New cases of Hepatitis A infections linked to strawberry smoothies have slowed so much that the state hardest hit, Virginia, is no longer providing daily updates.

In a weekly update, posted Thursday, the Virginia Department of Health reported 107 people who have tested positive for Hepatitis A reported drinking  smoothies Tropical Smoothie Café prior to becoming ill.

Nationwide there were 131 confirmed victims as of Sept. 29, according to the Centers for Disease Control and Prevention, which has not posted an update on the outbreak since Sept. 30. A CDC spokeswoman said Friday afternoon the agency will likely update the public next week on the status of the outbreak.

Of the 131 sick people, who live in eight states, about 40 percent — 52 people as of Sept. 29 — have had symptoms so severe that they required hospitalization.

Virginia officials say the first illnesses began in early May, with new victims continuing to be identified through September. It can take up to 50 days for symptoms to develop after exposure to Hepatitis A.

Virginia officials, working with federal officials, identified the outbreak in early August and linked it to frozen strawberries from Egypt that were served raw at Tropical Smoothie Café locations. The restaurant chain pulled the strawberries from all of its locations in multiple states over a period of several days.

The outbreak strain of Hepatitis A has been identified in strawberries from Egypt in previous years. Officials with the Food and Drug Administration have been in communication with their counterparts in Egypt since late August, but have declined to provide specific details about the investigation.

Government agencies in some countries in the Mideast have tested strawberries being imported into their countries from Egypt in recent weeks and declared them to be pathogen free.

As eight states, federal and international governments continue their investigation into the outbreak, victims are seeking compensation in court. There is also a civil case seeking class action status for anyone who consumed the implicated strawberries and were able to receive post-exposure vaccinations.

In addition to naming Tropical Smoothie Café as a defendant, some of the outbreak victims have also named 10 other companies and individuals that were involved with the importing and distribution of the suspect strawberries.

“This latest complaint identifies not only Tropical Smoothie Cafe LLC, whose corporate office is in Atlanta, GA, as a defendant, but also all the companies within the supply chain, which moved and distributed frozen strawberries from Egypt to restaurants in Virginia,” states the news release issued on behalf of the law firms.

Along with the fast food restaurant chain, defendants named in the civil case include the country’s largest foodservice supplier, Sysco Corp. of Houston, and several of its subsidiaries. Sysco supplies fresh and packaged foods, paper products and carious other supplies to restaurants, hospitals, hotels and institutional foodservice operations such as school cafeterias.

Other defendants named include:

• JMG Enterprises Inc. of Great Falls;
• Sysco Hampton Roads Inc. of Houston;
• Sysco VA LLC of Harrisonburg;
• Sysco Merchandising and Supply Chain Services Inc. of Houston;
• International Traders Inc. of Rocky Mount, NC;
• Patagonia Foods LLC of San Luis Obispo, CA; and
• VLM Foods USA Inc. of Plattsburgh, NY.

The outbreak victims who named the supply chain defendants are being represented by Zambri of Regan Zambri & Long in Washington D.C., and Bill Marler of Marler Clark, a Seattle-based firm specializing in food safety.

“It is a complex chain of distribution that moves strawberries from Egypt for use in the U.S.,” Marler said. “Upon information and belief, all of these companies played a role in not only shipping the fruit, but also in the illnesses that made the victims of this outbreak so sick that many of them required medical attention and have had to put their daily lives on hold.”

Marler’s co-counsel Salvatore J. Zambri contends the outbreak was avoidable. Marler said at the very least it could have been more quickly contained, avoiding the majority of the infections.

The Seattle food safety attorney criticized Tropical Smoothie Cafe for taking four days or more to remove the implicated strawberries from all of its locations. Marler also contends the Virginia health officials should have acted faster.

The Virginia health department didn’t warn the public about the outbreak until Aug. 19 — it notified Tropical Smoothie officials on Aug. 5. That two-week delay was critical for the public because post-exposure vaccination is only effective if given within two weeks of exposure.

For additional details, please see: “Berries tied to outbreak likely only went to Tropical Smoothie“

Editor’s note: Bill Marler, founding partner of Marler Clark in Seattle, is publisher of Food Safety News.

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