October 25, 2016

Virginia Hepatitis A Tropical Smoothie Outbreak Grows to 102 Sick

The hepatitis A outbreak in Virginia associated with Tropical Smoothie Cafe has grown to include 102 people. All of those reported consuming a smoothie at Tropical Smoothie Cafe before they got sick. About 37% of those sickened in this outbreak have been hospitalized for their illness because they are so sick.

Hepatitis A virus.

The 102 ill persons range in age from 14 to 70. The onset of illness dates range from early May through September. The case count by region is: 59 Northern, 15 Northwest, 16 Eastern, 12 Central, 0 Southwest.

The CDC says that at least 25 others are sick in this outbreak, which brings the nationwide total to 127. Epidemiologic and traceback evidence indicate that frozen strawberries imported from Egypt used to make the smoothies are the likely source of this outbreak. The strawberries were served at Tropical Smoothie Cafe locations before August 9, 2016 in Virginia, Maryland, North Carolina, and West Virginia.

On August 9, 2016, Tropical Smoothie Cafe reported that they removed the Egyptian frozen strawberries from their restaurants in those four states and switched to another supplier. They have since switched to another supplier for all of the restaurants in that chain nationwide.

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Because hepatitis A is so contagious, and the virus spreads easily person-to-person, it’s likely that the outbreak will continue to grow for a while. In addition, the symptoms of this illness can take up to 50 days to appear. That means people who may have been infected on August 8, 2016 may not get sick until September 27, 2016.

Adding to this problem is that some people with hepatitis A will not experience any symptoms at all. People are usually contagious for two weeks before symptoms even appear. Once a person has this disease, it is easily spread throughout a household.

The symptoms of hepatitis A include jaundice (yellowing of the eyes and skin), dark urine, clay-colored stools, abdominal cramps, fever, lethargy, weight loss, loss of appetite, nausea, and vomiting. There is no specific treatment for this illness. Most people get better within a few weeks, but some people may be sick for months. And those with chronic health problems or liver disease may suffer from liver failure.

The best way to prevent the spread of this illness is to wash your hands well after using the bathroom, after changing diapers, and after caring for someone who is sick. Always stay home from work or school if you are sick. Always wash your hands before preparing food or drink for others.

Hepatitis A infections are declining overall in this country as a result of education and immunization programs. Outbreaks of this illness in the past few years have been linked to produce, especially produce imported from other countries.

The CDC recommends that some groups be routinely vaccinated against hepatitis A: all children at age one, people with chronic liver disease, and travelers to other countries that have high rates of the illness. Anyone who works in a school, daycare, food service, or healthcare setting should also consider getting vaccinated. The hepatitis A or immune globulin vaccination is only effective if given within two weeks of exposure, before symptoms begin, or if you have not been exposed.

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