Frozen Strawberries from Egypt Linked to 134 Hepatitis A Cases

In early September, an outbreak of Hepatitis A linked to frozen strawberries was identified.  As of October 20th, there are 134 cases identified all linked to frozen strawberries served in smoothie drinks (fresh blended fruit and vegetable drinks) served at Tropical Smoothie Cafes.

The frozen strawberries were sourced from Egypt.  FDA issued an import alert for detention without physical inspection of frozen strawberries from Egypt, even though the Egypt Ministry of Climate Change and Environment "claimed Frozen Egyptian strawberries are free from Hepatitis A..".

 

FDA Release

 http://www.fda.gov/food/RecallsOutbreaksEmergencies/Outbreaks/ucm518775.htm

FDA Investigates Outbreak of Hepatitis A Illnesses Linked to Frozen Strawberries

October 20, 2016

Hepatitis A in Frozen Strawberries Infects 89 People

CDC reported that 89 people contracted Hepatitis A from frozen strawberries.  The outbreak was initially reported two weeks by the Virginia Department of Health.  In most all cases, the infections were linked to the strawberries being served in smoothie drinks served by Tropical Smoothie Café.

Smoothies, the blending of fruits and vegetables into a nutritious yet tasty beverage, can be an issue if any of the fruit and vegetable ingredients harbor pathogenic bacteria.  The risk can be made worse if the smoothie product is temperature abused.  The hard part when buying from a commercial smoothie producer is knowing where they source their ingredients.  In the past, had been an issue pomegranate sourced from the middle east.  That too was a source of Hepatitis A.
 

CDC Outbreak
http://www.cdc.gov/hepatitis/outbreaks/2016/hav-strawberries.htm
August 2016 - Multistate outbreak of hepatitis A linked to frozen strawberries
Posted September 8, 2016 10:15 AM ET

At a Glance

Case Count: 89

States: 7

Deaths: 0

Hospitalizations: 39

Hepatitis A Outbreak Link to Frozen Strawberries from Egypt

The VA Department of Health issued a health warning about a cluster of hepatitis A cases and has identified a potential association with frozen strawberries used in smoothies from Tropical Smoothie Cafe restaurants in Virginia.  The frozen strawberries came from Egypt.

This is not the first time that frozen fruit sourced from the Middle East has been a problem for Hepatitis A.   In 2013, frozen pomegranate seeds were linked to a Hepatitis A outbreak  where over 150 were infected.  Smoothies are an issue because there is no elimination step such as heating.  Any contamination on the fruit gets blended into the drink.

Virginia Department of Health News Release
http://www.vdh.virginia.gov/news/public-relations-contacts/news-releases/2016-statewide-news-releases/health-officials-warn-of-increased-hepatitis-a-risk/
Health Officials Warn of Increased Hepatitis A Risk
August 19, 2016

2012 Norovirus Outbreak in Germany Linked to Imported Frozen Strawberries

 A report details the 2012 outbreak of Norovirus in Germany where approximately 11,000 cases were reported.   The report concludes that fresh frozen strawberries imported from China were the food vehicle.

Because the fruit is fresh frozen, there are no destructive processes such as heat to remove or reduce Norovirus.  Keys to prevention for the grower / packer are having good personal hygiene programs including employee health policies, and systems to maintain potable wash water.

For the broker or the purchaser, supplier control should include ways to ensure that the grower/packer have these programs in place, especially for these minimally processed RTE items.  Testing for Norovirus in not commonly done.

