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  1. Outbreaks of Foodborne Illness

Outbreak Investigation of Hepatitis A: Fresh Conventional Blackberries (December 2019)

FDA’s investigation is complete. CDC announces outbreak is over.

February 19, 2020

The U.S. Food and Drug Administration (FDA), along with the Centers for Disease Control and Prevention (CDC), and state and local partners, investigated a multistate outbreak of hepatitis A illnesses in Indiana, Michigan, Minnesota, Missouri, Nebraska, and Wisconsin linked to fresh, conventional (non-organic) blackberries from the grocery stores Fresh Thyme Farmers Market and Woodman’s Market.  

As of February 19, 2020, 20 illnesses of hepatitis A were reported from seven states: Indiana, Michigan, Minnesota, Missouri, Nebraska, Pennsylvania, and Wisconsin. The most recent illness onset date was on November 15, 2019.

Ill patients reported consuming fresh, conventional blackberries bought in six states including Indiana, Michigan, Minnesota, Missouri, Nebraska, and Wisconsin. Case patients reported buying them from either Fresh Thyme Farmers Market or Woodman’s Market. CDC reports this outbreak investigation is over.

FDA completed its traceback investigation, however a single, common source of fresh, conventional blackberries could not be identified.

Recommendation

The FDA recommends that consumers should not eat any fresh, conventional blackberries if purchased between September 9 and September 30, 2019, from Fresh Thyme Farmers Market stores in these 11 states: IA, IL, IN, KY, MI, MO, MN, NE, OH, PA, and WI or from Woodman's Market located in Wisconsin and Illinois. People who purchased the fresh blackberries and then froze those berries for later consumption should not eat these berries. They should be thrown away.

If consumers purchased conventional blackberries from Fresh Thyme Farmers Market stores in the 11 states listed above or from Woodman’s Market located in Wisconsin and Illinois between September 9-30, ate those berries in the last two weeks, and have not been vaccinated for the hepatitis A virus (HAV), they should consult with their healthcare professional to determine whether post exposure prophylaxis (PEP) is indicated. PEP is recommended for unvaccinated people who have been exposed to HAV in the last two weeks. Those with evidence of previous hepatitis A vaccination or previous hepatitis A infection do not require PEP.

Contact your healthcare provider if you think you may have become ill from eating these blackberries, or if you believe that you have eaten these berries in the last two weeks.

Case Counts

Total Illnesses: 20
Hospitalizations: 11
Deaths: 0
Last illness onset: November 15, 2019
States with Cases: IN (3), MI, MN, MO, NE (7), PA, WI (6)

What is Hepatitis A virus?

Hepatitis A is a contagious virus that can cause liver disease. A hepatitis A virus (HAV) infection can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months. In rare cases, particularly for people with a pre-existing health condition or people with weakened immune systems, hepatitis A infections can progress to liver failure and death.

The majority of hepatitis A infections are from unknown causes or from being in close contact with an infected person; however, some hepatitis A infections are caused by eating or drinking contaminated food or water. Contamination of food can occur at any point during harvesting, processing, and distribution.

Illness usually occurs within 15 to 50 days after eating or drinking contaminated food or water. Symptoms of hepatitis A infection include fatigue, nausea, vomiting, abdominal pain, jaundice, dark urine, and pale stool. In some instances, particularly in children under the age of six, hepatitis A infection may be asymptomatic.

People with hepatitis A infections usually completely recover within one to two months; however, in rare cases hepatitis A may cause prolonged or relapsing infection.

Due to the range in severity of illness, people should consult their health care provider if they suspect that they have developed symptoms that resemble a(n) hepatitis A infection.

All people are susceptible to hepatitis A infection; however, individuals who have had hepatitis A before or who have been vaccinated are immune to hepatitis A infection.

General Food Safety Tips for Retailers

Restaurants and retailers should always practice safe food handling and preparation measures. It is recommended that employees wash hands, utensils, and surfaces with hot, soapy water before and after handling food.

