Hepatitis A Outbreak in Virginia: CDC Steps In to Help Investigate

As the number of cases of Hepatitis A cases tied to Tropical Smoothie Cafe soar in Virginia, the Centers for Disease Control and Prevention has stepped in. The number infected has grown to 70, including 15 outside of the state. At least 32 have been hospitalized.

Health officials from the CDC announced Thursday they are collaborating with public health officials in Virginia and several other states and the U.S. Food and Drug Administration (FDA) to investigate a multistate outbreak of foodborne hepatitis A.

The investigation began in early August when the Virginia Department of Health (VDH) identified an outbreak of hepatitis A cases potentially linked to smoothies from Tropical Smoothie Café restaurants in that state.Since then, more than 70 people infected with hepatitis A linked to this outbreak have been reported from seven states, with the majority in Virginia: Maryland (6), New York (1), North Carolina (1), Oregon (1), Virginia (59), West Virginia (5), and Wisconsin (1).

People with hepatitis A may not have symptoms until 15 to 50 days after consuming a contaminated food or drink, according to health officials.

Read more about the hepatitis A virus from the Virginia Department of Health.

Number of cases could grow

"We expect to see more ill people reported in this outbreak because of this long incubation period," the CDC noted in its announcement.

Epidemiologic and traceback evidence available at this time indicate that frozen strawberries imported from Egypt are the likely source of this outbreak, according to health officials.

In interviews, ill people answered questions about the foods they ate and other exposures in the month before they became ill. Of the 70 or more ill people, 68 (97 percent) reported drinking a smoothie from Tropical Smoothie Café in the month before illness started.

Ill people ate strawberries

Of the 54 ill people who were interviewed about the type of smoothie, all (100 percent) reported drinking a smoothie containing strawberries.

These ill people purchased smoothies at cafés located in a limited geographical area, including Virginia and neighboring states. The ill person in Oregon traveled to Virginia and while there, had purchased smoothies containing frozen strawberries from a Tropical Smoothie Café location, health authorities said.

Federal, state, and local officials are performing traceback investigations from the Tropical Smoothie Café locations where ill people reported drinking smoothies with frozen strawberries. The investigations currently indicate that the strawberries served in those locations were imported from Egypt. Investigators are working to determine which specific lots may have been contaminated with hepatitis A virus and to find out if the frozen strawberries were distributed to other U.S. customers. Frozen strawberries used at Tropical Smoothie Café locations were collected for testing. The FDA’s analysis is ongoing.

Tropical Smoothie Cafe removed tainted strawberries

On August 8, Tropical Smoothie Café reported that they removed the Egyptian frozen strawberries from 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.

At this time, the CDC says they do not have information to suggest that there is an ongoing risk of hepatitis A virus infection at Tropical Smoothie Cafes. "We are not yet aware of any other restaurants or retailers that may have received frozen strawberries linked to this outbreak. If this information changes, CDC will update the public immediately."

This investigation is ongoing. CDC and state and local public health partners are continuing to work to identify additional ill people and to interview those people about foods they ate before they got sick.

PHOTO of CDC sign courtesy of cdc.gov