Multistate Outbreak of Hepatitis A Virus Infections Linked to Fresh Organic Strawberries
Final Update
This outbreak investigation is over.
- Reported cases: 19
- States: 4
- Hospitalizations: 13
- Deaths: 0
CDC recommends that people who purchased fresh organic strawberries branded as FreshKampo or HEB during March 5, 2022, through April 15, 2022, and then froze those strawberries for later consumption take the following actions:
- Check your freezer for these fresh organic strawberries. If you froze them to eat later, do not eat them.
- Throw away any remaining fresh organic strawberries that you froze for later consumption. If you are unsure of what brand you purchased, when you purchased your fresh organic strawberries, or where you purchased them prior to freezing them, you should throw the strawberries away.
- If you have eaten these organic strawberries, purchased fresh and later frozen, within the last 14 days and are not vaccinated against hepatitis A, contact your local health department or health care provider to discuss getting postexposure prophylaxis (hepatitis A vaccine or immune globulin). Getting postexposure prophylaxis within 14 days of exposure can help prevent illness.
- As of August 14, 2022, this investigation is over.
- 19 outbreak-associated cases of hepatitis A were reported from 4 states (Arizona, California, Minnesota, and North Dakota).
- Illnesses started on dates ranging from March 28, 2022, to May 6, 2022.
- 13 people were hospitalized. No deaths were reported.
- Epidemiologic and traceback evidence indicated that fresh organic strawberries were the likely source of this outbreak.
- In interviews, 11/16 (69%) reported eating fresh organic strawberries.
Hepatitis A is a contagious liver infection caused by the hepatitis A virus. The hepatitis A virus is found in the stool and blood of people who are infected. The hepatitis A virus is spread when someone ingests the virus, usually through close personal contact with an infected person or from eating contaminated food or drink. Hepatitis A can be prevented with a vaccine, which is recommended for all children at age one and adults at risk.
Symptoms of Hepatitis A
- Symptoms of hepatitis A usually appear 2 to 7 weeks after exposure and can include
- Yellow skin or eyes
- Not wanting to eat
- Upset stomach
- Stomach pain
- Throwing up
- Fever
- Dark urine or light-colored stools
- Joint pain
- Diarrhea
- Feeling tired
- Not everyone with hepatitis A has symptoms. Adults are more likely to have symptoms than children.
- People who get hepatitis A may feel sick for a few weeks to several months but usually recover completely and do not have lasting liver damage. In some people, though, the illness may be so severe that the patient needs to be hospitalized.
- In rare cases, hepatitis A can cause liver failure and even death. This is more common in older people and in people with other serious health issues, such as chronic liver disease.
CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration investigated a multistate outbreak of hepatitis A linked to imported fresh organic strawberries. These potentially contaminated fresh organic strawberries were imported from Baja California, a state in northern Mexico, and branded as FreshKampo and HEB by a common supplier; they were purchased in the United States during March 5, 2022, through April 15, 2022. Traceback investigations showed that outbreak-associated cases in California and Minnesota purchased FreshKampo brand fresh organic strawberries prior to becoming ill. The Public Health Agency of Canada and the Canadian Food Inspection Agency also investigated an outbreak of hepatitis A; imported FreshKampo brand fresh organic strawberries were identified as the likely source of that outbreak.
As of August 14, 2022, a total of 19 outbreak-associated cases of hepatitis A were reported from 4 states. A list of the states and the number of cases in each is found on the Map of Reported Cases page.
Illnesses started on dates ranging from March 28, 2022, to May 6, 2022. Ill people ranged in age from 9 to 73 years, with a median age of 57 years. Sixty-three percent of ill people were female. Of 19 people with available information, 13 (68%) were hospitalized. No deaths were reported.
Investigation of the Outbreak
Epidemiologic and traceback evidence indicated that fresh organic strawberries, imported from Baja California, Mexico, were the likely source of this outbreak. The potentially affected FreshKampo and HEB products are past shelf life and no longer available for purchase in the United States. People who purchased FreshKampo or HEB fresh organic strawberries during March 5, 2022, through April 15, 2022, and then froze those strawberries for later consumption should not eat them. These products may have been sold at the following retailers, including, but not limited to: HEB, Kroger, Safeway, Sprouts Farmers Market, Trader Joe’s, Walmart, Weis Markets, and WinCo Foods.
A downstream recall previously reported (Urban Remedy Organic Revitalizing Tea Tonic Strawberry Hibiscus Rose) was reclassified as a market withdrawal. It was determined that the product was not made using implicated strawberries.
In interviews, ill people answered questions about the foods they ate and other exposures in the 2 to 7 weeks before they became ill. Of people who were interviewed, 11/16 (69%) reported eating fresh organic strawberries. This proportion was significantly higher than results from a survey of healthy people in which 50% reported eating fresh strawberries in the week before they were interviewed.
FDA completed its traceback investigation.
As of August 14, 2022, the investigation is over.