Food

FDA Investigates Multiple Salmonella Outbreak Strains Linked to Papayas

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August 11, 2017

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The U.S. Food and Drug Administration, along with the Centers for Disease Control and Prevention (CDC), the Maryland Department of Health (MDH), and other state and local partners, is investigating multiple Salmonella illnesses that are linked to papayas  from Mexico.

Update

The FDA is now advising that consumers avoid Caribeña, Cavi and Valery brands of Maradol papayas, and all varieties of papayas from the Carica de Campeche farm located in Campeche, MX, as a result of the FDA’s traceback investigation and testing. The FDA is working to identify additional brand(s) that these papayas are sold under and facilitate recall(s). Meanwhile, consumers should ask their retailers about the source of their papayas.

Fast Facts

  • The FDA is advising consumers not to eat Maradol papayas from the Carica de Campeche farm in Mexico because they are linked to an outbreak of salmonellosis.
  • Three brands of Maradol papayas have been recalled: Caribeña brand, distributed by Grande Produce; certain Cavi brand papayas distributed by Agroson’s; and Valery brand papayas, distributed by Freshtex Produce, LLC. If anyone has these papayas in their home, they should dispose of them immediately.
  • The agency is working to ensure that there are no other brand(s) of papayas on the market that may have originated from the Carica de Campeche farm. Meanwhile, consumers should ask their retailers where their papayas came from.
  • The FDA has also added the Carica de Campeche farm to Import Alert (IA) 99-35, after testing found multiple strains of Salmonella present in the fruit.
  • Thus far, Salmonella strains matching the outbreak patterns by PFGE were only isolated from papayas from the Carica de Campeche farm.
  • CDC reports 141 cases, 45 hospitalizations and one death from 19 states in the Salmonella Kiambu and Salmonella Thompson outbreak . The states involved are CT, DE, IA, IL, KY, LA, MA, MD, MI, MN, NC, NJ, NY, OH, OK, PA, TX, VA, and WI.

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What is the Problem and What is Being Done About It?

The FDA, CDC, MDH and other state and local officials are investigating Salmonella Kiambu and Salmonella Thompson illnesses linked to papayas from the Carica de Campeche farm in Mexico.

Three brands of Maradol papayas have been recalled:

  • Caribeña brand, distributed between July 10 and 19. The Caribeña brand can be identified by a red, green, and yellow sticker.
  • Cavi brand, distributed to wholesalers in New York, Connecticut and New Jersey from July 16-19 and available to consumers until July 31.The Cavi brand carries a purple, green, and black sticker with the words “cavi MEXICO 4395” in white. Only certain lot codes of Cavi papayas were recalled that were known to come from Carica de Campeche. Boxes provided to wholesalers are stamped with CARICA DE CAMPECHE on the upper left side of the box. Other Cavi papayas, sourced from other farms, are not being recalled.
  • Valery brand, distributed from July 10-13. Valery Maradol papayas have a red, yellow, and green sticker with “Valery” in yellow letters.

Consumers who have any of these papayas in their homes should throw them away.

The FDA and state partners continue to investigate the distribution of the papayas involved in this outbreak and are working to ensure that there are no other brand(s) that these papayas may have been sold under.

Papayas from the Carica de Campeche farm tested positive for Salmonella Kiambu, Salmonella Thompson, Salmonella Agona, Salmonella Senftenberg, and Salmonella Gaminara. On 8/3/2017, CDC announced it has added illnesses of Salmonella Thompson to this outbreak investigation based on epidemiological and laboratory evidence. Whole genome sequencing (WGS) is pending for these samples. The Carica de Campeche farm has been added to Import Alert (IA) 99-35.

The FDA increased testing of papayas from Mexico in an effort to see if fruit from other farms could be contaminated. If the FDA finds Salmonella in other shipments, those farms will also be added to IA 99-35.

Since 2011, papayas from Mexico have been screened at the border for Salmonella by third-party laboratories, and these shipments have not been allowed to enter the country without documentation of testing demonstrating the products test negative for Salmonella. Farms/companies have been able to request addition onto the “green” list of IA 21-17when they have had five consecutive shipments test negative for Salmonella. In contrast, farms/companies that want to request removal from the “red” list of IA 99-35 must present substantive documentation demonstrating that they have made corrections to prevent contamination, including, for example, a root cause analysis to identify potential sources and routes of contamination.

The FDA is closely communicating with Mexican food safety authorities, Servicio Nacional de Sanidad, Inocuidad y Calidad Agroalimentaria (SENASICA), and Comisión Federal para la Protección contra Riesgos Sanitarios (COFEPRIS), on the outbreak investigation and the FDA’s regulatory activities on implicated Mexican firms. Mexican food safety authorities are conducting inspections and other follow up activities at firms of interest.