Eurosurveillance
Volume 19, Issue 8, 27 February 2014
Surveillance and outbreak reports
Large multistate outbreak of norovirus gastroenteritis associated with frozen strawberries, Germany, 2012
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20719
H Bernard1,2, M Faber ()1,2, H Wilking 1, S Haller1,3,4, M Höhle1, A Schielke1, T Ducomble1,4,5, C Siffczyk6, S S Merbecks7, G Fricke8, O Hamouda1, K Stark1, D Werber1, on behalf of the Outbreak Investigation Team9
From 20 September through 5 October 2012, the largest recorded food-borne outbreak in Germany occurred. Norovirus was identified as the causative agent. We conducted four analytical epidemiological studies, two case–control studies and two surveys (in total 150 cases) in secondary schools in three different federal states. Overall, 390 institutions in five federal states reported nearly 11,000 cases of gastroenteritis. They were predominantly schools and childcare facilities and were supplied almost exclusively by one large catering company. The analytical epidemiological studies consistently identified dishes containing strawberries as the most likely vehicle, with estimated odds ratios ranging from 2.6 to 45.4. The dishes had been prepared in different regional kitchens of the catering company and were served in the schools two days before the peaks of the respective outbreaks. All affected institutions had received strawberries of one lot, imported frozen from China. The outbreak vehicle was identified within a week, which led to a timely recall and prevented more than half of the lot from reaching the consumer. This outbreak exemplifies the risk of large outbreaks in the era of global food trade. It underlines the importance of timely surveillance and epidemiological outbreak investigations for food safety.

Deer confirmed as E. coli source in Oregon Strawberry Outbreak

Deer dropping are the reported source of E.coli that contaminated strawberries.  For those who deal with fresh, ready-to-eat fruit and vegetables, this case puts additional pressure on addressing the movement of wild animals onto agricultural fields.

Deer confirmed as E. coli source in Oregon

http://www.thepacker.com/fruit-vegetable-enewsletter/packer-daily/Deer-confirmed-as-E-coli-source-in-Oregon-127966683.html

08/17/2011 4:24:36 PM  The Packer
Coral Beach

State officials announced test results that confirmed deer as the source of E. coli O157:H7 that contaminated fresh strawberries in Oregon, causing one death and making at least 14 other people sick in July.

Oregon’s Public Health epidemiologist Katrina Hedberg reported the results in a news release Aug. 17. Six samples positively matched the E. coli that was found in the people who were infected, Hedberg stated in the release.

More than 100 samples were taken Aug. 6 from five fields where the berries were grown at Jaquith Strawberry Farm in Newberg, Ore. Those samples included deer droppings, soil and strawberry plants. Growers Joe and Jerri Jaquith have been cooperating with state officials, who have said that no sub-standard or problematic conditions were found when the farm was inspected.

Oregon health and agriculture officials remain concerned that some of the strawberries may remain in consumers’ hands. They repeated warnings Aug. 17 that uncooked strawberries used for “freezer jam” or frozen for later use should be thrown out. The strawberries were sold at roadside stands and farmers markets. Harvest at the farm ceased July 29.

“At this time, the Oregon Department of Agriculture believes it has identified those operators and locations that possibly sold Jaquith strawberries,” Hedberg stated in the Aug. 17 release. A list of the 57 locations and 36 vendors is on the department website.

This outbreak, which sickened people from July 10-29, marks the second time in Oregon that E. coli O157:H7 carried by deer has been implicated in human illness.

The bacteria is most often associated with beef and dairy products, but in 1997 Oregon epidemiologist William Keene confirmed that venison jerky was contaminated with the pathogen. Since that time, E. coli has also been confirmed in wild elk.

There is an outbreak of E. coli O157 related to fresh strawberries in Oregon.  13 people have become ill from eating strawberries that came from a particular farm in NW Oregon.  No source has been identified on how the strawberries came to be contaminated.   This is the first outbreak of STEC E.coli related to strawberries.

Recall -- State / Local Press Release

FDA posts press releases and other notices of recalls and safety alerts from states as a service to consumers, the media, and other interested parties. FDA is not responsible for the content of these notices.

http://www.fda.gov/Safety/Recalls/ucm267667.htm

Fresh Strawberries From Washington County Farm Implicated In E. coli O157 Outbreak In NW Oregon

Contact:
Media:
Jonathan Modie
503-758-4914 (Primary)
971-673-1102 (Desk)
jonathan.n.modie@state.or.us

FOR IMMEDIATE RELEASE - August 8, 2011 - Oregon Public Health officials have identified fresh strawberries from a Newberg farm as the source of a cluster of Escherichia coli O157:H7 infections that sickened at least 10 people last month, including one person who died.

