December 4, 2016

FDA Collaborates with Egypt on Strawberry Hepatitis A Outbreak

The FDA is working with the Egyptian International Health Regulations National Focal Point about the investigation of strawberries that have been linked to a hepatitis A outbreak centered in Virginia. That outbreak, linked to Tropical Smoothie Cafes in that state, has sickened at least 70 people who live in 7 states.

Tropical Smoothie Cafe Cup

Public health officials are trying to identify all parts of the supply chain that brought the berries to the U.S. Government officials are “prohibited by law in most situations from releasing publicly certain confident commercial information about supply chains,” according to the FDA notice on this outbreak. FDA has increased surveillance of imported strawberries as a result of this outbreak investigation and “will provide more information as it becomes available.” FDA states that they are not aware of any other restaurants or retailers that may have received the frozen Egyptian strawberries that are linked to this outbreak.

Numbers on this outbreak are current as of August 31, 2016. States where the ill persons live include Maryland, North Carolina, New York, Oregon, Virginia, Wisconsin, and West Virginia. Thirty-two people have been hospitalized because their illnesses are so serious, which is a very high percentage of 45%. The typical hospitalization rate for hepatitis A outbreaks is 20%. Hospitalization for a hepatitis A infection usually occurs among the elderly, pregnant women, people with serious underlying health conditions, those with liver disease, and anyone who may be seriously dehydrated from nausea and vomiting.

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There are no specific medical treatments for this illness. Some drugs can treat some of the symptoms, but usually palliative care and support is offered.

The symptoms of hepatitis A include fatigue, jaundice (yellowing of the skin and eyes), dark urine, clay colored stools, nausea, abdominal pain, fever, vomiting, and diarrhea. The symptoms appear 15 to 50 days after infection. That means that, since Tropical Smoothie Cafes stopped serving the Egyptian strawberries on August 8, 2016, that new cases will be diagnosed.

In addition, people who are infected are contagious for two weeks before they start feeling sick. The virus is very contagious, so it is easily spread from person to person and through contaminated food and drink.

The best way to prevent the spread of this illness is to stay home if you are sick and to wash your hands with hot, soapy water after using the bathroom, changing diapers, caring for someone who is ill, and preparing food and drink. The virus is spread through the fecal-oral route, which means you must ingest a tiny amount of contaminated feces to pick up the virus.

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