Hepatitis A outbreak linked to strawberries sold at Kroger, Walmart, other grocery stores

A recent outbreak of hepatitis A cases have been linked to strawberries sold at Kroger, Aldi, Walmart, Trader Joe’s and other grocery stores nationwide.

Here’s the info from the FDA, which was updated on May 28, 2022:

The FDA, along with CDC, the Public Health Agency of Canada and the Canadian Food Inspection Agency, state, and local partners are investigating a multistate outbreak of hepatitis A infections in the United States and Canada potentially linked to fresh organic strawberries branded as FreshKampo and HEB, purchased between March 5, 2022, and April 25, 2022.

Currently, the potentially affected FreshKampo and HEB products are past shelf life. People who purchased FreshKampo and HEB fresh organic strawberries between March 5, 2022, and April 25, 2022, and then froze those strawberries for later consumption should not eat them. These products were sold at the following retailers, including, but not limited to:

• Aldi

• HEB

• Kroger

• Safeway

• Sprouts Farmers Market

• Trader Joe’s

• Walmart

• Weis Markets

• WinCo Foods

If you are unsure of what brand you purchased, when you purchased your strawberries, or where you purchased them from prior to freezing them, the strawberries should be thrown away.

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Epidemiologic and traceback data show that fresh organic strawberries  sold as FreshKampo and HEB brands that were purchased between March 5, 2022, and April 25, 2022, are a likely cause of illness in this outbreak. The traceback investigations show that cases in California, Minnesota, and Canada report having purchased fresh organic strawberries branded as FreshKampo or HEB prior to becoming ill. Illness onset dates range from March 28 – April 30, 2022.

As this investigation is ongoing, additional products may be included. More information will be provided in this advisory as it becomes available.

Recommendation

Consumers, restaurants, and retailers should not sell, serve, or eat any fresh organic strawberries branded as FreshKampo or HEB if purchased between March 5, 2022, and April 25, 2022. People who purchased the fresh strawberries and then froze those strawberries for later consumption should not eat them. They should be thrown away. Currently, the potentially affected product is past its shelf life. If you are unsure of what brand you purchased, when you purchased your strawberries, or where you purchased them from prior to freezing them, the strawberries should be thrown away.

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If consumers purchased fresh organic strawberries branded as FreshKampo or HEB between March 5, 2022, and April 25, 2022, ate those berries in the last two weeks, and have not been vaccinated against hepatitis A, they should immediately consult with their healthcare professional to determine whether post exposure prophylaxis (PEP) is needed. PEP is recommended for unvaccinated people who have been exposed to hepatitis A virus in the last two weeks because vaccination can prevent a hepatitis A infection if given within 14 days of exposure. Those with evidence of previous hepatitis A vaccination or previous hepatitis A infection do not require PEP.

Related: Salmonella outbreak triggers recall of products that used Jif peanut butter: What to know

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Contact your healthcare provider if you think you may have symptoms of a hepatitis A infection after eating these fresh organic strawberries, or if you believe that you have eaten these strawberries in the last two weeks.

Case Counts

• Total U.S. Illnesses: 17

• Hospitalizations: 12

• Deaths: 0

• Last illness onset: April 30, 2022

• States with Cases: CA (15), MN (1), ND (1)

• Product Distribution: Nationwide

Hepatitis A Virus (HAV)

Hepatitis A is a contagious virus that can cause liver disease. A hepatitis A virus (HAV) infection can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months. In rare cases, particularly for people with a pre-existing health condition or people with weakened immune systems, hepatitis A infections can progress to liver failure and death.

The majority of hepatitis A infections are from unknown causes or from being in close contact with an infected person; however, some hepatitis A infections are caused by eating or drinking contaminated food or water. Contamination of food and water can occur when an infected food handler prepares food without appropriate hand washing hygiene.

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Symptoms

Illness usually occurs within 15 to 50 days after eating or drinking contaminated food or water. Symptoms of hepatitis A infection include fatigue, nausea, vomiting, abdominal pain, jaundice, dark urine, and pale stool. In some instances, particularly in children under the age of six, hepatitis A infection may be asymptomatic.

People with hepatitis A infections usually completely recover within one to two weeks; however, in rare cases hepatitis A may become chronic, causing relapsing infection. Chronic hepatitis A infection can lead to more severe health problems, including liver failure, and death.

