Four more rare hepatitis A virus cases in the United States were linked over the weekend to Turkish-grown pomegranate seeds by the federal Centers for Disease Control and Prevention (CDC) in Atlanta, raising the total number of cases in the current outbreak to 140 in eight states.
The outbreak strain of the hepatitis A virus is not usually found the United States. The genotype is rarely seen anywhere in Americas, but rather it circulates in North Africa and the Middle East.
Two additional cases in California and one each in Colorado and Hawaii accounted for raising the total from the previously reported 136 illnesses. The 140 hepatitis A illnesses are found in eight states: Arizona (20), California (69), Colorado (26), Hawaii (8), New Mexico (6), Nevada (6), Utah (3), and Wisconsin (2).
All the illnesses are linked to the consumption of ‘Townsend Farms Organic Antioxidant Blend’, which was made with pomegranate seeds from Turkey. Almost half of the victims, 61, have required hospitalization.
Known as genotype 1B, the virus was found in clinical specimens of 56 people in seven states: AZ (6), CA (15), CO (22), HI (4), NM (4), NV (4) and WI (1), according to CDC. (The Wisconsin resident was exposed in California.)
This genotype was identified in a 2013 outbreak of hepatitis A virus infections in Europe linked to frozen berries and a 2012 outbreak in British Columbia related to a frozen berry blend with pomegranate seeds from Egypt.
CDC cautions that there is no evidence at this time that these outbreaks are related to the ongoing U. S. outbreak.
The most likely vehicle for the hepatitis A virus, according to both CDC and the U.S. Food and Drug Administration (FDA) is a common shipment of pomegranate seeds from a company in Turkey, Goknur Foodstuffs Import Export Trading.
The finding is based on FDA’s trace back and forward investigations and CDC epidemiological work. As a result, FDA will detain shipments of pomegranate seeds from Goknur when they are offered for import into the United States.
Pomegranate seeds from the same shipment were used by Townsend Farms to make the Townsend Farms and Harris Teeter Organic Antioxidant Blends and by Scenic Fruit Company to make the Woodstock Frozen Organic Pomegranate Kernels. FDA will be working with the firms that have distributed pomegranate seeds from this shipment from Turkey to help ensure that all recipients of these seeds are notified.
While the Townsend Farms frozen berries were sold at both Costco and Harris Teeter stores, only those sold at Costco stores have made people sick. The CDC profile of those stricken finds:
- 79 (56 percent) ill people are women
- Ages range from 1 – 84 years;
- 82 (59 percent) of those ill were between 40 – 64 years of age.
- 8 children age 18 or under were also ill. None were previously vaccinated.
- Illness onset dates range from 3/31/2013 – 6/24/2013
- 61 (44 percent) ill people (all over 18 years of age) have been hospitalized.
- No deaths have been reported.