The 55 cases are almost double the reported number of 28 cases less than a week ago, and more could be on the way.
Tropical Smoothie Cafe is based largely in Florida, North Carolina and Virginia, though the contaminated strawberries are only linked to Virginia cafes. More than half of the 44 Virginia residents infected have been hospitalized over the illness, according to the Virginia Department of Health.
Other cases linked to the outbreak have been reported in West Virginia, Maryland, North Carolina, Oregon and Wisconsin, a spokesperson for the Centers for Disease Control told HuffPost.
Hepatitis A is a highly contagious liver infection with symptoms including fever, nausea and fatigue, though symptoms don’t always appear. The virus is usually passed from person-to-person contact or through contaminated food.
Tropical Smoothie Cafe pulled all Egyptian strawberries ― a fraction of its overall strawberry inventory ― about 10 days ago, after the Virginia Department of Health linked the cafes to the hepatitis A outbreak.