Local News

Multistate Hepatitis A Outbreak Associated With Frozen Berry Blend

Date: June 12, 2013

Federal, state, and local health departments continue to investigate a national hepatitis A virus (HAV) outbreak involving 87 people in eight states associated with consumption of Townsend Farms Organic Antioxidant Blend frozen berries sold by Costco stores. Twelve San Diego County residents have been reported with confirmed hepatitis A after consuming the implicated product; seven were hospitalized. Illness onset dates range from March 31 to May 31, 2013. Case reports are expected to increase given the 15–50 day incubation period for hepatitis A. Click here for local updates and links to additional information and resources.

San Diego County healthcare providers are requested to:

  1. Be alert for suspect cases of hepatitis A, especially in patients with a history of consuming the berry blend product. Clinical jaundice may be a late sign or one that never develops, particularly in children.
  2. Order HAV IgM antibody serology rather than HAV total antibody serology when working up patients for acute disease. Total HAV antibody positivity may indicate immunity due to previous infection or immunization and is not sufficient evidence of an acute infection.
  3. Avoid ordering serology for people who have no symptoms nor elevated liver function tests, but report eating the implicated berries. False positive HAV IgM test results are common when asymptomatic people are tested.
  4. Advise patients in sensitive occupations not to work with suspected or confirmed HAV infection. Individuals employed in food service, healthcare, or child care should not be allowed to work in these settings for at least one week after jaundice onset or two weeks after symptom onset (if no jaundice), whichever is later. These individuals are at increased risk of spreading the infection to others via the fecal-oral route.
  5. Promptly report all suspect and confirmed cases to the Epidemiology Program by faxing a Confidential Morbidity Report (CMR) or by calling (619) 692-8499 (Monday–Friday, 8–5 pm) or (858) 565-5255 (after hours).

The CDC hepatitis A website for health professionals provides useful information about the virus, including vaccination, immune globulin, and post-exposure prophylaxis.

Click here for recently revised and updated post-exposure prophylaxis guidance from the California Department of Public Health.

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