In a follow-up on the hepatitis A outbreak in Virginia, The Virginia Department of Health (VDH) says the outbreak total has risen by five cases, bringing it to a total of 40.


VDH continues the investigation into the outbreak. They have identified a potential association with smoothies from Tropical Smoothie Café restaurants in Virginia.

On August 12, the Centers for Disease Control and Prevention notified VDH that genetic testing of multiple ill persons showed the illnesses were caused by a strain of hepatitis A that had been associated with past outbreaks due to frozen strawberries from Egypt. Frozen Egyptian strawberries used at Tropical Smoothie Café are thought to be the source of this outbreak. This product has been removed from use at all Tropical Smoothie locations in Virginia.

Hepatitis A is a liver disease caused by the hepatitis A virus (HAV).  The virus enters through the mouth, multiplies in the body, and is passed in the feces (stool).  The virus can then be carried on an infected person’s hands and can be spread by direct contact, or by consuming food or drink that has been handled by the individual.  In some cases, it can be spread by sexual contact or by consuming contaminated water or food (e.g., raw shellfish, fruits, vegetables).

The symptoms may appear from 15 to 50 days after exposure; most often, the symptoms appear within four weeks and include tiredness, poor appetite, fever and nausea.  Some people might also have vomiting and abdominal cramping. Urine may become darker in color, and then jaundice (a yellowing of the skin and the whites of the eyes) may appear.  The disease is rarely fatal and most people recover in a few weeks without any complications.