Fresh strawberries could be the cause of the recent outbreak of hepatitis among children in the US, American health officials have warned.
The strawberries are now past their shelf life but families may still be eating them or freezing them to enjoy later.
US stores that sold the organic berries included Aldi, HEB, Kroger, Safeway, Trader Joe's and Walmart, among others. The batch in question were bought between March 5 and April 25 and branded as FreshKampo.
So far, the outbreak is considered not to be linked to the ongoing hepatitis cases that have infected 216 people across 37 states in the US, according to the WHO.
In the US, 17 people have fallen ill - 15 in California and one each in Minnesota and North Dakota, according to the US Food and Drug Administration (FDA).
Twelve of those who fell ill were hospitalised.
In Canada, the strawberries were sold in Alberta and Saskatchewan between March 5 and 9.
Ten cases and four hospitalisations have been reported in both provinces, according to the Canadian Food Inspection Agency and the Public Health Agency of Canada.
Do strawberries increase virus spread?
The hepatitis A virus is one of the leading agents responsible for food-borne outbreaks associated with the consumption of contaminated frozen produce.
These viruses are transmitted through the faecal–oral route, say experts.
It has been shown that one milligram of poo from infected individuals may contain 106 to 108 genome copies of hepatitis or norovirus.
Therefore, contamination of berries with microscopic amounts of infected poo can cause outbreaks and illnesses.
Berries are a common conduit for viruses.
One study published in the National Library of Medicine found that over the past decade, frozen fruits have been a major vehicle of food-borne illnesses, mainly norovirus and hepatitis A infections.
The study’s results revealed that frozen fruits, especially berries, contributed to the majority of the outbreaks.
The virus is usually transmitted through the faecal-oral route, meaning that a person somehow ingests contaminated poo from an infected person.
If workers have not properly washed their hands after using the bathroom, they could transfer the virus to the fruit.
Another way strawberries can be contaminated is if the water used to irrigate them has been contaminated with raw sewage, which can carry the virus.
The recent UK hepatitis outbreak is being primarily attributed to adenovirus and other possible contributors, such as Covid-19.
The usual viruses that cause infectious hepatitis (hepatitis A to E) have not been detected in the UK, the UKHSA says.
Nonetheless, "we are working with other countries who are also seeing new cases to share information and learn more about these infections", Dr Renu Bindra, senior medical adviser and incident director at UKHSA, said in May 2022.
Meanwhile, shoppers in the US are being urged to throw away certain strawberries bought in March and April to reduce their risk of being infected.
“Epidemiologic and traceback data show that fresh organic strawberries sold as FreshKampo and HEB brands that were purchased between March 5, 2022, and April 25, 2022, are a likely cause of illness in this outbreak,” says the US Food and Drug Administration (FDA).
“Illness onset dates range from March 28 – April 30, 2022.
“If you are unsure of what brand you purchased, when you purchased your strawberries, or where you purchased them from prior to freezing them, the strawberries should be thrown away.
“As this investigation is ongoing, additional products may be included.
“More information will be provided in this advisory as it becomes available.”
