Papaya-linked Salmonella outbreak sickens 47 in 12 states

A Salmonella Kiambu outbreak likely linked to eating contaminated Maradol papayas has sickened 47 people in 12 states, 1 of them fatally, the US Centers for Disease Control and Prevention (CDC) recently announced.

Maradol papayas are large, oval fruits that weigh 3 or more pounds, have green skin that turns yellow when ripe, and have salmon-colored flesh. Federal officials are still examining the distribution chain, but they say the source of the contaminated fruit appears to be Mexico.

Patients tilt toward Hispanic females

Most of the cases were reported in five eastern states: New York (13), New Jersey (12), Virginia (6), Maryland (5), and Pennsylvania (4).  Seven states across a wide swath of the country, however, have each reported 1 case: Iowa, Kentucky, Louisiana, Massachusetts, Minnesota, Texas, and Utah.

So far, 12 people have been hospitalized. The death involved a person from New York City. Illness onsets began May 17, with the most recent on Jun 28.

Patient ages range from less than 1 year to 95 years, with a median age of 27. About two-thirds are female, and, of 31 patients with available information, 18 (58%) are Hispanic.

The WHO said health officials are using PulseNet, the national subtyping network, to identify further illnesses that may be part of the outbreak.

The epidemiologic and lab investigations both point to tainted papayas as the source of the outbreak. Interviews with 25 sick patients found that 11 (44%) had eaten papayas, a significantly higher proportion of papaya consumption than in healthy Hispanic people (16%) interviewed around the same time.

Investigation findings, product tracing

A probe into an illness cluster in Maryland by the Maryland Department of Health (MDH) found that several sick people had eaten papayas from the same location of a grocery store, and one of the samples collected from papayas at the store yielded the outbreak strain, as well as the Salmonella Thompson subtype, which had also been detected in ill people from the cluster. Both samples that tested positive were from Maradol papayas.

An announcement from the Food and Drug Administration (FDA) said the store is in Baltimore and that the outbreak involved Caribena brand Maradol papayas from Mexico. The fruit was distributed by Grande Produce in San Juan, Tex.

FDA officials, however, emphasized that the distribution pattern of the Caribena papayas doesn't explain all of the illnesses and that other firms may have distributed contaminated Maradol papayas, as well. "At this time, the farm(s) producing these papayas appear to only be in Mexico," the FDA said.

CDC officials said they are collecting more information to see if the Salmonella Thompson illness from Maryland is part of the multistate outbreak.

They recommend against eating, selling, or serving any Maradol papayas until more is known. Investigators are tracing the supply chain to see where the papayas were contaminated.

See also:

Jul 21 CDC outbreak announcement

Jul 22 FDA outbreak announcement

Jul 19 MDH statement

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