As of December 2, 2019, a total of 16 outbreak-associated cases of hepatitis A were reported from 6 states.

Illnesses started on dates ranging from October 8, 2019, to November 15, 2019. Ill people range in age from 14 to 73 years, with a median age of 50. Seventy-five percent of ill people are female. Of 15 people with available information, 9 (60%) were hospitalized. No deaths have been reported.

Illnesses might not yet be reported due to the time it takes for symptoms to appear after exposure (average 4 weeks) and the time it takes between when someone becomes ill and when the illness is reported.

Epidemiologic and traceback evidence are being collected and analyzed. A single, common supplier of fresh blackberries has not been identified.

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, 15/15 (100%) reported eating fresh blackberries; of 13 people with known fresh blackberry purchase location information, 13/13 (100%) purchased fresh blackberries from Fresh Thyme Farmers Market. This proportion was significantly higher than results from a survey of healthy people in which 7% reported eating fresh blackberries in the week before they were interviewed.

The FDA and regulatory officials in several states have collected records from grocery stores where ill people reported buying fresh blackberries and are conducting traceback investigations to try to identify a specific source of the fresh blackberries.

This outbreak investigation is ongoing, and CDC will update the public when more information becomes available.

As of November 26, 2019, this outbreak appears to be ongoing.

14 outbreak-associated cases of hepatitis A have been reported from 5 states (Indiana, Michigan, Minnesota, Nebraska, and Wisconsin).

Illnesses started on dates ranging from October 8, 2019, to November 15, 2019.8 people have been hospitalized. No deaths have been reported.

Epidemiologic and traceback evidence are being collected and analyzed. A single, common supplier of fresh blackberries has not been identified.

In interviews, 14/14 (100%) reported eating fresh blackberries. Of 12 cases with known fresh blackberry purchase location information, 12/12 (100%) purchased fresh blackberries from Fresh Thyme Farmers Market.

Traceback information to date shows that the berries came from a distribution center that ships fresh berries to Fresh Thyme Farmers Market stores in 11 states: Indiana, Illinois, Iowa, Kentucky, Mississippi, Missouri, Minnesota, Nebraska, Ohio, Pennsylvania, and Wisconsin.

This outbreak investigation is ongoing, and CDC will update the public when more information becomes available.

As of November 20, 2019, a total of 11 outbreak-associated cases of hepatitis A were reported from 3 states – Indiana (2), Wisconsin (3) and Nebraska (6)

Illnesses started on dates ranging from October 15, 2019, to November 5, 2019. Ill people range in age from 14 to 73 years, with a median age of 35. Seventy-three percent of ill people are female. Of 11 people with available information, 6 (55%) were hospitalized. No deaths have been reported.

Illnesses might not yet be reported due to the time it takes for symptoms to appear after exposure (average 4 weeks) and the time it takes between when someone becomes ill and when the illness is reported.

Epidemiologic and traceback evidence are being collected and analyzed. A single, common supplier of fresh blackberries has not been identified.

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, 11/11 (100%) reported eating fresh blackberries; of 9 people with known fresh blackberry purchase location information, 9/9 (100%) purchased fresh blackberries from Fresh Thyme Farmers Market. This proportion was significantly higher than results from a survey of healthy people in which 7% reported eating fresh blackberries in the week before they were interviewed.

The FDA and regulatory officials in several states have collected records from grocery stores where ill people reported buying fresh blackberries and are conducting traceback investigations to try to identify a specific source of the fresh blackberries.

This outbreak investigation is ongoing, and CDC will update the public when more information becomes available.

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. The FDA reports that hepatitis A virus contamination was found in multiple samples of ICAPP frozen strawberries.

Two employees at a Denny’s in Kissimmee have tested positive for hepatitis A and now, the Florida Department of Health is urging anyone who ate at the restaurant to get vaccinated.

The department’s Osceola County branch issued a news release Tuesday alerting the public that the two employees at the Denny’s at 2051 E. Irlo Bronson Memorial Highway in Kissimmee may have been infectious when they were working at the restaurant.

“This past weekend two employees at our Kissimmee, FL restaurant located at 2051 E. Irlo Bronson Memorial Highway were diagnosed with hepatitis A.  The diagnosis was immediately reported to the Florida Department of Health in Osceola County (FDOH-Osceola).  Denny’s immediately closed the restaurant and commenced both a cleaning process and food removal as required by the FDOH.  The restaurant was inspected by FDOH-Osceola inspectors and declared safe, and we are providing all Denny’s employees at the location with the hepatitis A vaccine.  The FDOH recommends that anyone who has questions or concerns about hepatitis A and their health to contact their county’s health department,” the statement read.

