More Cases Reported in Pomegranate-Related Hepatitis A Outbreak

The Centers for Disease Control (CDC) has reported that four more people have been infected with the hepatitis A virus that has been linked to pomegranate seeds imported from Turkey. Cases have been reported in eight states, and the total number of infected people now stands at 140. No deaths have been reported due to the outbreak, but 61 people have required hospitalization. The CDC and the Food and Drug Administration (FDA) have both pointed to pomegranate seeds imported by Turkish company Goknur Foodstuffs as the likely cause of the outbreak. The FDA has said that any further imports from Goknur Foodstuffs will be detained.

The hepatitis A virus is rare in North America and is found more commonly in the Middle East and North Africa. It is a viral liver disease and produces symptoms including nausea, vomiting, fatigue, and abdominal pain. The disease is challenging for medical professionals because it has an incubation time of two to six weeks, and some sufferers can infect others while displaying no symptoms themselves. Hepatitis A is transmitted when human feces contaminates food, which is often caused by poor hand hygiene when food is prepared or processed.

The CDC has reported cases in California, Hawaii, Nevada, Utah, Wisconsin, New Mexico, Colorado, and Arizona. California has the most reported cases, with 69 people in the state contracting the disease. An outbreak of hepatitis A was linked to a frozen berry blend that contained Turkish pomegranate seeds in 2012, but the CDC says that there is no evidence connecting the two events.

The CDC and the FDA worked jointly to find the cause of the outbreak. The CDC performed epidemiological work while the FDA used trace-back and trace-forward tools to isolate the source. The FDA’s deputy commissioner for foods, Michael R. Taylor, said that dealing with foods that contained multiple ingredients from many countries compounded the difficulty of finding the cause. He added that the investigation demonstrated the agency’s improved ability to respond to outbreaks.

The FDA ordered recalls in June of products that contained the seeds. Antioxidant blends made by Townsend Farms and sold under the Townsend Farms and Harris Teeter labels were recalled on June 4, and Woodstock Frozen Organic Pomegranate Kernels made by the Scenic Fruit Company were recalled on June 26. The agency has advised any person who may have consumed these products to see a medical professional to determine if a vaccination is appropriate. Vaccinations should be received within two weeks of contamination to prevent illness.

References:
CDC notice http://www.cdc.gov/hepatitis/Outbreaks/2013/A1b-03-31/
CDC hepatitis A information http://www.cdc.gov/hepatitis/HAV/index.htm
FDA recall June 4 http://www.fda.gov/Safety/Recalls/ucm355166.htm
FDA recall June 26 http://www.fda.gov/Safety/Recalls/ucm358740.htm
NBC News report http://www.nbcnews.com/health/fda-detains-pomegranate-seeds-turkey-tied-hepatitis-outbreak-6C10488453