State and local health officials, the U.S. Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) are investigating a multistate outbreak of hepatitis A that started in Nebraska and now includes Indiana and Wisconsin. There are currently 11 cases associated with the outbreak.

Six of those cases are in Nebraska including Douglas County, Three Rivers and Central District Health Department jurisdictions. The cases were reported to the Nebraska Department of Health and Human Services (DHHS) over the last several weeks. Four people were hospitalized.

“Our goal is to protect Nebraskans, pinpoint the source of the illness and make sure the risk is eliminated,” said Dr. Tom Safranek, State Epidemiologist for DHHS. “We sent an advisory to health care providers alerting them of the increased number of hepatitis A cases in early November. Public health officials have also been conducting interviews with Nebraskans who contracted the illness to help determine the cause.”

Based on those interviews and information collected from other states during the investigation so far, the 11 people who became ill reported eating fresh, non-organic blackberries from Fresh Thyme grocery stores in three states: Nebraska, Indiana and Wisconsin. According to federal health officials, trace back information shows that the berries came from a distribution center that ships fresh berries to Fresh Thyme grocery stores in other states.

The FDA is urging consumers in 11 states – Nebraska, Indiana, Wisconsin, Iowa, Illinois, Kentucky, Michigan, Missouri, Minnesota, Ohio and Pennsylvania – not to eat any remaining fresh blackberries purchased between Sept. 9 and Sept. 30, 2019 from Fresh Thyme grocery stores. If people put the berries in the freezer, the berries should be thrown away.

If people in any of the 11 states ate blackberries from Fresh Thyme grocery stores within the past two weeks and haven’t received hepatitis A vaccination, they should contact their healthcare provider about post-exposure prophylaxis (PEP). PEP can help prevent the disease and can be recommended for unvaccinated people within two weeks of exposure to hepatitis A. People vaccinated against hepatitis A or who have had hepatitis A do not require PEP.

Hepatitis A is a virus that can cause liver disease. It’s transmitted primarily by the fecal-oral route by either person-to-person contact or eating or drinking contaminated food or water. Hepatitis A has an incubation period of approximately 30 days. It can cause mild illness lasting a few weeks to severe illness lasting several months.

Symptoms of hepatitis A include:

  • Fever, tiredness, loss of appetite, nausea, vomiting, and/or joint pain
  • Severe stomach pains and diarrhea (mainly in children)
  • Yellowing skin or eyes, dark urine, clay-colored bowel movements
  • People experiencing symptoms should see a physician for diagnosis. There is no specific treatment for hepatitis A except for supportive care of pain and fever as needed.

Hepatitis A is a vaccine-preventable disease. The CDC’s Advisory Committee on Immunization Practices recommends all children receive two doses of hepatitis A vaccine starting at age 1 year. The vaccine is also recommended for people who are at increased risk of infection and for anyone who wants protection against hepatitis A infection.