Health officials are asking anyone who ate or drank at the location between Oct. 24 and Nov. 1 to get a vaccination. Those who dined between Oct. 14 and Oct. 23 should monitor for symptoms, including abdominal pain, nausea and vomiting. Anyone who experiences those symptoms should seek medical attention.

Those who have already received the vaccine or who have had a past history of hepatitis A do not need to take additional action.

Certain people are more at risk for infection than others but anyone can get a vaccine just in case. People at increased risk include:

  • All children at age 1 year
  • People who are experiencing homelessness
  • Users of recreational drugs, whether injected or not
  • Men who have sexual encounters with other men
  • People with direct contact with others who have hepatitis A
  • Travelers to countries where hepatitis A is common
  • People with chronic or long-term liver disease, including hepatitis B or hepatitis C
  • People with clotting-factor disorders
  • Family and caregivers of adoptees from countries where hepatitis A is common

The disease is most commonly transmitted through the fecal-oral route, officials said. Symptoms include:

  • Jaundice (yellowing skin and whites of eyes)
  • Fever
  • Diarrhea
  • Fatigue
  • Loss of appetite
  • Nausea and vomiting
  • Stomach pain
  • Dark-colored urine
  • Pale or clay-colored stool

The Florida Department of Health in Osceola County, located at 1875 Fortune Road in Kissimmee, offers hepatitis A vaccines for free or at a low cost at its clinic from 8 a.m. to 4 p.m. on weekdays.

The Kentucky Department for Public Health says more than a third of students haven’t received the mandated Hepatitis A vaccination.

The Lexington Herald-Leader reports immunization rates released Tuesday show about 65% of the 209,904 mandated students have received the shot. The state’s target compliance rate is 85%.

Results show seniors had the lowest compliance rate at 46% and kindergartners had the highest with 84.3%.

University of Kentucky infectious disease pediatrician Dr. Sean McTigue says the compliance lag is because of general hesitancy regarding vaccines and the need for two shots. McTigue believes it’ll take “at least two years” to get everyone onboard.

Kentucky experienced a Hepatitis A outbreak in 2017, prompting the mandated vaccination. As of September, the health department says 4,943 people are infected and 61 people have died.

Virginia: According to the Peninsula Health District, people who consumed food from Mr. C’s Pizza & Subs, located at 493 Wythe Creek Road, between September 12 through 21, September 30 and October 1 may have been exposed to the disease.

The PHD said risk to the public from this exposure is low, and there is no indication of any food products at this restaurant being the source of the infection.

If you have not been previously vaccinated and have never had hepatitis A, you are susceptible to the disease, and may be at risk if you ate anything from Mr. C’s Pizza & Subs on the dates mentioned above. Hepatitis A vaccines are available at various urgent care clinics and pharmacies and can be received at the PHD for free or at a reduced cost.

Indiana: The Greene County Health Department investigated the incident at the Papa John’s located at 1810 E. State Road 54 in Linton and determined the risk of infection is very low.

All employees at the restaurant are being vaccinated. 

Georgia: A case of hepatitis A has been diagnosed in a food handler at Vittles restaurant located in Smyrna, Georgia. An investigation found that this employee worked while infectious Wednesday, October 2, 2019. It is rare for restaurant patrons to become infected with hepatitis A virus due to an infected food handler, but anyone who consumed food or drink at Vittles on the above date should contact their healthcare provider to determine if a hepatitis A immunization is needed to prevent the disease. Most healthcare facilities and pharmacies carry the hepatitis A vaccine, but call ahead to ensure availability.

Hepatitis A vaccination is also available at Cobb & Douglas Public Health clinics Monday – Friday, 8:00 a.m. to 5:00 p.m. with no out-of-pocket cost, regardless of insurance status (Please bring insurance card if available.)

According to press reports, the Florida Department of Health is urging recent patrons of a restaurant at Derby Lane in St. Petersburg to get vaccinated for hepatitis A after a food service worker there tested positive for the virus.

The health department said people who visited the Derby Club at Derby Lane, 10490 Gandy Boulevard, between Sept. 16 and Sept. 18 may have been exposed to hepatitis A and recommends they get vaccinated. Recent patrons who consumed food or beverages at the restaurant between Saturday, Sept. 7 and Sunday, Sept. 15, should instead look for signs and symptoms of hepatitis A, health officials said.