The strawberries were produced last month by Jaquith Strawberry Farm located at 23135 SW Jaquith Road in Newberg. Jaquith finished its strawberry season in late July, and its strawberries are no longer on the market. Jaquith sold its strawberries to buyers who then resold them at roadside stands and farmer’s markets.

Health officials are urging consumers who may have purchased strawberries grown on this farm to throw them out. Strawberries that have been frozen or made into uncooked jam are of particular concern. Cooking kills E. coli O157:H7 bacteria.

“If you have any strawberries from this producer—frozen, in uncooked jam, or any uncooked form—throw them out,” says Paul Cieslak, M.D., from Oregon Public Health Division. He says people who have eaten the strawberries, but remain well need take no action. The incubation period for E. coli O157:H7 is typically two to seven days.

None of the following have been implicated in this outbreak:

• Berries other than strawberries.
• Strawberries sold since Aug. 1.
• Strawberries sold south of Benton County or east of Multnomah County.
• Strawberries sold in supermarkets.
• Strawberries picked at Jaquith Strawberry Farm’s U-pick field.

Ten people have confirmed E. coli O157:H7 infection caused by a single strain. They include residents of Washington, Clatsop, and Multnomah Counties. Six other people in northwest Oregon also have recently developed E. coli O157:H7 infection and appear to be part of this outbreak.

Of the confirmed cases, four have been hospitalized, and one elderly woman in Washington County died from kidney failure associated with E. coli O157:H7 infection. There were twelve females and four males among the cases, and their ages ranged from 4 to 85. They fell ill between July 10 and July 29.

Cieslak, manager of the Oregon Public Health’s communicable disease section, said his team has been working with county public health officials and the Oregon Department of Agriculture on tracking the infection cases. When a potential outbreak is investigated, public health officials ask those who’ve been sickened, family members and health care providers a slate of questions to find common exposures and “trace back” to the source.

“If someone gets sick, we ask questions about everything from what they’ve eaten, to whether they’ve been to common gatherings, to whether they’ve been swimming in a particular place, and then out of this we try to find commonalities,” he said. “The commonality among these cases has been strawberries at roadside stands and farmer’s markets supplied by this one farm last month.”

E. coli is a common inhabitant of the gastrointestinal tract and is usually harmless. But E. coli O157:H7 is a strain of the bacterium carried by some animals, that can contaminate food and water, and that produces toxins that can cause mild to severe intestinal illness, including severe cramps and diarrhea that is often bloody. Some patients develop complications that require hospitalization. About 5 percent of infected persons, especially young children and the elderly, suffer serious and potentially fatal kidney damage.

Antibiotics are not recommended for treatment of E. coli O157:H7 infection, and they may actually make kidney failure more likely. People infected with E. coli O157 should rest and drink plenty of fluids to reduce fatigue and dehydration.

Public health officials emphasize that fruits and vegetables are still important to a healthy diet; at least five servings per day are recommended. However, people need to take the following precautions with any uncooked produce:

1. Wash fruits and vegetables thoroughly before eating them.
2. Keep fruits and vegetables and other raw food separated from cooked food
3. Wash your hands thoroughly with soap after handling raw foods, as well as before eating, after using the toilet, and after changing diapers.

 

Owner of Jaquith Strawberry Farm saddened by E. coli outbreak

http://www.oregonlive.com/washingtoncounty/index.ssf/2011/08/owner_of_jaquith_strawberry_fa.html

Published: Wednesday, August 10, 2011, 9:42 AM Updated: Wednesday, August 10, 2011, 1:23 PM

Deer suspected as source of nation's first E. coli outbreak traced to tainted strawberries

Published: Monday, August 08, 2011, 8:38 PM Updated: Tuesday, August 09, 2011, 10:55 AM

http://www.oregonlive.com/washingtoncounty/index.ssf/2011/08/deer_suspected_as_cause_of_nat.html