Wellness

[Mindy D]

FDA In Brief: FDA Investigates Source of Non-Viral Hepatitis Cases Possibly Linked to Bottled Alkaline Water

March 16, 2021

The following quote is attributed to Frank Yiannas, Deputy Commissioner for Food Policy and Response:

“The FDA is committed to protecting the health of Americans and is especially concerned when there is a food safety issue impacting our youngest, and some of the most vulnerable in the population – infants and young children. Upon learning about reports of acute non-viral hepatitis in Nevada, impacting five young children, the FDA quickly activated a team to further investigate. We are working closely with the CDC, state and local partners to complete our investigation and monitor for any additional illnesses.

“We are advising consumers, restaurants and retailers to not consume, cook with, sell or serve “Real Water” alkaline water until more information is known about the cause of the illnesses. We are working to determine how the alkaline water may be related to the illnesses. Although the investigation is ongoing, epidemiologic information currently indicates that this alkaline water product may be the cause of the illnesses. We will provide additional updates as more information becomes available.”

Additional Information:

• On March 13, the U.S. Food and Drug Administration was alerted to five cases of acute non-viral hepatitis (resulting in acute liver failure) in infants and young children that occurred in November 2020 with an unknown cause reported to the Southern Nevada Health District. All five patients had been hospitalized but have since recovered. All patients were reported to have consumed “Real Water” brand alkaline water. These patients came from four different households. Additional people in the households were reported to have experienced less severe symptoms. Less severe symptoms included fever, vomiting, nausea, loss of appetite and fatigue.
• The consumption of “Real Water” brand alkaline water is the only common link identified between all of these cases to date. This brand of alkaline water is owned by Real Water Inc., headquartered in Mesa, Arizona.
• The FDA regulates bottled water under the Federal Food, Drug, and Cosmetic Act. Manufacturers are responsible for producing safe, wholesome and truthfully labeled food products. Health-related statements made by the firm have not been evaluated by the FDA.
• Symptoms of all types of hepatitis, including non-viral hepatitis, are similar and can include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay or gray-colored bowel movements, joint pain, yellow eyes and jaundice. Those experiencing these symptoms should contact their doctor.

Related Information

• Investigation of Acute Non-viral Hepatitis Illnesses – “Real Water” Brand Alkaline Water
• Bottled Water Everywhere: Keeping it Safe

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

• Content current as of:

  03/16/2021

[Mindy D]

Investigation of Acute Non-viral Hepatitis Illnesses – “Real Water” Brand Alkaline Water (March 2021)

Do not drink, cook with, sell, or serve “Real Water” alkaline water

The FDA, along with the CDC and the Southern Nevada Health District is investigating a number of reports of acute non-viral hepatitis in the state of Nevada.

The consumption of “Real Water” brand alkaline water is the only common link identified among all of these cases to date. This brand of alkaline water is owned by Real Water Inc., headquartered in Mesa, Arizona.

Although the investigation is ongoing, epidemiologic information currently indicates that this alkaline water product may be the cause of the illnesses. 

FDA is in the beginning stages of this investigation, and there may be additional products connected to this outbreak. FDA has initiated an investigation at the firm. 

As this outbreak investigation continues, the FDA will provide additional updates to this advisory as more information becomes available.

Recommendations

Consumers, restaurants, and retailers should not drink, cook with, sell, or serve “Real Water” alkaline water, until more information is known about the cause of the illnesses. These products include but are not limited to: 5-gallon containers (sold through home delivery/subscription), bottles (sold on-line and in stores), and the “Real Water” concentrate (sold on-line).

The 5-gallon containers are delivered to homes in the following areas, according to the firm’s website:

• Honolulu, HI through Aloha Water
• Orange County, CA through Paradise Bottling Company
• St. George, UT through Real Water Southern Utah
• Tucson, AZ through Aqua Pure
• Ventura and Santa Barbara, CA through Real Water Gold Coast

Additionally, according to the firm’s website, Real Water is sold in 1 gallon, 500 mL (16.9oz.), 1 liter, and 1.5 liter plastic bottles and in a 750 mL glass bottle.

Symptoms of all types of hepatitis, including non-viral hepatitis, are similar and can include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay or gray-colored bowel movements, joint pain, yellow eyes, and jaundice. Those experiencing these symptoms should contact their doctor.

[Mindy D]

[Porcelain]

That is so weird. What could have happened to it? I don't understand how anyone could contaminate water with hepatitis.

[BlueFinch]

Yikes!  Real Water is the only common link -- so far. Further investigation may reveal other links.

If it's determined it's from the bottle water, it's very troubling that this source of contamination has occurred. 

[Mindy D]

---

@Porcelain wrote:

That is so weird. What could have happened to it? I don't understand how anyone could contaminate water with hepatitis.

---

@Porcelain @The water is not contaminated with a viral hepatitis. That usually occurs with fecal contamination of water. This is non-infectious hepatitis which usually occurs in the presence of some type of toxin. I'm assuming that no toxin has been identified so far. I'm assuming that some  bottles have been tested for the presence of any toxic substances. Perhaps a toxic substance entered the bottles or the water at the bottling plant level. Could some type of industrial substance have gotten into the bottles? Could some type of toxic substance have gotten into the water source? Perhaps the alkaline water itself is toxic to the livers of the children and has never been previously identified as causing liver toxicity in children. This is a mystery. 

[Anonymous032819]

This is why I prefer good ol tap water.

[agb80]

I was really shocked to hear this about Real Water.  I tried it for the first time in one small bottle that I purchased when I was out at the grocery store with my husband.  This was about 2 or 3 months ago and if I had liked it I would have started buying it all the time but instead I told my husband that it tasted funny and I dumped it into the sink. How strange and so glad.