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Hepatitis A
In the 2-6 weeks prior to symptom onset: Did the patient consume raw or undercooked shellfish? Yes No Unk If yes, Type:_____________________________ Where:____________________________ Date/time:_________________________ In the 2-6 weeks prior to symptom onset: Did the patient consume fresh or frozen berries? Yes No Unk If yes, Fresh or Frozen:___________________________ Type:____________________________ Brand:_________________________