Due to the range in severity of illness, people should consult their health care provider if they suspect that they have developed symptoms that resemble a(n) hepatitis A infection.

At-Risk Groups

All people are susceptible to hepatitis A infection; however, individuals who have had hepatitis A before or who have been vaccinated are immune to hepatitis A infection. Learn more about People at Risk of Foodborne Illness.

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Treatment and Prevention of Hepatitis A

Because hepatitis A virus infections can have serious health consequences, the Centers for Disease Control and Prevention (CDC) recommends providing post-exposure prophylaxis (PEP) for unvaccinated people who have consumed any contaminated food or water within two weeks of exposure.

PEP consists of:

• Hepatitis A vaccine for people between the ages of 1 and 40 years

• Hepatitis A virus-specific immunoglobulin (IG) for people outside of this age range, but the hepatitis A vaccine can be substituted if IG is not available.

• Those with evidence of previous vaccination or who can confirm previous hepatitis A illness do not require PEP.

If you are unsure if you have been vaccinated against hepatitis A, contact your health professional to check your immunization records. If you have been vaccinated, no further action is needed.  If you have never received the hepatitis A vaccine, getting a single dose within two weeks of exposure can protect against illness. If you are unable to determine whether you have already been vaccinated, receiving an additional dose of vaccine is not harmful if you have already been vaccinated.

Who Should Receive the Hepatitis A Vaccine?

In general, CDC recommends the following groups be vaccinated for hepatitis A:

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• All children at age 1 year

• Travelers to countries that have high rates of hepatitis A

• Family members and caregivers of recent adoptees from countries where hepatitis A is common

• Men who have unprotected sexual contact with other men

• Users of injection and illegal drugs

• People with chronic (lifelong) liver diseases, hepatitis B, or hepatitis C

• People who are treated with clotting-factor concentrates

• People who work with hepatitis A infected animals or in a hepatitis A research laboratory

Foods Linked to U.S. Outbreaks of Hepatitis A

Although foodborne illnesses caused by hepatitis A are not common in the U.S., water, shellfish, raw vegetables and fruit (berries), and salads are most frequently cited as potential foodborne sources.

Preventing Foodborne Illness at Home

Hepatitis A can have serious health consequences. The CDC advises the post-exposure prophylaxis (PEP) described above for unvaccinated persons who have consumed any products contaminated by the hepatitis A virus.

To prevent hepatitis A contamination or transmission, consumers should always practice safe food handling and preparation measures by following the steps below:

• Wash hands with warm water and soap for at least 20 seconds before and after handling raw foods.

• Thoroughly wash hands after using the bathroom and changing diapers for protection against hepatitis A, as well as other foodborne diseases.

• Wash the inside walls and shelves of the refrigerator, cutting boards and countertops, and utensils that may have contacted contaminated foods; then sanitize them with a solution of one tablespoon of chlorine bleach to one gallon of hot water; dry with a clean cloth or paper towel that has not been previously used.

• Wash hands with warm water and soap following the cleaning and sanitation process.

• Consumers can also submit a voluntarily report, a complaint, or adverse event (illness or serious allergic reaction) related to a food product.

Advice for Restaurants and Retailers

Retailers, restaurants, and other food service operators who have processed and packaged any potentially contaminated products need to be concerned about cross contamination of cutting surfaces and utensils through contact with the potentially contaminated products.

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In the event that retailers and/or other food service operators are found to have handled recalled or other potentially contaminated food in their facilities, they should:

• Wash hands with warm water and soap for at least 20 seconds before and after handling raw foods.

• Contact their local health department and communicate to their customers regarding possible exposure to hepatitis A virus and the potential benefit of post-exposure prophylaxis.

• Wash the inside walls and shelves of the refrigerator, cutting boards and countertops, and utensils that may have contacted contaminated foods; then sanitize them with a solution of one tablespoon of chlorine bleach to one gallon of hot water; dry with a clean cloth or paper towel that has not been previously used.

• Wash and sanitize display cases where potentially contaminated products were served or stored.

• Always wash hands with warm water and soap following the cleaning and sanitation process.

• Conduct regular frequent cleaning and sanitizing of cutting boards and utensils used in processing to help minimize the likelihood of cross-contamination.

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