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

Food Safety Alert

This outbreak investigation is over.

At a Glance
  • Reported cases: 10
  • States: 4
  • Hospitalizations: 4
  • Deaths: 0
Advice to Consumers
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CDC recommends that people who purchased recalled frozen organic strawberries should not eat, serve, or sell these recalled frozen organic strawberries.

 

  • Check your freezer for these recalled frozen organic strawberries and return or throw away any remaining product.
  • If you have eaten these recalled frozen organic strawberries within the last 14 days and are not vaccinated against hepatitis A, contact your local health department or health care provider to discuss postexposure prophylaxis (hepatitis A vaccine or immune globulin). Getting postexposure prophylaxis within 14 days of exposure can help prevent illness.
Final Outbreak Information
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  • As of September 4, 2023, this investigation is over.
    • 10 outbreak-associated cases of hepatitis A were reported from 4 states (California, Hawaii, Oregon, and Washington).
    • Illnesses started on dates ranging from November 24, 2022, to May 27, 2023.
    • 4 people were hospitalized. No deaths were reported.
  • Epidemiologic and traceback evidence indicated that frozen organic strawberries were the likely source of this outbreak.
    • In interviews, 10/10 (100%) people reported eating frozen organic strawberries.
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

Human figure with ache
  • 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.
Final Investigation Details

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:

Multistate Outbreak of Hepatitis A Virus Infections – Brands Affected
Brand Name Product Name Net Wt. UPC Best By Date, Best If Use Date, Best Before Date Distributed in States
Simply Nature Organic Strawberries 24 oz. 4099100256222 6/14/2024 Arizona,
Arkansas,
California,
Illinois,
Iowa,
Michigan,
Minnesota,
Missouri,
North Dakota,
Ohio,
South Dakota,
Wisconsin
Vital Choice Organic Strawberries 16 oz. 834297005024 5/20/2024 Washington
Kirkland Signature Organic Strawberries 4 lbs. 96619140404 10/8/2024 Alaska,
Idaho,
Montana,
Oregon,
Utah,
Washington
Made With Organic Strawberries 10 oz. 814343021390 11/20/2024 Illinois,
Maryland
PCC Community Markets Organic Strawberries 32 oz. 22827109469 29/10/2024 Washington
Trader Joe’s Organic Tropical Fruit Blend Pineapple, Bananas, Strawberries & Mango 16 oz. 00511919 04/25/24,
05/12/24,
05/23/24,
05/30/24,
06/07/24
Nationwide

On March 17, 2023, a retailer, Meijer, also issued press to voluntarily recall Made-With brand frozen organic strawberries from certain market store locations.

In response to this investigation, on June 7, 2023, Wawona Frozen Foods of Clovis, California, initiated a voluntary recall of year-old packages of Wawona brand Organic DayBreak Blend 4-lb. bags that were distributed to Costco Wholesale stores in Arizona, California, Colorado, Utah, and Washington from April 15, 2022, to June 26, 2022, with “Use By” dates of 9/23/2023, 9/29/2023, 9/30/2023, and 10/18/2023:

Table depicting voluntary recall of year-old packages of Wawona brand Organic DayBreak Blend 4-lb. bags that were distributed to Costco Wholesale stores in Arizona, California, Colorado, Utah, and Washington from April 15, 2022, to June 26, 2022, with “Use By” dates of 9/23/2023, 9/29/2023, 9/30/2023, and 10/18/2023.
Best If Used By 09/23/2023 Best If Used By 09/29/2023 Best If Used By 09/30/2023 Best If Used By 10/18/2023
Affected Lot Codes: Affected Lot Codes: Affected Lot Codes: Affected Lot Codes:
20082D04 20088D04 20089D09 20108D04
20082D05 20088D05 20089D10 20108D05
20082D06 20088D06 20089D11 20108D06
20082D07 20088D07 20089D12 20108D07
20082D08 20088D08 20108D08
20088D09
20088D10
20088D11
20088D12

In response to this investigation, on June 12, 2023, Willamette Valley Fruit Co. of Salem, Oregon, voluntarily recalled select packages of frozen fruit containing strawberries distributed to the following retailers: Walmart (from January 24, 2023, to June 8, 2023), Costco Wholesale Stores (from October 3, 2022, to June 8, 2023), and HEB (from July 18, 2022, to June 8, 2023). Products subject to this recall include:

Table depicting products selected for voluntary recall
Retailer Product Name Net weight Lot Code Best By Date Distributed in States
Walmart Great Value Sliced Strawberries 4 lbs. 4018305
4019305
7/19/2024
7/20/2024
AR, AZ, CA,
CO, HI, IA, ID,
IL, IN, KS, KY,
LA, MD, MI,
MN, MO, MT,
ND, NE, NV,
NY, OH, OK,
OR, PA, SD,
TX, UT, VA,
WI, WV, WY
Great Value Mixed Fruit 4 lbs. 4024205
4025305
4032305
4033305
4034305
4035305
7/25/2024
7/26/2024
8/2/2024
8/3/2024
8/4/2024
8/5/2024
Great Value Antioxidant Fruit Blend 40 oz. 4032305 8/2/2024
Costco Wholesale Rader Farms Fresh Start Smoothie Blend 48 oz. bag containing six 8 oz. pouches 4224202
4313202
4314202
4363202
4364202
4017302
4018302
4042306
4043306
4060306
2/11/2024
5/10/2024
5/11/2024
6/29/2024
6/30/2024
7/18/2024
7/19/2024
8/12/2024
8/13/2024
8/30/2024
AZ, CA, CO, TX
HEB Rader Farms Organic Berry Trio 3 lbs. 4153205
4283202
4284202
4058302
4059302
12/02/2023
4/10/2024
4/11/2024
8/28/2024
8/29/2024
TX

FDA completed its traceback investigation.

As of September 4, 2023, this outbreak investigation is over.