--- title: Final Settlements reached in Multi-state Hepatitis A Outbreak date: 2019-11-09T07:09:34-08:00 author: Bill Marler canonical_url: "https://marlerclark.com/news_events/final-settlements-reached-in-multi-state-hepatitis-a-outbreak" section: News --- [All News](/news_events) / [Outbreaks](https://marlerclark.com/news_events/outbreaks) / # Final Settlements reached in Multi-state Hepatitis A Outbreak ![](https://www.hepatitisblog.com/files/2019/11/StateMap-300x191.jpg)Epidemiologic and traceback evidence indicate frozen strawberries imported from Egypt were the likely source of this outbreak. In interviews, nearly all ill people interviewed reported drinking smoothies containing strawberries at Tropical Smoothie Café locations prior to August 8 in a limited geographical area, including Maryland, North Carolina, Virginia, and West Virginia, but there have been a small number of cases outside of that geographic area with no Tropical Smoothie Café exposure. Information available at this time does not indicate an ongoing risk of acquiring hepatitis A virus infection at Tropical Smoothie Café’s, as the contaminated food product has been removed as of August 8. As of December 13, 2016: 143 people with hepatitis A have been reported from nine states: Arkansas (1), California (1), Maryland (12), New York (5), North Carolina (4), Oregon (1), Virginia (109), West Virginia (7), and Wisconsin (3). 129 of these cases reported eating a smoothie from Tropical Smoothie Café. There have been no cases reporting illness from this same exposure since September 23, 2016. 14 cases had no direct exposure to Tropical smoothie café. The latest illness onset date among these cases was October 25, 2016. 56 ill people were hospitalized. No deaths were reported. FDA traceback information indicated that the frozen strawberries served in the Tropical Smoothie Café locations were from the International Company for Agricultural Production & Processing (ICAPP), imported from Egypt. On August 8, 2016, Tropical Smoothie Café reported that they removed the Egyptian frozen strawberries from their restaurants in Maryland, North Carolina, Virginia, and West Virginia and switched to another supplier out of an abundance of caution. Information available at this time does not indicate an ongoing risk of hepatitis A virus infection at Tropical Smoothie Cafes. On October 30, 2016, the International Company for Agricultural Production & Processing (ICAPP) recalled all of its frozen strawberries that were imported into the U.S. since January 1, 2016. The recalled products were distributed for sale to and use in food service establishments nationwide. 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