Outbreak of Hepatitis A Virus Infections Potentially Linked to Fresh Blackberries

Food Safety Alert

Originally published on November 20, 2019 at 4:15 PM ET

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of hepatitis A that may be linked to fresh conventional (non-organic) blackberries purchased during September 9-30, 2019 from Fresh Thyme Farmers Market, a Midwest grocery chain.

Efforts to identify suppliers of the blackberries are ongoing. A risk of acquiring hepatitis A virus infection is present for anyone who consumed contaminated blackberries purchased during this timeframe, including blackberries that may have been frozen for later consumption.

This investigation is ongoing, and CDC will update the public as more information becomes available.

Advice to Consumers

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CDC recommends that people who purchased fresh blackberries from any Fresh Thyme Farmers Market location (which has stores in 11 Midwest states) during September 9-30, 2019 take the following actions:

  • Check your freezer for these blackberries. If you froze them to eat later, do not eat them.
  • Throw away any remaining blackberries.
  • If you have eaten these blackberries, purchased fresh and later frozen, within the last 14 days and are not vaccinated against hepatitis A, contact your local health department or healthcare provider to discuss getting postexposure prophylaxis (hepatitis A vaccine or immune globulin). Getting postexposure prophylaxis within 14 days of exposure can help prevent illness.

Latest Outbreak Information

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  • As of December 2, 2019, this outbreak appears to be ongoing.
  • 16 outbreak-associated cases of hepatitis A have been reported from 6 states (Indiana, Michigan, Minnesota, Missouri, Nebraska, and Wisconsin).
    • Illnesses started on dates ranging from October 8, 2019, to November 15, 2019.
    • 9 people have been hospitalized. No deaths have been reported.
  • Epidemiologic and traceback evidence are being collected and analyzed. A single, common supplier of fresh blackberries has not been identified.
    • In interviews, 15/15 (100%) reported eating fresh blackberries
      • Of 13 cases with known fresh blackberry purchase location information, 13/13 (100%) purchased fresh blackberries from Fresh Thyme Farmers Market
  • This outbreak investigation is ongoing, and CDC will update the public when more information becomes available.
At a Glance
  • Reported cases: 16
  • States: 6
  • Hospitalizations: 9
  • Deaths: 0
  • Recall: No
By the Numbers

Case count map

Click to view case count map.

Timeline

Click to view case timeline.

What is Hepatitis A

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

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  • 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.
Investigation Details

December 2, 2019

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA)external icon are investigating a multistate outbreak of hepatitis A associated with exposure to contaminated fresh blackberries sold at Fresh Thyme Farmers Market grocery stores during September 2019.

As of December 2, 2019, a total of 16 outbreak-associated cases of hepatitis A were reported from 6 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 October 8, 2019, to November 15, 2019. Ill people range in age from 14 to 73 years, with a median age of 50. Seventy-five percent of ill people are female. Of 15 people with available information, 9 (60%) were hospitalized. No deaths have been reported.

Illnesses might not yet be reported due to the time it takes for symptoms to appear after exposure (average 4 weeks) and the time it takes between when someone becomes ill and when the illness is reported.

Investigation of the Outbreak

Epidemiologic and traceback evidence are being collected and analyzed. A single, common supplier of fresh blackberries has not been identified.

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, 15/15 (100%) reported eating fresh blackberries; of 13 people with known fresh blackberry purchase location information, 13/13 (100%) purchased fresh blackberries from Fresh Thyme Farmers Market. This proportion was significantly higher than results from a survey pdf icon[PDF – 29 pages] of healthy people in which 7% reported eating fresh blackberries in the week before they were interviewed.

The FDA and regulatory officials in several states have collected records from grocery stores where ill people reported buying fresh blackberries and are conducting traceback investigations to try to identify a specific source of the fresh blackberries.

This outbreak investigation is ongoing, and CDC will update the public when more information becomes available.