Frozen strawberries imported from Egypt and used by Tropical Smoothie Café locations in Virginia are possibly linked to a cluster of Hepatitis A infections, spurring state health officials to issue a public health warning. The restaurant chain has already pulled the implicated strawberries from all of its restaurants, not just the 100 locations in Virginia, according to a company statement issued today. “Individuals who consumed a smoothie from a Tropical Smoothie Café in Virginia that contained frozen strawberries on Aug. 5, 6, 7 or 8 may still benefit from vaccine or immune globulin to prevent Hepatitis A,” the Virginia Department of Health warning said. “Vaccine or immune globulin administered within two weeks of exposure to Hepatitis A virus is effective at preventing the disease. If you have had Hepatitis A or have been vaccinated for Hepatitis A, you are already immune and therefore not at risk for getting the disease.” By using genetic testing, the health department matched lab samples from current sick people to a Hepatitis A strain known to have been present in strawberries from Egypt that were linked to previous outbreaks. Virginia officials are working with the state agriculture department, the Food and Drug Administration and the Centers for Disease Control and Prevention to investigate the illnesses. They did not indicate in the public warning how many people are confirmed sick or whether they are all Virginia residents. As of this afternoon, it was not known whether other restaurants or restaurant suppliers received the implicated strawberries from Egypt. “Egyptian strawberries represent a fraction of our overall strawberries purchased, and were predominantly only distributed to stores in the Virginia market,” Tropical Smoothie Cafe’s statement. “Today, our strawberries are sourced from Mexico and California. “Our primary concern is for the safety and well-being of our guests and crew members and we will continue to cooperate with the health authorities in the investigation. “Our cafes and their food handling practices have not been implicated in any way — the health department believes this is a single product issue sourced from Egypt.” Virginia’s health officials said in their warning that anyone who consumed a smoothie with strawberries at a restaurant within the past 50 days should watch for symptoms of Hepatitis A. The virus is easily transmitted through food, beverages and from person-to-person via the fecal-oral route. “Frequent hand-washing with soap and warm water after using the bathroom, changing a diaper, or before preparing food can help prevent the spread of Hepatitis A,” according to the Virginia public health warning. “It is very important for people who have symptoms of hepatitis A to stay home from work, especially if they work in food service.” Anyone with symptoms is urged to see a doctor immediately. The classic symptom of Hepatitis A is jaundice, which is a yellowing of the skin or the eyes, Virginia’s warning states. Other symptoms include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine and light-colored stools. Symptoms take from 15 to 50 days to develop after exposure to the virus. People in Virginia can contact their local health department with questions concerning the investigation. (To sign up for a free subscription to Food Safety News, click here.)