Multistate Outbreak of Hepatitis A Virus Infections Linked to Frozen Organic Strawberries

CDC, state public health and regulatory officials, and the U.S. Food and Drug Administration investigated a multistate outbreak of hepatitis A linked to frozen organic strawberries imported from certain farms located in Baja California, Mexico, by a common supplier. Frozen organic strawberries were sold to a variety of retailers under multiple brand labels. Traceback and epidemiological investigations showed that people with outbreak-associated cases purchased the same retail brand of frozen organic strawberries prior to becoming ill.

As of September 4, 2023, a total of 10 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 Where Sick People Lived page.

Illnesses started on dates ranging from November 24, 2022, to May 27, 2023. Ill people ranged in age from 38 to 64 years, with a median age of 56.5 years. Thirty percent of ill people were female. Of 10 people with available information, 4 (40%) were hospitalized. No deaths were reported.

Investigation of the Outbreak

Epidemiologic and traceback evidence indicated that frozen organic strawberries, imported fresh from a single farm located in Baja California, Mexico in 2022, were the source of this outbreak. The hepatitis A virus strain causing illnesses in this outbreak was genetically identical to the strain that caused a foodborne hepatitis A outbreak in 2022, which was linked to fresh organic strawberries imported from the same farm in Baja California, Mexico, and sold at various retailers. This single farm supplied strawberries to multiple importers across both outbreaks and some recipients processed fresh strawberries into the frozen berries consumed in the 2023 outbreak.

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, 10/10 (100%) reported eating frozen organic strawberries. This proportion was significantly higher than results from a survey of healthy people in which 24% reported eating frozen berries in the week before they were interviewed.

In response to this investigation, California Splendor, Inc. of San Diego, California voluntarily recalled certain lots of 4-lb. bags of Kirkland Signature Frozen Organic Whole Strawberries that were sold at Costco stores in Los Angeles, California; Hawaii; and two San Diego, California business centers. The lots subject to this recall include: 140962-08, 142222-23, 142792-54, 142862-57, 142912-59, 142162-20, 142202-21, 142782-53, 142852-56, 142902-58, 142212-22, 142232-24, 142842-55.

In response to this investigation, Scenic Fruit Company of Gresham, Oregon voluntarily recalled frozen organic strawberries, sold to Costco, Trader Joe’s, Aldi, KeHE, Vital Choice Seafood, and PCC Community Markets in certain states. Products subject to this recall include: