Two more people are confirmed infected and a sixth state is involved in a hepatitis A outbreak associated with fresh blackberries that were sold in September. More than half of the victims have required hospitalization.

Although the blackberries were sold fresh from Sept. 9-30 at Fresh Thyme Farmers Market grocery stores, infections continue to be reported, likely for two main reasons. Freezing does not kill the hepatitis A virus, according to the Food and Drug Administration. Also, it takes up to 50 days or more in some patients for the infection symptoms to develop.

“On Dec. 3, the CDC updated their case counts to 16 illnesses, with the most recent illness onset date on Nov. 15,” according to an update from the FDA. “Based on the epidemiological information collected in the investigation thus far, ill patients reported consuming fresh conventional blackberries from Fresh Thyme Farmers Market stores in six states: Indiana, Michigan, Minnesota, Missouri, Nebraska, and Wisconsin.

“However, traceback information to date shows that these berries came from a distribution center that ships fresh berries to Fresh Thyme Farmers Market stores in 11 states.”

Fresh Thyme officials report that the implicated berries could have been shipped to stores in Iowa, Illinois, Indiana, Kentucky, Michigan, Missouri, Minnesota, Nebraska, Ohio, Pennsylvania and Wisconsin.

The holiday season could be playing a part in the continued pattern of infections as consumers thaw berries they bought earlier in the fall and froze for use in fruit salads and other holiday dishes requiring raw berries.

Officials with the FDA are urging people to discard any blackberries they have on hand that were sold at Fresh Thyme stores in any of the 11 states in September.

There is a post-exposure that people can receive to prevent the hepatitis A virus from infecting them, but it must be given within two weeks of exposure.

“If consumers purchased fresh conventional blackberries from Fresh Thyme Farmers Market stores in the 11 states listed above between Sept. 9-30, ate those berries in the last two weeks, and have not been vaccinated for the hepatitis A virus (HAV), they should consult with their healthcare professional to determine whether post exposure prophylaxis (PEP) is indicated,” the FDA update says. “PEP is recommended for unvaccinated people who have been exposed to HAV in the last two weeks.”

About hepatitis A infections
Hepatitis A is a contagious virus that can cause liver disease. A hepatitis A virus (HAV) infection can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months. In rare cases, particularly for people with a pre-existing health condition or people with weakened immune systems, hepatitis A infections can progress to liver failure and death.

The majority of hepatitis A infections are from unknown causes or from being in close contact with an infected person; however, some hepatitis A infections are caused by eating or drinking contaminated food or water. Contamination of food can occur at any point during harvesting, processing, and distribution.

Illness usually occurs within 15 to 50 days after eating or drinking contaminated food or water. Symptoms of hepatitis A infection include fatigue, nausea, vomiting, abdominal pain, jaundice, dark urine, and pale stool. 

In some instances, particularly in children under the age of six, hepatitis A infection may be asymptomatic. People with hepatitis A infections usually completely recover within one to two months; however, in rare cases hepatitis A may cause prolonged or relapsing infection.

Due to the range in severity of illness, people should consult their health care provider if they suspect that they have developed symptoms that resemble a hepatitis A infection. All people are susceptible to hepatitis A infection; however, individuals who have had hepatitis A before or who have been vaccinated are immune to hepatitis A infection.

(To sign up for a free subscription to Food Safety News, click here.)