Beginning in September 2016, several states, the CDC, and the FDA investigated a several states, CDC, and the FDA investigated a multistate outbreak of foodborne hepatitis A. Epidemiologic and traceback evidence indicate that frozen strawberries imported from Egypt are the likely source of this outbreak. Although no discovery has been done to date to confirm how the Egyptian strawberries made it to consumers, we have learned that Tropical Smoothie had a bulk purchasing agreement with Patagonia. Patagonia bought from VLM Canada. It is also our understanding that VLM Canada bought from ICAPP and that VLM USA was the importer. It appears that the strawberries entered the US in Norfolk into VLM USA’s possession and then were transferred to Preferred Freezers Storage, Inc. in Chesapeake into Patagonia’s possession. From there, ITI picked up the berries and delivered them to either Sysco Hampton Roads or Sysco VA. Sysco delivered them to Tropical Smoothie franchisees.
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.
In total, 134 people with hepatitis A have been reported from nine states: Arkansas (1), California (1), Maryland (12), New York (3), North Carolina (1), Oregon (1), Virginia (107), West Virginia (7), and Wisconsin (1). Of these cases, 129 people reported eating a smoothie containing strawberries from a Tropical Smoothie Café, and five cases reported having no exposure to Tropical Smoothie Café. There have been no cases reporting illness from this same exposure since September 23, 2016. The latest illness onset date among these cases was October 1, 2016. The investigation into these cases is ongoing. Of the 134 cases, 52 ill people have been hospitalized, and no deaths have been 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 Cafés.
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. The FDA reports that hepatitis A virus contamination was found in four samples of ICAPP frozen strawberries.