Healthy Choices

‘Disease detectives’ trace last year’s hepatitis A outbreak to Turkish pomegranates

Virginia Dexter and Geoff Soza testified Thursday in a Food and Drug Administration hearing in Sacramento in favor of stricter food safety protocols and inspections.
Virginia Dexter and Geoff Soza testified Thursday in a Food and Drug Administration hearing in Sacramento in favor of stricter food safety protocols and inspections. Pew Charitable Trust

A mysterious outbreak last year of a foreign strain of hepatitis A set in motion a federal government investigation that led food-safety sleuths halfway around the world to Turkey.

There, in a pomegranate grove, the detective work paid off: Investigators found the likely culprit of a widespread foodborne virus that sickened at least 165 people in 10 states, including California.

Lab tests of specimens from the patients traced the virus to a particular strain called genotype 1B, rarely seen in the Americas yet common to North Africa and the Middle East.

Together, experts from the U.S. Food and Drug Administration worked painstakingly and step-by-step with the federal Epidemic Intelligence Service – also known as the “disease detectives” – to trace shipments of pomegranate seeds from the Turkish Goknur Foodstuffs Import Export Trading Co.

Using techniques that combined epidemiology, data from several sources, genetic analysis of patient samples and product-tracing, the investigators quickly located the common denominator of the outbreak in the U.S. to the frozen food section of Costco stores.

The tainted Turkish pomegranate seeds had somehow been contaminated by microscopic amounts of fecal matter and were included in a five-berry combination package sold under the name of Townsend Farms Organic Antioxidant Blend, an Oregon agribusiness.

“The investigation captured the whole global aspect of today’s food system,” said Mike Taylor, deputy commissioner for foods and veterinary medicine for the U.S. Food and Drug Administration. “It was a very robust process.”

It turns out that 80 percent of seafood consumed in the U.S. comes from overseas, as does 50 percent of fresh fruit and 20 percent of vegetables, Taylor said.

In the case of the hepatitis A outbreak, all 165 people who took ill said they ate the Townsend berries – in smoothies, on cereal, over ice cream – while seeking a healthful diet with the benefits of antioxidants. And all had purchased the fruit at Costco.

Federal officials said the fruit was contaminated either by unclean hands or polluted water. The contamination could have occurred, they said, at any point in the growing, harvesting, processing or handling of the fruit.

Even in the tiniest of doses, hepatitis A can cause severe, life-threatening damage to the liver, an organ critical to keeping the body functioning by removing waste products before recirculating the blood.

Fortunately for consumers, Costco maintains a record of who buys what in their stores, and store representatives phoned as many customers as possible with notice of the recall of Townsend’s berry mix. The retail chain could not be reached for comment Thursday.

Virginia Dexter was traveling when her son took the call. Upon her return home to Fields Landing along California’s northwest coast, she found an ambiguous note by the phone in her son’s handwriting that said, simply: “Costco – bad berries.” She shrugged it off, at the time unaware of its import.

On Thursday, the retired elementary school teacher testified about her near-fatal bout with the virus during a hearing the FDA held in downtown Sacramento. For the first time in 70 years, the federal agency is undertaking a major update of food safety inspection rules to emphasize prevention over enforcement.

Taylor said the result will likely be a stronger presence overseas for FDA authorities, and inspection and enforcement tools to hold food producers accountable for the safety of imported products.

Dexter expressed hope that “Food producers and everyone along the food supply chain do everything they can to prevent contamination and the illnesses it causes.”

She described herself as a very active person who works out, gardens, hikes and travels. She also tries to source food locally whenever possible.

“My family and I eat healthy foods, with most of the vegetables coming from our garden,” she said.

On June 1 last year, she came down with the chills, had a fever of 103 and flu-like symptoms.

“When my husband called the Humboldt Health Department to see what flus were in our area, they said there were none,” she said. “They asked him if I had purchased and eaten the newly recalled berry mix, which I had used in making smoothies for months.”

By the time she reached a hospital, Dexter said, her liver enzymes had risen to the near-deadly level of 1,800. When healthy, she said, her liver enzyme levels are around 24.

“I was prepped for a liver transplant,” she said, but slowly improved over a period of eight months during which she had no energy and felt like she was in a fog. “At night when I tried to go to sleep, it felt like every cell in my body was shaking.”

Geoff Soza, from Southern California, told the FDA officials that “I have experienced first-hand the real meaning of ‘food poisoning.’ My body truly felt as though I had been poisoned. I do not want anybody to have to go through what I did.”

Soza said his liver enzyme levels were up to 3,200 and he came near death. “The organic frozen berry mix that I had been eating for a healthy breakfast every day for months (was) contaminated with this virulent virus. There must be severe consequences for food safety failures.”

Both Soza and Dexter have since been vaccinated for hepatitis A – something they advocate for everyone.

Dexter said that the last time she went to Costco, she noticed that the Townsend frozen berry mix had been reduced from five fruits to three. It is no longer being recalled.

Both former patients said they were surprised to learn that a virus can survive freezing temperatures. Both also endorsed the tougher, more comprehensive food safety inspection procedures that are scheduled to be implemented in late 2016.

Call The Bee’s Cynthia H. Craft, (916) 321-1270.