Sun-dried tomatoes may be contaminated with hepatitis A virus: Officials warn

By Dr. Ananya Mandal, MDMar 5 2012

Health officials are looking at the possible link between recent outbreaks of hepatitis A and eating sun-dried tomatoes.

The Health Protection Agency (HPA) said two confirmed cases of the infection had been found to have an identical strain to three cases reported in England and confirmed at HPA Colindale in 2010. Both people had recently eaten sun-dried tomatoes.

The three UK cases in 2010 had the same strain associated with a cluster of cases of hepatitis A in the Netherlands at that time, which were also linked to the tomatoes. The HPA said one of the three cases identified in 2010 had travelled to the Netherlands and consumed sun-dried tomatoes there.

A joint statement from the HPA and Food Standards Agency (FSA) said, “Sun-dried tomatoes are being investigated as one possible source of the hepatitis A cases reported last year. However, no food source has been conclusively identified so far and no other relevant cases have been reported in the UK since November 2011. The investigation by FSA and HPA is ongoing.”

Writing in the medical journal Eurosurveillance, Carlos Carvalho, of the HPA, said, “A single food source may be contaminated with more than one strain. A food-borne outbreak with multiple strains in at least two European countries is suspected.”

Symptoms appear around 28 days after infection and include aches, loss of appetite, abdominal discomfort, fever and fatigue. Patients may also develop itchy skin and jaundice which can last several months. In the most serious cases, acute hepatitis A can develop into fulminant hepatitis A in which toxins attack the liver, leading to life-threatening complications. Around half of these patients will need a liver transplant to survive. Hepatitis A is diagnosed by a blood test, but there is no treatment other than rest and fluids.

It is most common in countries where sanitation is poor, with vaccination against it recommended for those travelling to such areas. Hepatitis A is the only common food-borne disease preventable by vaccine. According to the World Health Organization, there are estimated 1.5 million new cases of illness due to hepatitis A each year worldwide.