Virginia Department of Health offices say a cluster of hepatitis A cases may be associated with smoothies from Tropical Smoothie Cafe locations in Virginia.

Testing linked the illnesses to a strain of hepatitis A found in frozen strawberries from Egypt that caused past outbreaks, according to a statewide news release from the Health Department. Tropical Smoothie Cafe immediately withdrew all strawberries sourced from Egypt and found an alternate supply, according to the department.

Anyone who consumed a smoothie with frozen strawberries within the past 50 days is encouraged to watch for symptoms of hepatitis A, including jaundice, which appears as a yellowing of the skin or the eyes. If illness occurs, seek medical care and take steps to protect others from the infection.

Anyone who consumed a smoothie from a Tropical Smoothie Cafe in Virginia containing frozen strawberries on Aug. 5 to 8 may still benefit from a vaccine or immune globulin to prevent the disease. Anyone who has had hepatitis A or has been vaccinated is already immune, health officials said.

A Tropical Smoothie Cafe is located on Prices Fork Road in Blacksburg. The next closest to Roanoke is in Lynchburg.

Hepatitis A is an inflammation of the liver caused by a virus. In addition to jaundice, symptoms include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine and light-colored stools. Symptoms develop 15 to 50 days after exposure, which occurs through direct contact with another person who has the infection or by consuming contaminated food or drink.

Frequent handwashing with soap and warm water after using the bathroom or changing a diaper or before preparing food can help prevent the spread of hepatitis A.

It is important for people who have symptoms of hepatitis A to stay home from work, especially if they work in food service.

Other restaurants may also have received the frozen strawberries from Egypt. The state Health Department is working with the Virginia Department of Agriculture and Consumer Services, the U.S. Food and Drug Administration, and the Centers for Disease Control and Prevention to identify additional locations where the product may have been distributed, the statement said.