FDA investigating Hepatitis A cases related to frozen strawberries

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Frozen Strawberries

The FDA announced this week that it is continuing to investigate a Hepatitis A outbreak in Virginia and surrounding states, including North Carolina.

The investigation began in early August when the Virginia Department of Health (VDH) investigated a cluster of Hepatitis A cases in Virginia. The outbreak was linked to the International Company for Agricultural Production & Processing (ICAPP), an Egyptian company which had previously been involved with a FDA recall.

icapp

The FDA and CDC traced and identified the viral strain in contaminated frozen strawberries from ICAPP, used by the Tropical Smoothie Cafes in the Virginia area (ICAPP products are not available for retail). Tropical Smoothie Cafe immediately removed all ICAPP strawberries from their Virginia stores and by late August had removed them from their supply chain completely.

The FDA stated “at this time we, we do not have information to suggest that there is an ongoing risk of hepatitis A virus infection at Tropical Smoothie Cafes.”

However, because of the virus’s long incubation period – from 15 to 50 days – symptoms continued to appear in late August, with more cases developing in September and into October.  ICAPP did not officially recall frozen strawberries until Monday, Oct. 31, which could potentially mean additional cases could develop. The current FDA investigation involves nine states surrounding Virginia, including North Carolina. At present, the FDA reports 134 cases of Hepatitis A in the nine-state area, with 52 people hospitalized.

The FDA is cautioning people with potentially related symptoms to contact their healthcare provider. This is especially true for people who consumed strawberry smoothies from a Tropical Smoothie Cafe location in the Virginia area during or prior to August.

Symptoms include fatigue, abdominal pain, jaundice, abnormal liver tests, dark urine and pale stool.

The FDA and CDC note that Hepatitis A does not produce symptoms in all people, but can be spread person to person. The virus can survive in conditions outside the body for months. and is mostly commonly spread by improper hygiene (i.e. insufficient hand-washing after using the restrooms). Particularly at risk are infants and people with liver problems (including Hepatitis B and C) and blood-clotting issues (including hemophilia).

The latest FDA release, which includes the case history, symptom descriptions, and information on prevention and treatment of Hepatitis A, can be found here. The original VDH announcement can be found here. The CDC’s information page on Hepatitis A can be found here.