The number of hepatitis A cases linked to Tropical Smoothie Cafe restaurants in Virginia climbed to 40 on Monday.
Here are answers to common questions about the cases that are linked to strawberries from Egypt that were used in the chain’s stores until early August – and could go back to May:
Where are the cases?
Eleven were in the eastern region that includes Hampton Roads. Eighteen were in the north region, five in the northwest, six in the central.
Why isn’t the health department revealing specific locations?
Typically, state health officials only release the region of the state where an infectious disease case surfaces, in order to protect the privacy of patients. Since a restaurant location wouldn’t reveal a patient’s residence, we posed this question to Diane Woolard, director of surveillance and investigation at the Virginia Department of Health, who emailed this answer:
“The frozen strawberries were distributed to Tropical Smoothies all across the state. The risk potential exists at any location. Naming certain locations could give a different and false impression. We do believe the risk is low overall and the product is not available at those Cafes any longer, so their food is safe to eat.”
Why didn’t the health department alert the public when Tropical Smoothie Cafe removed the strawberries from the restaurants Aug. 6-8?
Tropical Smoothie voluntarily removed the product Aug. 6-8 when health officials notified them of their hypothesis that the virus might be linked to frozen strawberries from Egypt. The link was not firm enough at that point to alert the public, according to Woolard. Interviews with more people who were diagnosed with hepatitis A strengthened the connection enough that the public was notified Aug. 19.
Why do companies use strawberries from Egypt?
According to William Marler, a lawyer who specializes in food safety cases, companies like Tropical Smoothie depend on products from other countries because local strawberries are not available in the quantity they need year-round. Sometimes companies will buy them from California and Mexico during the winter, but can also include other countries. Price comes into play as well.
What are the symptoms of hepatitis A?
People who ate at the chain’s restaurants from July 1 through Aug. 8 should monitor themselves for yellowing of the skin or eyes, fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine and light-colored stools. The virus that causes liver inflammation has an incubation period of 15 to 50 days. Symptoms range from mild to severe, and usually do not last more than two months.
Who can I call for more information?
Call your local health department. A list of numbers can be found here. Tropical Smoothie Cafe also has a customer help line that people can call with concerns: 1-855-292-4770.
This story originally appeared on PilotOnline.com.