Washington and California Hepatitis A Outbreak linked to Imported Strawberries

As of July 18, 2023, there are:

• 10 outbreak-associated cases of hepatitis A reported from four states; Hawaii, Oregon,Washington and California.
• Illnesses started on dates ranging from November 24, 2022, to June, 4 2023.
• 4 people have been hospitalized. No deaths have been reported.
• Epidemiologic and traceback evidence indicate that frozen organic strawberries are the likely source of this outbreak.
• Those interviewed reported 10/10 (100%), reported eating frozen organic strawberries.

CDC, state public health and regulatory officials, and the U.S. Food and Drug Administration are investigating an outbreak of hepatitis A linked to frozen organic strawberries imported from certain farms located in Baja California, Mexico, by a common supplier. Frozen organic strawberries may be sold to a variety of retailers under multiple brand labels. Traceback and epidemiological investigations show that people with outbreak-associated cases in Washington purchased the same retail brand of frozen organic strawberries prior to becoming ill.

Illnesses started on dates ranging from November 24, 2022, to June 4, 2023. Ill people range in age from 38 to 61 years, with a median age of 56.5 years. Forty percent of ill people are female. Of 10 people with available information, 4 (40%) have been hospitalized. No deaths have been reported.

Epidemiologic and traceback evidence indicate that frozen organic strawberries, imported fresh from certain farms located in Baja California, Mexico in 2022, are the likely source of this outbreak. The hepatitis A virus strain causing illnesses in this outbreak is genetically identical to the strain that caused a foodborne hepatitis A outbreak in 2022, which was linked to fresh organic strawberries imported from Baja California, Mexico, and sold at various retailers.

In interviews, ill people answered questions about the foods they ate and other exposures in the 2 to 7 weeks before they became ill. Of people who were interviewed, all of them reported eating frozen organic strawberries. This proportion was significantly higher than results from a survey of healthy people in which 24% reported eating frozen berries in the week before they were interviewed.

In response to this investigation, California Splendor, Inc. of San Diego, California voluntarily recalled certain lots of 4-lb. bags of Kirkland Signature Frozen Organic Whole Strawberries that were sold at Costco stores in Los Angeles, California; Hawaii; and two San Diego, California business centers. The lots subject to this recall include: 140962-08, 142222-23, 142792-54, 142862-57, 142912-59, 142162-20, 142202-21, 142782-53, 142852-56, 142902-58, 142212-22, 142232-24, 142842-55.

In response to this investigation, Scenic Fruit Company of Gresham, Oregon voluntarily recalled frozen organic strawberries, sold to Costco, Trader Joe’s, Aldi, KeHE, Vital Choice Seafood, and PCC Community Markets in certain states. Products subject to this recall include:

On March 17, 2023, a retailer, Meijer, also issued press to voluntarily recall Made-With brand frozen organic strawberries from certain market store locations.

UPC’s Carried by Meijer:

In response to this investigation, on June 7, 2023, Wawona Frozen Foods of Clovis, California, initiated a voluntary recall of year-old packages of Wawona brand Organic DayBreak Blend 4-lb. bags that were distributed to Costco Wholesale stores in Arizona, California, Colorado, Utah, and Washington from April 15, 2022, to June 26, 2022, with “Use By” dates of 9/23/2023, 9/29/2023, 9/30/2023, and 10/18/2023:

In response to this investigation, on June 12, 2023, Willamette Valley Fruit Co. of Salem, Oregon, voluntarily recalled select packages of frozen fruit containing strawberries distributed to the following retailers: Walmart (from January 24, 2023, to June 8, 2023), Costco Wholesale Stores (from October 3, 2022, to June 8, 2023), and HEB (from July 18, 2022, to June 8, 2023). Products subject to this recall include:

FDA’s investigation is ongoing; additional products might be included in the future.

Hepatitis A is a contagious liver infection caused by the hepatitis A virus. The hepatitis A virus is found in the stool and blood of people who are infected. The hepatitis A virus is spread when someone ingests the virus, usually through close personal contact with an infected person or from eating contaminated food or drink. Hepatitis A can be prevented with a vaccine, which is recommended for all children at age one and adults at risk.

Symptoms of Hepatitis A:

• Symptoms of hepatitis A usually appear 2 to 7 weeks after exposure and can include:

◦ Yellow skin or eyes

◦ Not wanting to eat

◦ Upset stomach

◦ Stomach pain

◦ Throwing up

◦ Fever

◦ Dark urine or light-colored stools

◦ Joint pain

◦ Diarrhea

◦ Feeling tired

• Not everyone with hepatitis A has symptoms. Adults are more likely to have symptoms than children.

• People who get hepatitis A may feel sick for a few weeks to several months but usually recover completely and do not have lasting liver damage. In some people, though, the illness may be so severe that the patient needs to be hospitalized.

• In rare cases, hepatitis A can cause liver failure and even death. This is more common in older people and in people with other serious health issues, such as chronic liver disease.