Strawberries likely cause of hepatitis outbreak in US warns FDA as cases rise in the UK

Hepatitis: Dr Hilary Jones outlines the main symptoms

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Cases of hepatitis – inflammation of the liver – are rising among children across the world. The UK has now recorded hundreds of cases. As of 25 May, 222 cases have been recorded: 158 are in England, 31 in Scotland, 17 in Wales and 16 in Northern Ireland. Doctor Renu Bindra, senior medical adviser and incident director at UK Health Security Agency (UKHSA), said: “Our investigations continue to suggest an association with adenovirus, and we are exploring this link, along with other possible contributing factors including prior infections such as COVID-19.”

On the other side of the pond, the hepatitis outbreak is being attributed to an altogether different cause.

Contaminated strawberries are the likely cause of a hepatitis A outbreak in the US and Canada, the US-based Food and Drug Administration (FDA) announced on Saturday.

The potentially tainted strawberries were sold under the brands FreshKampo and HEB and were purchased between March 5 and April 25, 2022, in the US (In Canada, the berries were purchased between March 5 and March 9 at various co-op stores in Alberta and Saskatchewan, according to the Public Health Agency of Canada).

US stores that sold the berries included Aldi, HEB, Kroger, Safeway, Trader Joe’s and Walmart, among others.

The potentially affected berries are now past their shelf life, but if any consumers froze the berries for later consumption, they should not eat them, the FDA warns.

“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,” the agency advised.

The FDA has teamed up with the Centers for Disease Control and Prevention (CDC), the Public Health Agency of Canada and the Canadian Food Inspection Agency to investigate the hepatitis cases further and determine if any other contaminated products may have contributed to the outbreak.

So far, in the US, the strawberries have been linked to 17 cases of hepatitis A, including 12 in California, one in Minnesota and one in North Dakota.

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Twelve of the affected individuals required hospitalisation, but there have been no deaths related to the outbreak, the FDA says.

In Canada, four cases were identified in Alberta and six were detected in Saskatchewan, according to the Public Health Agency of Canada.

Four of these 10 cases required hospitalisation, and no deaths have been reported.

What this means for the UK

So far, the outbreak is considered not to be linked to the ongoing spread of hepatitis that has infected 216 people across 37 states in the US, according to the WHO.

The UK outbreak is being primarily attributed to adenovirus and other possible contributors, such as COVID-19.

What’s more, the contaminated strawberries are linked to a hepatitis A outbreak.

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”, Doctor Renu Bindra, senior medical adviser and incident director at UKHSA said on Friday.

She continued: “The likelihood of children developing hepatitis remains extremely low.

“Maintaining normal hygiene measures, including making sure children regularly wash their hands properly, helps to reduce the spread of many common infections, including adenovirus.”

Doctor Bindra added: “We continue to remind everyone to be alert to the signs of hepatitis – particularly jaundice, look for a yellow tinge in the whites of the eyes – and contact your doctor if you are concerned.”

The global picture is nonetheless concerning.

In recent weeks, several countries have seen a surge in hepatitis cases, with the European Centre for Disease Prevention and Control stating that around 190 unexplained cases of severe hepatitis have been reported in children around the world, with some 40 cases recorded in the European Union and European Economic Area.

Hepatitis symptoms include:

  • Yellowing of the white part of the eyes or skin (jaundice)
  • Dark urine
  • Pale, grey-coloured faeces (poo)
  • Itchy skin
  • Muscle and joint pain
  • A high temperature
  • Feeling and being sick
  • Feeling unusually tired all the time
  • Loss of appetite
  • Tummy pain.

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