Hepatitis A is a viral illness that affects the liver and causes fever, abdominal pain, loss of appetite, nausea, vomiting, jaundice or yellowing of skin and eyes and dark urine.

Anyone experiencing symptoms of hepatitis A should promptly seek medical attention.

A Derby Lane representative released the following statement on the business’ behalf:

On September 23rd, management learned of a potential exposure to hepatitis A at Derby Lane from one employee who was diagnosed on Sunday, September 22nd. That employee was treated and could not return to work until they were cleared by the Florida Department of Health.

Derby Lane was considered a low-level risk; however, we took this potential exposure very seriously and worked closely with the Health Department during their investigation.

Derby Lane expects that all employees maintain the highest standards in hygiene, food safety, and on- site cleanliness and will continue to diligently monitor our staff to ensure proper protocol is being followed.
Vaccinations have been administered to Food and Beverage employees, and have been made available to all Derby Lane employees.

We also encourage our customers who dined with us in the Derby Club Restaurant Circa 1925 from September 7th thru September 18th get vaccinated as well. The vaccination is readily available at pharmacies in the Tampa Bay area, as well as at your local Health Department.

If you believe you are at risk, you can get a free vaccination at one of the following clinics on weekdays between 7:30 a.m. and 5 p.m.:

Tarpon Springs, 301 S. Disston Avenue
Clearwater, 310 N. Myrtle Avenue
Mid-County, 8751 Ulmerton Road in Largo
Pinellas Park, 6350 76th Avenue North
St. Petersburg, 205 Dr. Martin Luther King Jr. Street North

Tippecanoe County health officials on Wednesday warned diners who ate at Arni’s in Lafayette’s Market Square on Sept. 13 or 14 that they might have been exposed to hepatitis A and should get vaccinations, after the discovery that an employee who handled food at the popular restaurant was diagnosed with the illness.

The restaurant, the flagship location for the Lafayette-based Arni’s chain, is open for business and “a thorough disinfection of the restaurant has been conducted,” according to Khala Hochstedler, administrator with the Tippecanoe County Health Department. She said management at Arni’s was working closely with the health department.

Hochstedler said the case was reported to the county health department Monday, after the patient went to a Lafayette hospital with symptoms of hepatitis A, which can include nausea, diarrhea and jaundice. She said a health department investigation showed that the patient had worked Sept. 13 and 14 at Arni’s.

“We’ve been getting the word out for a while now that people who go out to eat or work in food service should get vaccinated for hepatitis A,” Hochstedler said. “There’s a been an outbreak of hepatitis A in Indiana, and we were waiting for it to happen here. This isn’t Arni’s fault. This could have happened at any restaurant.”

Hochstedler sad that “it is relatively rare” to be infected with hepatitis A through an infected food handler. But she said Tippecanoe County health officials were recommending that anyone who at Arni’s Market Square on those two days get a hepatitis A vaccination within 14 days to protect against the viral infection of the liver.

State health officials are warning recent patrons of Cap’n Fish’s Boothbay Harbor Boat Trips may have be at risk for acute hepatitis A virus infection.

An announcement Saturday from the Maine Center for Disease Control and Prevention said a food service worker  prepared food while infectious from Aug. 18 through Sept. 8, and that patrons of the Boothbay Harbor business may be exposed. Hepatitis A is a contagious liver disease, whose symptoms can range from mild illness to severe sickness that could require hospitalization.

The business provides scenic cruises and whale-watching trips for visitors to the region.

To reduce the likelihood of illness, the Maine CDC recommends that anyone who ate, drank or worked at Boothbay Harbor Boat Trips in Maine on Sept. 2, 4, and 5 should get the hepatitis A vaccine. People with compromised immune systems, or parents of children younger than 12 months, should consult a health care provider about receiving hepatitis A immune globulin.

People who visited the Cap’n Fish’s Boothbay Harbor Boat Trips on Aug. 19, 21, 22, 23 24, 26, 28, 29 and 30 could have been exposed but are outside the window for which the vaccine could help prevent illness from this exposure, said the Maine CDC. Those individuals should watch for symptoms and seek medical attention if they develop any symptoms.

The state agency is working with the business owner and local health care providers to notify affected parties and minimize risk of further exposure.