ATLANTA, Sept. 1 (UPI) -- A hepatitis A outbreak has struck 55 people across six states and is linked to frozen strawberries from Egypt, the Centers for Disease Control said Wednesday.
The outbreak has mostly hit Virginia, where 44 people have been infected, but other cases has been confirmed by the CDC in West Virginia, Maryland, North Carolina, Wisconsin and across the country in Oregon.
"Due to the relatively long incubation period for hepatitis A -- 15 to 50 days -- before people start experiencing symptoms, we expect to see more ill people reported in this outbreak," CDC spokeswoman Nora Spencer-Loveall said.
The disease is highly contagious viral infection of the liver, but is not chronic.
The outbreak has been tied to frozen Egyptian strawberries used in Tropical Smoothie Café smoothies. There are about 500 Tropical Smoothie Café locations in 40 states.
"You get it from some sort of fecal/oral contamination. Most commonly, we get hepatitis A from contaminated foods. We see it more in poorly cooked food. We can see it in meats, in mayonnaise, chicken, but you can really get it with anything. It usually relates to handling," Dr. David Bernstein, chief of the division of hepatology at Northwell Health in Manhasset, New York, told CBS News.
The symptoms are similar to other viral infections, including nausea, stomach pain, low-grade fever and diarrhea to a headache and sore throat, Bernstein said.
People who think they might be infected should see a doctor, but many won't realize they have hepatitis A unless they show symptoms like yellowing of the eyes or dark urine.
Many patients don't bother seeing a doctor unless they develop symptoms like yellowing of the eyes or dark urine. "About 99.9 percent get sick and get over it," Bernstein said.