Frozen pomegranate arils from Egypt are under recall in Australia because they have been linked to a hepatitis A outbreak in New South Wales.

Coles stores in Australia are the exclusive distributors of the Creative Gourmet brand frozen pomegranate arils. All seven of the people who have been confirmed with hepatitis A infections reported eating frozen pomegranate arils from Coles before becoming sick, according to the News South Wales Health.

“Genetic testing available to date on some of the cases has identified a unique strain of hepatitis A,” according to a statement from the public health agency. “NSW Health is also working with other states and territories to determine if they also have locally acquired cases of hepatitis A with this strain — genotype 1B.”

The health department is also working with the New South Wales Food Authority on the investigation. Government officials say Entyce Food Ingredients Pty. Ltd., the recalling firm, is assisting with the investigation

The CEO of the NSW Food Authority, Lisa Szabo, said only imported frozen pomegranate products are implicated, stressing there is no link to Australian grown pomegranates. 

Because of the long incubation period for hepatitis A, which can take up to 50 days after exposure to the virus, health officials are urging anyone who has eaten frozen pomegranate arils from Coles to monitor themselves for symptoms in the coming weeks.

Anyone who ate the suspect frozen fruit in the past two weeks still has time to receive the post-exposure vaccine. Beyond two weeks after exposure the vaccine is not effective. 

Outbreak patients infected with the highly contagious virus are based in Sydney, the Central Coast and Wollongong. So far this year there have been only nine confirmed locally acquired cases of hepatitis A in New South Wales.

The hepatitis A virus can be transmitted through contaminated foods or beverages, close personal contact, or contact with surfaces that have become contaminated because of poor hygiene. Infected people are contagious before they show symptoms. Some infected people do not develop symptoms.

Some people recover with little difficulty, but others develop serious infections that can cause lifelong complications and sometimes death. Symptoms can include fever, nausea, lack of appetite, abdominal pain, followed by dark urine, pale stools and yellowing of the eyes and skin.

In recent years in the United States frozen fruit, including pomegranate arils and strawberries, have caused multi-state hepatitis A outbreaks. An outbreak among customers of Tropical Smoothie locations was traced to frozen strawberries from Egypt. 

Also, a deadly hepatitis A outbreak in Hawaii was traced to frozen imported scallops.