Health officials have linked at least 30 cases of hepatitis A to a frozen berry and pomegranate mix that’s sold at Costco. The illnesses have so far been reported in California, Oregon, Arizona, Colorado and New Mexico, but authorities are bracing for the outbreak to spread.

The product–called the Townsend Farms Organic Anti-oxidant Blend Frozen Berry Mix–has been pulled from store shelves. Costco is reportedly notifying any of its members who bought the item since late February.

USA Today:

Health officials don’t yet know if the product was sold at other stores or markets. They do know that frozen berry blends are often used to make smoothies, frozen bar drinks and other types of desserts and drinks. One concern is that smaller businesses might have bought bulk frozen berries at Costco and then used them in other products.

Hepatitis A is a highly contagious liver infection caused by a virus. Of the people who’ve been sickened in this outbreak, 47% have been hospitalized, the CDC said. Some people who contract it have no symptoms but many have fever, fatigue, nausea, vomiting, and abdominal and joint pain.

The virus is most often transmitted when an infected food handler prepares food with dirty hands. Food contaminated with hepatitis A can also transmit the disease to people who ate or handled it.

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