Frozen strawberries from Egypt implicated in a Hepatitis A outbreak and used by Tropical Smoothie Café were not distributed to other restaurants or retailers as far as federal officials know, but more people are expected to get sick. logo Tropical Smoothie CafeVirginia, the hardest hit of the eight states with victims, reported Monday that 104 Virginians are confirmed in the outbreak, an increase of 10 cases during the past 10 days. That brings the nationwide total to 129, with at least 47 having had symptoms so severe they required hospitalization, according to the most recent numbers from the Centers for Disease Control and Prevention, which were posted Sept. 16. Tropical Smoothie Café pulled the implicated strawberries from its restaurants by Aug. 8, ending the direct exposure period at its locations, according to state and federal officials. But additional outbreak cases are still possible. “Symptoms of Hepatitis A virus infection can take up to 50 days to appear. As a result, CDC continues to identify cases of Hepatitis A related to the initial contaminated product,” according to the CDC update. One thing working to the benefit of public health at this point is that federal officials don’t think the imported frozen strawberries were distributed to any other customers in the U.S. “At this time, we are not aware of any other restaurants or retailers that may have received frozen strawberries linked to this outbreak,” a spokeswoman for the Food and Drug Administration said Monday afternoon. The spokeswoman said FDA “is in continued conversations” with Egyptian officials about the outbreak investigation but she declined to say when the agency last communicated with the Egyptian International Health Regulations National Focal Point. Meanwhile the CDC is monitoring for new Hepatitis A cases nationwide and reviewing previously reported cases as it checks for additional outbreak victims who did and did not consume strawberry smoothies. “The epidemiological investigation is ongoing, paying particular attention to those who do not recall consuming smoothies, but it is not uncommon to not be able to identify the exposure of some cases in any outbreak,” a spokeswoman said Monday. “CDC is continuing to look for cases and determine whether they are part of this outbreak strain, and it’s too soon for us to confirm this information.” While Virginia health officials are updating their state’s case count every day at noon, the CDC does not have a specific schedule for outbreak updates. As of its update Sept. 16, the CDC’s state-by-state outbreak count was:

  • Arkansas 1;
  • Maryland 12;
  • New York 3;
  • North Carolina 1;
  • Oregon 1 who contracted the infection while visiting Virginia;
  • West Virginia 6; and
  • Wisconsin 1.

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