Your Health: Dr. Goodfriend on Hepatitis A

Your Health: Dr. Goodfriend on Hepatitis A

Last month, the Virginia Department of Health identified an outbreak of hepatitis A linked to imported frozen strawberries used by Tropical Smoothie Cafes with over 60 cases associated with this outbreak so far in Virginia. This has resulted in a number of people being hospitalized and many more concerned that they may get sick, infect others, or need to miss time from school or work. It also increases the risk of subsequent outbreaks if these cases work in restaurants, day care facilities or other high risk jobs where they might transmit their infection to others.

Hepatitis A (formerly known as infectious hepatitis) is a liver disease caused by a virus that passes in the feces (stool) of an infected person and can be spread by folks who have direct contact with that person or by consuming food or drink that has been handled by them. It can also be spread by consuming contaminated water or food. About 15 to 50 days after exposure, an infected person may experience tiredness, poor appetite, fever and nausea, abdominal cramping and jaundice, which is characterized by a yellowing of the skin and eyes and darkening of the urine. Additionally, some infected people may have mild or no symptoms and therefore may never be diagnosed. People with these symptoms should consider contacting their doctor, whether or not they ate at a Tropical Smoothie Café.

There are about 50 cases of hepatitis A reported in Virginia each year.  Fortunately, it can be prevented by routine vaccination. The Centers for Disease Control and Prevention (CDC) recommends that all infants receive vaccination against hepatitis A beginning at their first birthday ( and that anyone after that age get vaccinated if they may come in contact with hepatitis A in the future, such as by traveling to one of the many countries where hepatitis A is still common (

Frequent and careful hand washing is also critical for preventing the spread of hepatitis A and many other infections. As with the occasional case of measles or pertussis (whooping cough) in our community, this outbreak is a reminder that many diseases that are uncommon in the United States are just one plane flight, one hand shake, or one smoothie away from infecting us. In addition to hepatitis A, it is important for each of us to stay up to date on all recommended vaccinations during childhood, in our teen years and through our adulthood to remain safe from these vaccine preventable infections, both for ourselves and for those in our family who may be less able to fight off these diseases (

Contact Loudoun’s Health Department at or by telephone at 703-771-5829 with any questions or concerns about hepatitis A or any other public health issue, and follow us on Facebook at

Dr. David Goodfriend is Director of the Loudoun County Health Department and a regular contributor to the Tribune.