UPDATE Recalled Strawberries [Potential Hepatitis A Contaminated Food Product]

Message Details
Date Sent: 11/04/2016 12:53 PM EDT
Sender: Michigan Health Alert Network
Subject: UPDATE Recalled Strawberries [Potential Hepatitis A Contaminated Food Product]

Message:

11/4/2016 HAN UPDATE
This HAN is being sent to the following roles: Administration, Communicable Disease, Infection Prevention, Communications, Public Information, Education, Emergency Management, Emergency Preparedness, Environmental, Epidemiology, HAN Coordinator, Health Officer, Healthcare, Human Services, Laboratory, Pharmacy, Physician, Medical Director
MDARD has provided a list of facilities identified as receiving recalled frozen strawberries since 01/01/2016. In the distribution list of these products MDHHS has identified the following vulnerable and/or institutionalized populations: 6 Camps, 171 Healthcare facilities, 3 Jails/Detention facilities, and 44 Schools / Head Starts (includes some university / vocational level).  Special consideration should be made regarding to these locations regarding follow-up, assessment, messaging, and PEP within all local health jurisdictions. 

A press release identifying facilities that may have served the recalled strawberries in the last 14 days will be posted today.

Please note that while PEP is aimed at exposures within the last 14 days, the incubation period for Hepatitis A can be up to 50 days. Individuals who have consumed frozen strawberries within this time period and develop symptoms of Hepatitis A should seek care.

We are asking LHDs to reinterview all HEP A cases going back to 09/01/2016 who haven’t been previously interviewed as part of the Whole Foods investigation in SE Michigan. Completed questionnaires should be uploaded to the MDSS record.  Significant findings can be shared with your regional epidemiologist or the Communicable Disease Division 517/335-8165. 

Supplemental Questionnaire: Attached
Laboratories are asked to hold hepatitis A IgM positive serum specimens for two weeks in the event they are needed for additional testing at MDHHS.

MDARD and MDHHS have issued a joint press release regarding the frozen strawberry recall: http://www.michigan.gov/mdard/0,4610,7-125-1660-396983--,00.html

CDC 2016 - Multistate outbreak of hepatitis A linked to frozen strawberries: http://www.cdc.gov/hepatitis/outbreaks/2016/hav-strawberries.htm

Please distribute within your provider networks

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HAN: Potential Hepatitis A Contaminated Food Product Distributed Nationally to Institutional and Commercial Facilities -- United States, 2016

10/31/2016 - CDC has been notified of a product action related to frozen strawberries imported from Egypt that may be contaminated with hepatitis A virus and were distributed throughout the United States. On October 27, one supplier has notified facilities (schools, assisted living facilities, etc.) where potentially contaminated strawberries may have been dispersed and consumed about the potential contamination of the strawberries. State and local health officials may be contacted by facilities that have been notified by their suppliers affected by these product actions and may be asked for recommendations for people who have consumed the strawberries. [One local health department in Michigan has been notified that a nursing home in their jurisdiction has received the frozen strawberries; post-exposure prophylaxis is planned for the nursing home residents. It is unknown at this time where the frozen strawberries were distributed in Michigan. Additional information on HAV IG and vaccine availability in Michigan will be forthcoming.]

Information is currently limited, and the magnitude of the risk of the contamination is unknown at this time. Currently, CDC is aware that the product action impacts a very large amount of product distributed nationwide. CDC is working with FDA, state, and local officials in this investigation. Updates will be disseminated when available and are expected Oct 31/Nov 1.

Because hepatitis A can have serious health consequences, CDC advises post-exposure prophylaxis (PEP) for unvaccinated persons who have consumed these strawberries in the last 2 weeks. PEP offers no preventive benefit to persons whose exposure occurred more than 2 weeks ago. 

PEP consists of:

1. HAV vaccine for people between the ages of 1 year and 40 years
2. HAV-specific immunoglobulin (IG) for people falling outside of that age range. If IG is not available, hepatitis A vaccine can be substituted.

Currently CDC is aware that the product action impacts a very large amount of product distributed nationwide, but is unclear how much of that product was distributed in a timeframe that would allow for successful use of PEP. State and local health departments may wish to take time in planning their response, especially if consumption of the product in question was recent and allows for timely PEP within a 2 week period. CDC is aware of the potential burden on local and state health departments and the potential need for mobilizing large amounts of vaccine and immunoglobulin.

NOTE: CDC recommends that all children be vaccinated against Hepatitis A at age 1.  Any parent or caregiver who is unsure if a child has been vaccinated should consult their health care provider and confirm vaccination status.
Attachments:

• MI_HepA_Frozen_Strawberry_Questionnaire_110316.pdf