NORFOLK, Va. — Health officials say the number of hepatitis A cases linked to a chain of smoothie shops has more than tripled in Virginia and spread out of state.

The Virginian-Pilot newspaper reports (http://bit.ly/2bVX7Nv ) that 66 people are sick with the liver disease, 55 of them in Virginia. Last week, the number of people who were sick in the state was 17.

Cases tied to the Tropical Smoothie Cafe chain also have been reported in Maryland, West Virginia, North Carolina, Oregon and Wisconsin. Health officials have traced the outbreak to strawberries imported from Egypt.

In Virginia, the stricken ranged in age from 14 to 68. Nearly half sought hospital care.

The World Health Organization says almost everyone fully recovers. Symptoms include yellowing of the skin or eyes, fever and nausea.


Information from: The Virginian-Pilot, http://pilotonline.com