May 1997
ATLANTA — Strawberries tainted with hepatitis A virus (HAV) were sent to several states and as many as 9,000 children and adults in Los Angeles alone may have been exposed, said officials from the Centers for Disease Control and Prevention (CDC).
The Mexican-grown strawberries were part of the Department of Agriculture's (USDA) Food Surplus Program and were shipped by government-contracted food handlers in San Diego to smaller distributors in parts of Arizona, California, Florida, Georgia, Tennessee, Iowa and Michigan. The strawberries were then sent to various federally subsidized school lunch programs in those states.
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In Michigan, where the only illnesses have appeared so far, nearly 200 suspected cases of HAV have been linked to the strawberries, state health officials said. The strawberries found their way into school lunchrooms in three southern Michigan counties, infecting 151 unsuspecting elementary, middle and high school students and teachers in one county alone the first week. The remaining cases, none fatal, have also been in Michigan, with 72 cases in Battle Creek and 16 more cases in Saginaw County in central Michigan. More than 2,200 children had to be inoculated in Michigan, while about 9,000 Los Angeles and 2,000 Georgia school children had to be immunized with immune globulin (IG).
"We were concerned the virus would spread beyond the school population and begin infecting others in the community, but so far it appears we have been able to hold the line and contain it,'' said Margaret Cooke, spokeswoman for the Michigan Department of Agriculture.
Besides Michigan, none of the other states who received the tainted fruit are reporting hepatitis A outbreaks among the 26 million students participating in school lunch programs. But state and federal health officials said they weren't taking any chances and "exercised preventive measures'' to ensure the virus did not spread among the population.
Four ounce frozen strawberry fruit cups served in 18 Los Angeles county schools may also have been contaminated with the virus. There have been no reported illnesses, but Los Angeles health officials suspect as many as 9,000 children and adults may have been exposed. CDC officials recommended that the affected states immediately set up immunization centers to distribute IG, a post-exposure prophylaxis that bolsters resistance to the virus.
"We brought the best of our services to bear on the outbreak,'' said David Satcher, MD, director of the CDC. "And we are committed to working toward more enhanced food detection services.''
In New York State, the Agway food chain put out a recall of frozen sliced strawberries when it learned that the strawberries it had been selling since last July were shipped by the same San Diego firm currently under investigation for the hepatitis A cases in Michigan.
Federal investigators said the 30 lb. containers of sliced frozen strawberries were grown and harvested on a farm in Guadalajara, Mexico, in April and May of 1996. The contaminated berries were transported across the border to the San Diego distributor, who shipped them to several sub-contractors and various USDA-sponsored school lunch programs in the country. CDC officials immediately ordered the California distributor shut down while investigations were conducted and company records checked to determine how the strawberries made their way into the country.
But the mystery for federal investigators right now is how the bad berries got through inspectors, since USDA mandates require food distributors with government contracts to certify their food as being "home grown.''
"We could be dealing with a criminal offense here because we require that all food coming into the surplus program be grown domestically,'' said Tom Amontree, communications director for the Department of Agriculture. "Because this avoids the problem of any foreign bacteria coming into the country and creating outbreaks like the one we have now.''
Despite quick action by federal agencies, criticism was leveled against them for not having proper safeguards in place to prevent the tainted fruit from getting into the population.
Officials announced plans to consolidate the actions of the FDA, CDC and USDA to better monitor where the government surplus food is coming from and how it is handled.
Investigators could not determine whether the contamination was limited to some of the containers or what caused the strawberries to become tainted in the first place. But speculation among some state health department officials is that the water used in growing the south-of-the-border strawberries could have contained microorganisms that precipitated the hepatitis A outbreak.
The CDC estimates there are about 140,000 cases of hepatitis A in the United States each year; the last major outbreak was in 1989.
For more information:
- CDC. Hepatitis A associated with consumption of frozen strawberries — Michigan, March, 1997. MMWR1997:45;288, 295.
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