  • Regular frequent cleaning and sanitizing of food contact surfaces and utensils used in food preparation may help to minimize the likelihood of cross-contamination.
  • Wash and sanitize display cases and refrigerators where potentially contaminated products were stored.
  • Wash and sanitize cutting boards, surfaces, and utensils used to prepare, serve, or store potentially contaminated products.
  • Wash hands with hot water and soap following the cleaning and sanitation process. 

General Food Safety Tips for Consumers

People should consult their healthcare provider if they suspect that they have developed symptoms that resemble a Hepatitis A infection.

Consumers should follow these steps for preventing foodborne illness:

  • Wash the inside walls and shelves of the refrigerator, cutting boards and countertops, and utensils that may have contacted contaminated foods; then sanitize them with a solution of one tablespoon of chlorine bleach to one gallon of hot water; dry with a clean cloth or paper towel that has not been previously used.
  • Wash and sanitize surfaces used to serve or store potentially contaminated products.
  • Wash hands with warm water and soap following the cleaning and sanitation process.

Consumers can also submit a voluntarily report, a complaint, or adverse event (illness or serious allergic reaction) related to a food product.

Produce items should be rinsed in clean, running water without the use of cleaners or soaps. After washing, dry produce with a clean cloth towel or paper towel to further reduce pathogens that may be present on the surface.

Previous Updates

December 10, 2019

The U.S. Food and Drug Administration (FDA), along with the Centers for Disease Control and Prevention (CDC), and state and local partners, are investigating a multistate outbreak of hepatitis A illnesses in Indiana, Michigan, Minnesota, Missouri, Nebraska, and Wisconsin potentially linked to fresh, conventional (non-organic) blackberries from the grocery stores Fresh Thyme Farmers Market and Woodman’s Market.

On December 10, 2019, CDC updated their case counts to 18 illnesses, with the most recent illness onset date on November 15, 2019.

Based on the epidemiological information collected in the investigation thus far, ill patients reported consuming fresh, conventional blackberries bought in six states including Indiana, Michigan, Minnesota, Missouri, Nebraska, and Wisconsin. Case patients reported buying them from either Fresh Thyme Farmers Market or Woodman’s Market.

Currently, traceback information shows that the berries from Fresh Thyme Farmers Market came from a distribution center that ships fresh berries to Fresh Thyme Farmers Market stores in 11 states: IA, IL, IN, KY, MI, MO, MN, NE, OH, PA, and WI. As this investigation continues, the FDA will work with our federal and state partners to obtain additional information, including Woodman’s Market, during the traceback investigation and will update this advisory as more information becomes available.

December 3, 2019

The U.S. Food and Drug Administration (FDA), along with the Centers for Disease Control and Prevention (CDC), and state and local partners, are investigating a multistate outbreak of hepatitis A illnesses in Indiana, Michigan, Minnesota, Missouri, Nebraska, and Wisconsin potentially linked to fresh conventional (non-organic) blackberries from the grocery store, Fresh Thyme Farmers Market.

On December 3, 2019, CDC updated their case counts to 16 illnesses, with the most recent illness onset date on November 15, 2019.

Based on the epidemiological information collected in the investigation thus far, ill patients reported consuming fresh conventional blackberries from Fresh Thyme Farmers Market stores in six states: Indiana, Michigan, Minnesota, Missouri, Nebraska, and Wisconsin.

However, traceback information to date shows that these berries came from a distribution center that ships fresh berries to Fresh Thyme Farmers Market stores in 11 states: IA, IL, IN, KY, MI, MO, MN, NE, OH, PA, and WI. As this investigation continues, the FDA will work with our federal and state partners to obtain additional information during the traceback investigation and will update this advisory as more information becomes available.


Who to Contact

Consumers who have symptoms should contact their health care provider to report their symptoms and receive care.

To report a complaint or adverse event (illness or serious allergic reaction), you can

Visit www.fda.gov/fcic for additional consumer and industry assistance.

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