By USA Today

Health officials have linked an outbreak of acute hepatitis A that has sickened at least 30 people in five states to a frozen berry and pomegranate mix.

Washoe County is among the areas where people have gotten sick, according to this item from the Washoe County Health District.

Cases have been reported in Colorado, New Mexico, Nevada, Arizona, and California. In a release Friday, the Centers for Disease Control and Prevention said the first victims fell ill on April 29 and the most recent case was May 17. It is believed more will come.

The outbreak appears to be linked to a frozen berry blend sold by Costco called The Townsend Farms Organic Anti-oxidant Blend Frozen Berry Mix, a frozen berry and pomegranate seed mix. Costco is notifying all members who purchased the product since late February and has removed it from its shelves.

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 the hepatitis A virus. Of the people who’ve been sickened in this outbreak 47 percent have been hospitalized, CDC said. Some people who contract it have no symptoms but many have fever, fatigue, nausea, vomiting, 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.

According to the label, the berry blend contained pomegranate seeds and other produce from the U.S., Argentina, Chile, and Turkey.

The strain of hepatitis A in this outbreak is rarely seen in the United States, said CDC’s Lola Russell. It’s known to circulate in North African and the Middle East. The same type of hepatitis A was identified in a 2013 outbreak in Europe linked to frozen berries and another one in 2012 in Canada linked to a frozen berry blend with pomegranate seeds from Egypt, she said.