Virginia Hepatitis A Cases Linked to Contaminated Frozen Strawberries from Egypt

August 19, 2016

Dear Colleague:

The Virginia Department of Health is asking clinicians to consider hepatitis A in patients who consumed frozen strawberries at restaurants within the fifty days prior to illness onset due to the virus’ long incubation period.

Virginia is experiencing a significant increase in Hepatitis A cases. Many cases report consuming a smoothie containing strawberries from Tropical Smoothie Café. Evidence suggests that frozen strawberries imported from Egypt may be associated with illness. Upon learning of the potential link to strawberries, Tropical Smoothie Café immediately conducted a voluntary product withdrawal of all strawberries sourced from Egypt beginning on August 6th. Other restaurants may also have received the frozen strawberries imported from Egypt.

The Virginia Department of Health Recommendations for Clinicians:

  • Screen any ill persons who consumed smoothies containing frozen strawberries at a restaurant location in Virginia for hepatitis A and test if clinically indicated;
  • Individuals who consumed a smoothie from Tropical Smoothie Café between August 5th and August 8th may still benefit from hepatitis A vaccine or immune globulin;
  • Report any illnesses, including suspected cases of hepatitis A related to consumption of smoothie products containing contaminated strawberries, to your local health district;
  • Counsel patients with symptoms of hepatitis A to stay home from work, especially if they work in the food service industry.

Thank you for counseling your patients on actions they can take to prevent Hepatitis A. Please visit the CDC’s hepatitis A information page for recommendations on vaccine or immune globulin administration, prevention messages, or other hepatitis A related information.


Marissa J. Levine, MD, MPH, FAAFP
State Health Commissioner