West Virginia (7), and Wisconsin (1).

52 ill people have been hospitalized. No deaths have been reported.

Federal health officials say this; however, does  not indicate an ongoing risk of acquiring hepatitis A virus infection at Tropical Smoothie Café’s, as the contaminated food product has been removed as of August 8. Symptoms of hepatitis A virus infection can take up to 50 days to appear.

Epidemiologic and traceback evidence indicate frozen strawberries imported from Egypt are the likely source of this outbreak.

On August 8, 2016, Tropical Smoothie Café reported that they removed the Egyptian frozen strawberries from their restaurants in Maryland, North Carolina, Virginia, and West Virginia and switched to another supplier. Out of an abundance of caution, Tropical Smoothie Café has since switched to another supplier for all restaurants nationwide.

[Byline Robert Herriman]


Published Date: 2016-10-22 21:25:31
Subject: PRO/EDR> Hepatitis A – USA (19): (MI) prepared food
Archive Number: 20161022.4578285

Date: Thursday, 20 October 2016
Source: Detroit Free Press [edited]

The prepared foods section at Whole Foods’ Detroit [Michigan] store on Mack Avenue is linked to 2 recent cases of hepatitis A, the Detroit health department announced today, 20 Oct 2016. The department is asking anyone who ate prepared foods at the store from 6-12 Oct 2016 to speak to a doctor and seek preventative treatment.

“While it remains unclear exactly how either of these individuals contracted hepatitis A, and we know that Whole Foods Market Detroit has a comprehensive food safety protocol, we want to do our best to protect our residents and those of surrounding communities who may have been exposed,” said Dr. Abdul El-Sayed, executive director of the Detroit health department.

Hepatitis A, a contagious liver disease, can be spread when ingesting food or drink infected with the hepatitis A virus. Symptoms include fever, diarrhea, nausea, vomiting, yellow eyes and skin and dark urine, according to the city’s health department.

[Byline: Joe Guillen]

Communicated by:

[According to another report (, one case was diagnosed in an employee who handles prepared food at the store and the other was a customer who ate prepared food. It is possible that the food preparer also ingested the food vehicle rather than contaminating it. The time of onset of the 2 cases can help differentiate the 2 scenarios. Either way, additional cases are likely to occur. Many cases of acute hepatitis A are asymptomatic or anicteric (not jaundice) and may not be diagnosed. Intervention early in the incubation period with HAV vaccine or immune globulin can mitigate or prevent the infection. – Mod.LL

A HealthMap/ProMED-mail map can be accessed at:]

See Also

Hepatitis A – USA (18): (HI) frozen scallops 20160930.4527512
Hepatitis A – USA (17): (HI) frozen scallops 20160915.4490624
Hepatitis A – USA (16): fruit smoothies, strawberries ex Egypt 20160915.4490623
Hepatitis A – USA (15): comment 20160910.4477503
Hepatitis A – USA (14): fruit smoothies, strawberries ex Egypt 20160909.4477372
Hepatitis A – USA (13): fruit smoothies, strawberries ex Egypt 20160903.4461205
Hepatitis A – USA (12): (HI) frozen scallops 20160903.4463425
Hepatitis A – USA (11): (MI) raw sewage contact 20160827.4445808
Hepatitis A – USA (10): (VA) fruit smoothies, imported strawberries 20160822.4431203
Hepatitis A – USA (09): (HI) frozen scallops 20160817.4422480
Hepatitis A – USA (08): (HI) 20160810.4405316
Hepatitis A – USA (07): (HI) 20160729.4376124
Hepatitis A – USA (06): (HI) 20160721.4360060
Hepatitis A – USA (05): (HI) 20160713.4342961
Hepatitis A – USA (04): (HI) RFI 20160707.4330783
Hepatitis A – USA (03): (HI) 20160703.4323888
Hepatitis A – USA (02): (PR) hospital workers 20160630.4314683

Hepatitis A – New Zealand: Chinese frozen berries, alert, recall 20151206.3843919
Hepatitis A – Australia (02): frozen berries 20150221.3177076
Hepatitis A – Australia: (VI,NS) frozen berries 20150215.3168431
Hepatitis A – Italy: frozen berries 20140919.2784633
Hepatitis A – EU (02): frozen berries, possible sources 20140914.2773302
Hepatitis A – Norway (02): berry mix cake ex Germany 20140418.2411579
Hepatitis A – EU: frozen berries 20140415.2403191
Hepatitis A – USA (11): (ND) frozen berries, possible church exposure 20131028.2026002
Hepatitis A – USA (10): frozen berries, update 20130925.1967843
Hepatitis A – EU (06): (Ireland) frozen berries, susp 20130909.1932982
Hepatitis A – EU (05): (Italy) frozen berries 20130704.1807698
Hepatitis A – EU (04): (Nordic countries) frozen berries 20130704.1807629
Hepatitis A – USA (07): frozen berries 20130704.1807334
Hepatitis A – USA: frozen berries 20130601.1750001
Hepatitis A – EU (03): Sweden, frozen berries 20130502.1685349
Hepatitis A – EU: Nordic countries, food-borne, frozen berries 20130417.1653060

A ProMED-mail post
ProMED-mail is a program of the International Society for Infectious Diseases

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