Hepatitis A Smoothie Cases Soar to 59 in Virginia; 33 of Those in Northern Virginia

The number of people in Virginia who report they have Hepatitis A due to consuming a strawberry smoothie from Tropical Smoothie Cafe has jumped to 59 cases as of Thursday, according to the Virginia Department of Health.

The smoothies were made with frozen strawberries from Egypt that were tainted, health officials said. Tropical Smoothie Cafe immediately pulled the strawberries from its restaurants.

Of those 59 cases reported as of Thursday, 33 of them are reported in the Northern Virginia suburbs, the department reports. On Monday, the number of cases reported in Northern Virginia was at 18.

Tropical Smoothie Cafe has many locations in the Northern Virginia area, including in Ashburn, Reston, Oakton, Dunn Loring, Falls Church, Arlington, Alexandria, Leesburg and Fredericksburg.

A Loudoun man is suing Tropical Smoothie Cafe seeking $100,000; Constantinos Raptis is the plaintiff in the lawsuit, which says he drank smoothies at a Tropical Smoothie in Purcellville in early August and began showing Hepatitis A symptoms Aug. 15. His suit was filed in Loudoun County Circuit Court. The Tropical Smoothie CEO has issued an apology that was posted on YouTube.

Approximately 41 percent of the afflicted residents, for whom information is available, have been hospitalized, the health department reports. The 59 ill residents range in age from 14-68. Onsets of illness for the 59 cases range from early May through August.

In addition to the 33 cases in the Northern Virginia suburbs, the breakdown for the rest of Virginia is:

• Northeast: 8
• Eastern: 12
• Central: 6
• Southwest: 0

The Virginia Department of Health (VDH) is investigating the outbreak of hepatitis A cases and has identified a potential association with smoothies from Tropical Smoothie Café restaurants in Virginia.

The department reports that anyone who consumed a smoothie from a Tropical Smoothie Cafe in Virginia that contained frozen strawberries, on August 5, 6, 7 or 8, is at risk. If you have had hepatitis A or have been vaccinated for hepatitis A, you are already immune and therefore not at risk for getting the disease, the health department said. Anyone who consumed a smoothie after the frozen strawberries were removed from restaurants is not thought to be at risk for hepatitis A.

On August 12, the Centers for Disease Control and Prevention notified VDH that genetic testing of multiple ill persons showed the illnesses were caused by a strain of hepatitis A that had been associated with past outbreaks due to frozen strawberries from Egypt. Frozen Egyptian strawberries used at Tropical Smoothie Café are thought to be the source of this outbreak in Virginia. This product has been removed from use at all Tropical Smoothie locations in Virginia.

Onsets of illness for the 59 cases range from early May through August, according to the health department. The common exposure shared by ill persons was not "hypothesized" until August; at that time, VDH re-interviewed persons reported earlier in the year to confirm the link with smoothie consumption. The investigation into this outbreak is ongoing.

Here's more about Hepatitis A from the CDC and the Virginia Department of Health:

Symptoms of Hepatitis A
Hepatitis A is an inflammation of the liver caused by the hepatitis A virus. The classic symptom of hepatitis A is jaundice, which is a yellowing of the skin or the eyes. Other symptoms of hepatitis A include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine and light-colored stools. Symptoms develop 15-50 days after exposure to the virus, which can occur through direct contact with another person who has the infection or by consuming food or drink that has been contaminated with the virus.

Preventing spread of Hepatitis A
Frequent handwashing with soap and warm water after using the bathroom, changing a diaper, or before preparing food can help prevent the spread of hepatitis A. It is very important for people who have symptoms of hepatitis A to stay home from work, especially if they work in food service.

Routine vaccination against hepatitis A has reduced the risk of this disease in the past decade. Vaccination is available to anyone, but specifically recommended for all children, for travelers to certain countries, and for people at high risk for infection with the virus. Hepatitis A vaccine is available from health care providers (including some pharmacies and travel clinics) to protect against this disease.

Individuals can contact their local health department with any questions concerning this investigation. For more information, visit http://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/hepatitis-a/.

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