The number of hepatitis A cases associated with Townsend Farms Organic Antioxidant Blend has grown to 159, according to an update from the Centers for Disease Control and Prevention that was issued today. According to the CDC, cases were reported in 10 states:  Arizona, California, Colorado, Hawaii, New Hampshire, New Jersey, New Mexico, Nevada, Utah and Wisconsin.  The agency noted, however, that the cases reported from Wisconsin resulted from exposure to the Townsend Farms product in California, the cases reported from New Hampshire reported exposure during travel to Nevada, and the case reported in New Jersey was a household contact from a confirmed case from Colorado. Household contact can resulted in what are known as “secondary cases,” or cases that are the result of exposure to an infected individual rather than contaminated product. In its latest update, the CDC stated that illnesses had been reported in individuals ranging in age from 1 to 84 years.  Sixty-nine people who contracted hepatitis A after eating the Townsend Farms berry blend were hospitalized; no deaths have been reported. Illness onset dates range from March 31, 2013 to July 25, 2013. While the product was sold at both Costco Wholesale stores and Harris Teeter stores, no ill people have been identified that bought the product at Harris Teeter. Townsend Farms of Fairview, Oregon recalled its frozen Organic Antioxidant Blend for potential hepatitis A contamination on June 3, 2013.  Costco notified its members who purchased the product, urging them to receive prophylactic treatment to prevent hepatitis A infection and to discard the berry blend.  The recall was expanded on June 28, to include additional UPC codes. Public health officials ultimately determined that pomegranate seeds included in the Townsend Farms mix were the source of the hepatitis A outbreak.  The pomegranate seeds were imported from Turkey by Goknur Foodstuffs Import Export Trading.  FDA said it will detain shipments of pomegranate seeds from  Goknur when they are offered for import into the United States. Hepatitis A Hepatitis A is a communicable disease that spreads via a “fecal-oral route.”  Food-related outbreaks are usually associated with food that is contaminated during cultivation, harvesting, processing or distribution.  Infected restaurant workers are a common source of hepatitis A exposure. Approximately 10 to 12 days after exposure, hepatitis A is present in an infected person’s blood and is excreted into their feces.  About 2 weeks after exposure, symptoms appear and the amount of hepatitis A virus excreted in a person’s feces lessens. While young children do not typically exhibit symptoms of hepatitis A infection, older children and adults typically experience muscle aches, headache, abdominal discomfort, loss of appetite, fever and malaise 15 to 50 days after exposure.  After a few days of these symptoms, jaundice—a yellowing of the skin and eyes—sets in. In general, symptoms of hepatitis A usually last less than 2 months, although relapse is not altogether uncommon.  Unlike with chronic forms of hepatitis, such as B and C, individuals with hepatitis A infections typically recover.  Once a person has recovered from a hepatitis A infection, they are immune to the virus.