US multistate outbreak of hepatitis A virus infections linked to pomegranate seeds from Turkey (Final Update)

The U.S. Centers for Disease Control and Prevention reports this outbreak investigation has been finalized and the published report
can be found in the journal Lancet Infectious Diseases at http://www.thelancet.com/journals/laninf/issue/current http://www.cdc.gov/hepatitis/Outbreaks/2013/A1b-03-31/index.html

  • 165 people were confirmed to have become ill from hepatitis A after eating ‘Townsend Farms Organic Antioxidant Blend’ in 10 states: Arizona (24), California (80), Colorado (29), Hawaii (8), New Hampshire (1), New Jersey (1), New Mexico (11), Nevada (6), Utah (3), and Wisconsin (2). [Note: The cases reported from Wisconsin resulted from exposure to
    the product in California, the cases reported from New Hampshire reported fruit exposure during travel to Nevada, and the case reported in New Jersey was a household contact of a confirmed case from Colorado.] Eight of the confirmed cases were household contacts of confirmed cases (secondary cases).pomegranate
  • 91 (55%) female ill persons
  • Ages ranged from <1 – 84 years;
  • 95 (58%) of those ill were between 40 – 64 years of age.
  • 11 children age 18 or under were also ill. None were previously vaccinated.
  • Illness onset dates ranged from 3/31/2013 – 8/12/2013
  • 69 (42%) ill people were hospitalized, and no deaths were reported
  • All ill people who reported eating this product purchased it from Costco markets; however, the product was also sold at Harris Teeter stores. No ill people were identified that bought the product at Harris Teeter.

Laboratory Investigation:

  • The major outbreak strain of hepatitis A virus, belonging to genotype 1B, was found in clinical specimens of 117 ill persons. This genotype is rarely seen in the Americas but circulates in North Africa and the Middle East.

Regulatory Investigation:

  • By combining information gained from FDA’s traceback and traceforward investigations and the CDC’s epidemiological investigation, FDA and CDC have determined that the most likely vehicle for the hepatitis A virus appears to be a common shipment of pomegranate seeds from a company in Turkey, Goknur Foodstuffs Import Export Trading.
  • FDA has detained all shipments of pomegranate seeds from Goknur when they are offered for import into the United States.
  • These pomegranate seeds were used by Townsend Farms to make the Townsend Farms and Harris Teeter Organic Antioxidant Blends and by Scenic Fruit Company to make the Woodstock Frozen Organic Pomegranate Kernels.
  • On June 4, 2013, Townsend Farms, Inc. of Fairview, Oregon voluntarily recalled certain lots of its frozen Organic Antioxidant BlendExternal Web Site Icon because of potential hepatitis A virus contamination.
  • On June 28, 2013, Townsend Farms, Inc. of Fairview, Oregon, expanded its voluntary limited lot recall of frozen Organic Antioxidant Blend, 3 lbExternal Web Site Icon. because of potential hepatitis A virus contamination.
  • On June 26, 2013, Scenic Fruit Company of Gresham, Oregon recalled specific lots of Woodstock Frozen Organic Pomegranate KernelsExternal Web Site Icon because of potential hepatitis A virus contamination.
  • Additional information regarding these recalls was updated regularly at: FDA Investigates Multistate Outbreak of Hepatitis A Illnesses Associated with Pomegranate seeds from Turkish ImporterExternal Web Site Icon.
  • Consumers should not eat recalled products containing pomegranate seeds. The recalled products should be discarded.

49 now sick; Fingering pomegranate, keeping hepatitis A out of frozen berries starts at the farm

State-sponsored jazz got something right: food safety for produce starts at the farm.

Nancy Shute of NPR reports the Centers for Disease Control and Prevention that at least 49 people in seven states have gotten Hepatitis A from eating organic frozen berries.

Hepatitis A in frozen berries is not a new problem — though most recorded outbreaks have been small. Way back in the 1980s people got the same virus raspberryfrom frozen raspberries used to make mousse in Scotland. A 2003 outbreak in New Zealand was traced to a single blueberry farm. Finland banned serving uncooked berries in institutional settings after multiple outbreaks in the late 1990s.

Canada also has a hepatitis A outbreak caused by frozen berries. One last year in British Columbia came from a frozen berry blend with pomegranate seeds from Egypt.

Pomegranate seeds are also in the berry blend fingered in the new outbreak. According to the label, the berries were a cosmopolitan bunch — from the U.S., Argentina, Chile and Turkey. The manufacturer, Townsend Farms Inc. of Fairview, Ore., issued a recall notice yesterday. The berries were sold through Costco and Harris Teeter stores.

Growers and processors should be screening workers for symptoms of hepatitis A, says Juan Silva, a professor of food technology at Mississippi State strawberryUniversity. He says they also should be requiring good hygiene either through hand-washing or wearing gloves.

“You need constant training and awareness for supervisors and employees that they can cause this kind of problem,” Silva says. “Try to make them realize that they are responsible for the safety of people who eat the food.”

Cooking or pasteurizing food is one of the only reliable ways to kill the hepatitis A virus, Silva says. So you’ll probably be safe if you’re planning to make pie or cobbler.

But antimicrobial rinses haven’t proven to kill enough germs on fresh fruit to be worth their while. Irradiation kills bacteria, but it’s much harder to zap viruses, so that’s not a sure bet, either. And freezing food doesn’t kill the germs, alas. That’s how scientists keep the bacteria they study frisky.

“There’s no post-harvest intervention as of now that’s capable of eliminating the virus,” Silva told The Salt. “That’s why prevention is key.”

So what’s a smoothie lover to do?

No one’s suggesting getting vaccinated just to make smoothies, but as more and more people gain protection from the vaccine, outbreaks like these will pose less of a risk.