DSHS Issues Hepatitis A Health Advisory

A Texas Department of State Health Services (DSHS) health advisory states the International Company for Agricultural Production and Processing (ICAPP) in Egypt has recalled all frozen strawberries and frozen strawberry products it has imported into the United States since Jan. 1, 2016. According to the advisory, the recall is the result of a current hepatitis A outbreak investigation by the U.S. Food and Drug Administration, the U.S. Centers for Disease Control and Prevention (CDC), and state health departments. DSHS says Texas has one suspected case of hepatitis A.

DSHS instructs physicians to consider hepatitis A as a diagnosis for any patients presenting with symptoms of acute hepatitis. The department says serological testing is required to confirm the diagnosis of hepatitis A. The confirmatory test for hepatitis A is IgM anti-HAV. 

Those with the hepatitis A virus are most infectious two weeks prior to symptom onset, the advisory states. The incubation period is approximately 28 days (range 15–50 days). Symptoms include fever, fatigue, loss of appetite, nausea, vomiting, abdominal discomfort, dark urine, clay-colored bowel movements, joint pain, and jaundice. Symptoms can last for several weeks and typically do not last more than two months. Children younger than 6 years of age with hepatitis A are often asymptomatic.

Texas' infectious disease reporting regulations require confirmed or suspected acute hepatitis A cases to be reported within one work day. Hepatitis A reports should be made to your local health department or by calling (800) 705-8868.

DSHS reminds physicians to check the vaccination history of all patients and to offer hepatitis A vaccine to anyone who is not up to date with the vaccine schedule. Two doses of hepatitis A vaccine given six months apart remains an effective way to prevent disease and outbreaks, DSHS says. Hepatitis A vaccine is recommended for: 


  • All children at 1 year of age,
  • Food service workers or other food handlers, 
  • International travelers, including on cruise ships, 
  • Men who have sex with men, 
  • Drug users (injection and non-injection), 
  • Persons with clotting-factor disorders, 
  • Persons who work with non-human primates or with hepatitis A in a research laboratory,
  • Persons with chronic liver disease, including HBV- and HCV-infected persons with chronic liver disease,
  • Family and care givers of recent adoptees from countries where hepatitis A is common, and 
  • Anyone else seeking long-term protection.

Detailed guidelines for hepatitis A vaccination are available on the CDC website

Action, Nov. 15, 2016 

Last Updated On

November 14, 2016

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