"She looked like a daffodil," Patty Bischoff said of her daughter.
Amanda ended up among about 150 Michigan schoolchildren and adults whom authorities believe contracted hepatitis A from tainted frozen strawberries that were part of a federal school lunch program. She recovered before her ninth birthday Friday, but thousands of students and educators in six states may have been exposed to the virus.
The U.S. Department of Agriculture said yesterday it will investigate how Mexican-grown strawberries got into the program, which is required to buy only U.S. products, according to a spokesperson.
So far, the only reported illnesses linked to the tainted berries have been in Michigan. Fruits with the same lot numbers were also sent to Arizona, California, Georgia, Iowa and Tennessee.
As many as 9,000 youngsters and adults may have been exposed to the fruit in Los Angeles, where officials determined that fruit cups served last week in 18 public schools may have been contaminated.
Hepatitis A causes a mild liver infection and is often spread through uncooked food. Those at risk of more severe symptoms are the elderly, people with weak immune systems and the very young.
For most people, symptoms appear about 28 days after exposure. They include jaundice, fatigue, abdominal discomfort, vomiting, fever and dark urine.
The virus can be transmitted orally or through human waste, often by food handlers with poor personal hygiene, through undercooked shellfish from infected waters or through tainted water or ice.
"This is an unusual outbreak because it is linked to one source that has nationwide implications," said Ian Williams, an epidemiologist with the Centers for Disease Control and Prevention in Atlanta.
In Amanda's hometown of Marshall, about 97 miles west of Detroit, the epidemic peaked a couple weeks ago - before officials had connected the strawberries to the disease.
Most people don't have to be hospitalized, but Amanda was one of nine people in Marshall who required treatment for dehydration, said Oaklawn Hospital spokesperson Jill Kingsley-Hinde.
About 2,000 people in the Marshall area got protective gamma globulin shots after the illnesses began, she said - including many who lined up at school basketball games where the shots were offered. Some doctors extended their office hours to deal with the problem.
Health officials also were tracking down children from across the state who participated in a Special Olympics competition where strawberry shortcake made with the tainted fruit was served.
The hepatitis was linked to the strawberries late last week, said Dr. David Johnson, chief medical executive of the Public Health Agency at the Michigan Department of Community Health. No one in Michigan is known to have become sick recently, he said.
"My prediction is we've seen the bulk of the actual cases that we're going to see already," he said.
Dr. Thomas Dobbins of Marshall was one who had extended his office hours to handle the influx of patients. The virus hit close to home - his 8-year-old daughter, Kehvren, got sick.
"It's unfortunate - it would have been impossible to have identified the strawberries without the increase in disease," Dobbins said.
"It's kind of a miserable thing all around for people that get a good case of it," he said. "To absolutely assume that kids aren't going to get really sick with this is wrong."
So far this is not the most serious outbreak of the disease.
Memphis has been fighting outbreaks of hepatitis A, mostly in inner-city neighborhoods, that have led to more than 2,000 cases of the disease since 1994, the CDC said.
School officials checked freezers across the country yesterday in districts that received the fruit.
"We were scheduled to serve strawberries today, but we pulled them off and served something else," said Superintendent Harold Prior of Algona School District in Iowa.
Amanda Bischoff said Wednesday she really knew she was sick when she didn't want to play Barbie dolls with her cousin. "I felt sort of sick like I had the flu," she said.
On Monday, Amanda will go back to school. She said she likes school, but has a lot of homework to make up from the three weeks she missed because of the virus.
Her mother said Amanda is finally getting her appetite back - in fact, it's stronger than ever, her mother said. But there was one item not on the menu at her recent birthday party.
"I didn't serve her strawberry shortcake," Mrs. Bischoff said.