The U.S. Centers for Disease Control and Prevention (CDC) updated this outbreak on Friday afternoon to a total of 119 cases of Hepatitis A from eight states. Forty-seven of these individuals have been hospitalized, but no related deaths are being reported. As of Sept. 14, CDC gives the state-by-state breakdown of the 119 total cases as follows: Arkansas (1), Maryland (12), New York (3), North Carolina (1), Oregon (1), Virginia (94), West Virginia (6), and Wisconsin (1). However, on Friday the Virginia Department of Health updated its case count to 98, which would put the total number of outbreak cases at 123. “Information available at this time does not indicate an ongoing risk of hepatitis A virus infection at Tropical Smoothie Cafes. We are not yet aware of any other restaurants or retailers that may have received frozen strawberries linked to this outbreak. If this information changes, CDC will update the public immediately,” CDC’s update stated. Previous coverage follows: Sept. 16 update: The Virginia Department of Health has updated its case count in the Hepatitis A outbreak linked to smoothies made with imported strawberries. There are now 98 Virginia residents sickened by the virus, which is four more than reported on Sept. 14. Two of the new cases are from the northern part of the state, and two are from the northwest area, the department stated. According to the update, the 98 Virginia residents with Hepatitis A reported consuming a smoothie at Tropical Smoothie Café prior to becoming ill. The Centers for Disease Control and Prevention (CDC) has not updated its numbers on this outbreak since Sept. 8, when it reported 89 total cases of Hepatitis A from seven states, including 70 from Virginia. Sept. 14 update: According to the Virginia Department of Health, there are now 94 residents of that state who have tested positive for Hepatitis A and have reported consuming a smoothie at Tropical Smoothie Café before becoming ill. That number of cases is 24 more than last reported by the U.S. Centers for Disease Control and Prevention (CDC) on Sept. 8. The Virginia health department’s update posted Wednesday stated that approximately 38 percent of the residents for whom information is available have been hospitalized for their illness. The 94 sickened Virginia residents range in age from 14-70, according to the state update. Onsets of illness for the 94 cases range from early May through September. The case count by region of the state is: 55 in the northern part, 13 northwest, 15 eastern, 11 central, and none from the southwest. Previous coverage follows: According to an update posted Thursday by the U.S. Centers for Disease Control and Prevention (CDC), there are now 89 people with Hepatitis A being reported from seven states. That’s an increase of 20 cases and one additional state from the most recent announcement on Sept. 1. Thirty-nine people have been hospitalized in connection with this outbreak, but no deaths have been reported, the agency noted. CDC listed the 89 cases and their states of residence as: Virginia (70); Maryland (10); West Virginia (5), and one each in New York, North Carolina, Oregon and Wisconsin. The agency added that information available at this time does not indicate an ongoing risk of acquiring Hepatitis A virus infection at Tropical Smoothie Cafés since the contaminated food product (imported frozen strawberries) has been removed as of Aug. 8. “Symptoms of hepatitis A virus infection can take up to 50 days to appear. As a result, CDC continues to identify cases of hepatitis A related to the initial contaminated product,” the agency stated. Previous coverage follows: Another state and 18 more people are now included in a Hepatitis A outbreak linked to frozen, imported strawberries served in smoothies, bringing the totals to six states and 69 victims. Virginia remains the hardest hit, with 55 residents confirmed with Hepatitis A infections as of noon Wednesday, according to the state health department. The initial cases identified in the outbreak, which officials believe began in May, were among Virginia residents. All 55 Virginia victims report consuming smoothies with strawberries at Tropical Smoothie Café restaurants before becoming ill. West Virginia officials did not name a specific restaurant chain in a notice posted Wednesday, but they did identify frozen strawberries from Egypt and “used by restaurants in a variety of smoothies,” as the suspected source of seven cases in their state. The Centers for Disease Control and Prevention is now leading the epidemiological investigation of the outbreak, an agency spokeswoman said Wednesday afternoon. She said CDC staff was preparing information for posting on the agency’s website, but as of midnight EDT nothing had been posted. As of Tuesday, CDC had confirmation of four victims in Maryland and one each in North Carolina, Oregon and Wisconsin. Tropical Smoothie Café CEO Mike Rotondo said in a YouTube video posted Sunday that the company pulled all of the implicated strawberries from all of its locations in all states after Virginia health officials contacted the company on Aug. 5. West Virginia officials say an ongoing public risk remains. “While there is no information to suggest there is an ongoing risk of hepatitis A virus from the strawberries used in the smoothies, there can be transmission from person to person with contacts of the reported cases,” according to the West Virginia department of health. Virginia officials continue to refine outbreak information posted on the state health department’s website. All references to the implicated strawberries having been imported from Egypt have been removed. References to CDC notifying the state on Aug. 12 of test results confirming the outbreak have also been removed from the Virginia health department website. Discussion of the last possible exposure date for customers of Tropical Smoothie Cafés in the state was added. “Those smoothies (served at Tropical Smoothie Cafés) would have been consumed before Aug. 9,” according to the revised content on the Virginia website. “Tropical Smoothie Cafés in Virginia received this product and ensured it was removed from use at all their restaurant locations by or before Aug. 9. “Approximately 46 percent of the residents, for whom information is available, have been hospitalized for their illness. The 55 ill residents range in age from 14-68. Onsets of illness for the 55 cases range from early May through August.” Public health officials are urging anyone in any state who has had a smoothie containing frozen strawberries in the past 50 days to monitor themselves for Hepatitis A symptoms. The symptoms usually take 15 to 50 days to develop. Anyone with Hepatitis A symptoms should seek medical attention. Classic symptoms of Hepatitis A include jaundice, fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine and light-colored stools. The virus can be transmitted through direct contact with another person who has Hepatitis A or by consuming food or drink that has been contaminated with the virus. For additional details on the outbreak, please see “Hepatitis A outbreak linked to smoothies spans 5 states; 51 sick” Editor’s note: Food Safety News Managing Editor Coral Beach contributed to some of the previously reported sections of this story. (To sign up for a free subscription to Food Safety News, click here.)