Hepatitis A Outbreak Now up to 59 Cases in Virginia as 5 Other States Investigate Possible Links

— -- An hepatitis A outbreak first identified in Virginia among people who drank smoothies containing strawberries from Egypt has been linked to cases of the virus in six other states, according to state health officials and the U.S. Centers for Disease Control and Prevention.

Today, the Virginia Health Department confirmed 59 people have been found infected with hepatitis A.

Federal and state health officials have reported hepatitis A cases linked to the frozen strawberries six other states: North Carolina (1), Maryland (6), Wisconsin (1), New York (1), West Virginia (5) and Oregon (1), according to the CDC. Nearly all patients interviewed reported drinking smoothies with strawberries at Tropical Smoothie Café locations in Maryland, North Carolina, Virginia and West Virginia.

Of those sickened, at least 32 have been hospitalized. No deaths have been reported. CDC officials said they expect the outbreak to grow since the incubation period for the virus is between 15 to 50 days.

Yesterday West Virginia health officials said that they have three confirmed cases of hepatitis A linked to the frozen strawberries.

“The Bureau for Public Health has received reports of seven cases of hepatitis A that we are currently investigating in Berkeley and Jefferson counties,” said Dr. Rahul Gupta, West Virginia’s public health commissioner, in a statement yesterday. “Three of these cases of hepatitis A have been directly linked to the outbreak.”

In Virginia, meanwhile, the number of confirmed cases has risen to 59 in Virginia, with those afflicted ranging in age from 14 to 68, according to the state health department. Of those who have become ill, 41 percent reported having been hospitalized for their symptoms, the blog said. All reported symptoms at different times from May through August.

The hepatitis A virus can cause inflammation of the liver. The incubation period for the virus is 15 to 50 days, and symptoms can include fever, fatigue, loss of appetite, vomiting and abdominal pain. A vaccine and immunoglobulin treatment are available for hepatitis A, and both can help protect against the virus if they are taken soon after exposure to the virus.

The outbreak in Virginia was identified on Aug. 12 when CDC officials noticed that multiple people had been sickened by the same strain of hepatitis A. The cases have now been linked to frozen strawberries from Egypt that were used in smoothies by the Tropical Smoothie Cafe company chain.

The strawberries, sourced from Egypt, have been voluntarily removed from all restaurants, according to Tropical Smoothie Cafe company officials.

Tropical Smoothie Cafe released a statement today saying they are now only sourcing strawberries from the Americas and working with the CDC and FDA during the outbreak.

“Food safety is Tropical Smoothie Cafe’s top priority, and we are deeply sorry for anyone who may have become ill after visiting one of our Virginia-area cafés. Our first concern is their health and recovery," the company said in a statement today. "After being notified by The Virginia Department of Health of possible links between strawberries sourced from Egypt and Hepatitis A, we voluntarily pulled all Egyptian strawberries from our cafés."

The have listed additional information here for consumers.

Last month, the company’s CEO, Mike Rotondo, addressed customers in a statement.

"'Eat better, feel better' is not just a marketing slogan -- it's a promise, and it's something I believe in very dearly,” Rotondo’s statement said. “Recently some strawberries may have made their way into the supply chain that could challenge that concept. I sincerely apologize for any issues this may have caused for any of our customers," he said in a statement on video on the company's Facebook page on Aug. 21. "We voluntarily and immediately removed all of those strawberries from all of our cafes, and we have sourced new strawberries for every location. We take this issue very seriously. Your health and your safety is our top priority."