A North Carolina outbreak of hepatitis A (search) probably came from green onions, which also have been blamed for outbreaks linked to restaurants in Georgia, Tennessee and Pennsylvania, according to a preliminary state health report.

The Georgia Division of Public Health (search) found that the hepatitis A strain that sickened 16 people in North Carolina was the same as the one that afflicted 259 people in Georgia and likely came from the same source.

The Georgia outbreak had previously been traced to green onions shipped from Mexico, and the report said a single Atlanta Farmers' Market (search) distributor provided green onions from California suppliers to three Georgia restaurants where multiple people got the liver infection.

Health officials have said that water can contain several different strains of the virus that could contaminate a harvest during irrigation or processing. The vegetables also could have been contaminated by infected workers.

There were no deaths stemming from the Georgia outbreak in September and October. This month, three people have died and more than 600 have been sickened in Pennsylvania in the nation's biggest known outbreak of the disease.

"We were very lucky in Georgia that people that got sick have gotten better or are continuing to recover," said Richard Quartarone, health division spokesman. "We were able to act very quickly on it."

Federal health officials said Friday that green onions from Mexico were probably responsible for the Pennsylvania outbreak, but stopped short of saying they came from one of three Mexican companies known to have supplied the onions blamed for other outbreaks.