UPDATED CONTENT: As of noon Friday, Sept. 2, the Virginia Department of Health reports 66 residents of the state have been confirmed with Hepatitis A infections in this outbreak. That’s an increase of seven cases in the state since the department’s report on Thursday. Overall, the nationwide total now stands at 81. FDA officials are working with Egyptian officials on an investigation into a Hepatitis A outbreak linked to frozen strawberries from Egypt that were served in smoothies. 
As of today, 74 people in seven states have been confirmed through laboratory testing to be infected with the outbreak strain. Federal officials report that symptoms of at least 32 of the victims were so severe they required hospitalization. They expect additional people to be stricken because of the 15- to 50-day incubation time for Hepatitis A. The vast majority of the victims reported having Tropical Smoothie Café smoothies containing strawberries before they became ill, according to state and federal officials. “The FDA’s investigation into the source and distribution of the strawberries is ongoing; and the agency has been in touch with the Egyptian International Health Regulations National Focal Point to discuss the investigation,” according to a notice posted on the Food and Drug Administration’s website this afternoon. “FDA is working to identify other parts of the relevant supply chain and will take appropriate action as necessary. However, FDA is prohibited by law in most situations from releasing publicly certain confidential commercial information about supply chains.The FDA has initiated increased surveillance of imported strawberries and will provide more information as it becomes available.” The hardest hit state is Virginia, where 59 residents are infected, according to a noon update from the state’s health department. That’s an increase of four people in 24 hours. They range in age from 14 to 58. People in Virginia started coming down with Hepatitis A in early May. In early August, the Virginia Department of Health recognized an abnormal spike in the number of infections. They launched an investigation and contacted the Centers for Disease Control and Prevention. CDC leads epidemiological investigation Today CDC posted its initial report on the outbreak — which included Virginia’s count of 55 from Wednesday — reporting 70 people from seven states are infected. The states and number of confirmed victims are: Maryland, 6; New York, 1; North Carolina, 1; Oregon, 1; Virginia, 55 (Wednesday’s count); West Virginia, 5, and Wisconsin, 1. 
Of those 70 people, 68 reported consuming a smoothie from Tropical Smoothie Café before becoming ill. That’s 97 percent. “Of the 54 ill people who were interviewed about the type of smoothie, all reported drinking a smoothie containing strawberries,” CDC reported. “These ill people purchased smoothies at cafés located in a limited geographical area, including Virginia and neighboring states. The ill person in Oregon traveled to Virginia and while there, had purchased smoothies containing frozen strawberries from a Tropical Smoothie Café location.” Although FDA did not reference any testing of the imported, frozen strawberries in its outbreak post today, CDC reported the other agency is waiting on lab results. A CDC spokeswoman said earlier this week that CDC does not test food samples. That’s the responsibility of FDA and the U.S. Department of Agriculture, depending on the food item involved. “Investigators are working to determine which specific lots may have been contaminated with Hepatitis A virus and to find out if the frozen strawberries were distributed to other U.S. customers,” CDC reported “Frozen strawberries used at Tropical Smoothie Café locations were collected for testing. The FDA’s analysis is ongoing.” Both CDC and FDA reported there is no information to suggest there is an ongoing risk of Hepatitis A infection at Tropical Smoothie Cafés. Neither agency has any information suggesting any other restaurants or retailers received the implicated frozen strawberries from Egypt, according to their reports today. Response by Tropical Smoothie Café All U.S. and state agencies involved in the investigation have reported Tropical Smoothie Café management responded quickly upon receiving notification from Virginia officials that the strawberries used in the chain’s restaurants were a possible source of the outbreak. 