The Centers for Disease Control and Prevention (CDC) said 89 people from seven states have been sickened in an outbreak of the liver disease hepatitis A linked to strawberries at a smoothie chain.
Investigators have interviewed 54 of the people who became ill and all of them said they drank a smoothie containing strawberries before August 8,2016 at a Tropical Smoothie Cafe location in Maryland, North Carolina, Virginia or West Virginia, the New York Times reports.
Thirty-nine people have been hospitalized, but to date no deaths have been reported, according ot the Times.
The smoothie chain removed the contaminated strawberries on August 8. The CDC said there is no indication of a continuing risk.
Tropical Smoothie Cafe issued a statement apologizing to “those who have become ill after eating at one of our cafes.” The company said, “We hope you recover quickly and completely.”
Hepatitis A is contagious liver infection that ranges in severity from a mild illness that lasts weeks to a severe illness that lasts several months, according to the Food and Drug Administration. The infection is typically spread by ingesting fecal matter from contact with objects, food or drinks contaminated by an infected person. An infected restaurant worker who handles food or beverages can spread the infection.
Symptoms include fatigue, abdominal pain, jaundice, abnormal liver tests, dark urine and pale stool. Symptoms can take up to 50 days to appear, so more cases could still be reported, according to the Times. Seventy of the infected customers were in Virginia, 10 were in Maryland, five in West Virginia, and one each were in New York, North Carolina, Wisconsin and Oregon. The World Health Organization said hepatitis A can lead to significant economic consequences for patients who must take time off to recover and for food establishments linked with an outbreak.
Mild cases of hepatitis A generally do not require treatment. Most people recover completely with no permanent liver damage. There is no specific treatment for hepatitis A. To cope with nausea, the Mayo Clinic recommends snacking throughout the day rather than eating full meals. During the illness, the liver may have difficulty processing medications and alcohol. People with hepatitis A should not drink alcohol while infected and should discuss any medication use with a doctor.
The CDC traced the infection to frozen strawberries imported from Egypt. The agency said it does not know of any other restaurants that may have received the contaminated strawberries. Tropical Smoothie Café said it has switched to another strawberry supplier for its restaurants nationwide. The company also said it would now use only strawberries from the Americas. The FDA said it would increase surveillance of imported strawberries.
Children often receive a hepatitis A vaccine as part of routine childhood vaccinations, and this has helped limit hepatitis A cases in United States. There were an estimated 2,500 cases in 2014, the CDC said. Most cases are related to international travel.