As of Monday, 34 cases of acute hepatitis A had been reported across five U.S. states in what is suspected to be the result of contaminated frozen berry and pomegranate seed mix, the Centers for Disease Control and Prevention (CDC) announced.

Public health officials, the CDC and the U.S. Food and Drug Administration were collaborating to find the source of the rare outbreak that had already sent 11 to the hospital across Colorado, New Mexico, Nevada, Arizona and California.

Townsend Farms Organic Anti-Oxidant Blend had been identified as a possible source of the infections. In 25 interviews, 19 individuals reported having eaten the blend, most likely from Costco markets.

Costco has notified members who purchased the product since February 2013 to remove the mix from their shelves. Onset dates of the illness range from April 29 to May 21.

Based on initial laboratory testing from two cases, the strain appears to be genotype 1B, a strain rarely seen in the Americas, according to the CDC. Most cases are known to occur in North Africa and the Middle East.

The same genotype was also linked to a 2013 outbreak in Europe linked to frozen berries and to a 2012 outbreak in British Columbia linked to a frozen berry mix with pomegranate seeds from Egypt.

The fruit from the Townsend Farms blend reportedly originated from the U.S., Argentina, Chile and Turkey.

Related story: More Scandinavian Hepatitis A cases linked to frozen berries

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