CDC reports 141 cases, 45 hospitalizations and one death from 19 states in the Salmonella Kiambu and Salmonella Thompson outbreaks. The states involved are CT, DE, IA, IL, KY, LA, MA, MD, MI, MN, NC, NJ, NY, OH, OK, PA, TX, VA, and WI.

Timeline

On June 26, 2017, the CDC notified the FDA about a Salmonella Kiambu cluster detected by PulseNet. All 47 cases have the same pattern by pulsed-field gel electrophoresis (PFGE). Whole Genome Sequencing (WGS) analysis was conducted on ten patient samples in the outbreak cluster and all were highly related. This indicates that the patients were likely sickened by the same type of food.

MDH informed the FDA, CDC, and state partners that several ill people shopped at the same Baltimore retail location and purchased papayas. Records and samples of green and yellow papaya were collected. On July 17, 2017, Maryland reported that three of ten samples had preliminarily tested positive for Salmonella. All positive samples were Caribeña brand yellow Maradol papayas from Mexico; none of the green papayas were positive. Further WGS testing linked one of the papaya samples to the Salmonella Kiambu outbreak and another to Salmonella Thompson. However, Maradol papayas are green before they ripen and turn yellow, so consumers should not eat Caribeña brand papayas regardless of the color.

On July 19, 2017, MDH issued an advisory warning consumers not to eat Caribeña brand yellow Maradol papayas. Further WGS testing linked one of the papaya samples to the Salmonella Kiambu outbreak and another to Salmonella Thompson.

On July 26, 2017, Grande Produce issued a press release to notify consumers that it had conducted a limited recall of Caribeña brand Maradol papayas distributed during the dates of July 10 to July 19, 2017

On July 27, 2017, the FDA issued an outbreak posting advising consumers to avoid all Caribeña brand Maradol papayas, regardless of color or date of distribution.

On August 3, 2017, following extensive traceback and testing, the FDA added papaya farm Carica de Campeche to Import Alert (IA) 99-35. Papayas from the Carica de Campeche farm tested positive for Salmonella Kiambu, Salmonella Thompson, Salmonella Agona, Salmonella Senftenberg, and Salmonella Gaminara.

On August 4, 2017, Agroson’s, LLC, issued a press release announcing the recall of certain Cavi brand Maradol papayas. Agroson’s states that the papayas were distributed on July 16-19, and available to consumers until July 31.

Also on August 4, 2017, CDC announced it is adding Salmonella Thompson illness to this outbreak investigation because of epidemiological evidence. Also, FDA and Maryland state testing has indicated that both serotypes of Salmonella were present in a single fruit.

On August 7, 2017, Freshtex Produce, LLC, issued a press release announcing the recall of Valery brand Maradol papayas that were distributed in the state of Illinois from July 10-13. These papayas may have been further distributed outside of Illinois.

FDA, CDC, state, and local health officials continue to actively investigate the cases with papaya exposure and will provide updates as additional information becomes available.

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What are the Symptoms of Salmonella Infection?

Most people infected with Salmonella develop diarrhea, fever, and abdominal cramps. The illness usually lasts 4 to 7 days, and most people recover without treatment.

How Soon After Exposure do Symptoms Appear?

Most people infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection.

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What are the Complications of Salmonella Infections?

In some people, the diarrhea may be so severe that the patient needs to be hospitalized. In these patients, the Salmonella infection may spread from the intestines to the blood stream, and then to other body sites and can cause death unless the person is treated promptly with antibiotics.

Who is at Risk?

Children are the most likely to get salmonellosis. Children younger than five, the elderly, and those people with weakened immune systems are more likely to have severe infections. 

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What Do Restaurants and Retailers Need To Do?

Retailers, restaurants, and other food service operators who have served any potentially contaminated papayas need to be concerned about cross contamination of cutting surfaces and utensils. They should follow the steps below:

  • Wash and sanitize display cases and refrigerators where potentially contaminated products were stored.
  • Wash and sanitize cutting boards, surfaces, and utensils used to prepare, serve, or store potentially contaminated products.
  • Wash hands with hot water and soap following the cleaning and sanitation process.
  • Regular frequent cleaning and sanitizing of food contact surfaces and utensils used in food preparation may help to minimize the likelihood of cross-contamination.

Avoid cross contamination through contact with crates or other containers where potentially contaminated products were held or shipped. Wash and sanitize such containers as appropriate.

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What Do Consumers Need To Do?

Consumers should ask restaurants and retailers whether they use Caribeña or Cavi brands of Maradol papayas and/or whether their distributors receive product from the Carica de Campeche farm in Mexico. If so, consumers should not consume or purchase those products and throw away any such products they have in their home. At this time, CDC is advising consumers not to eat any Maradol papayas regardless of their origin while the traceback investigation is ongoing.

For refrigerators and other food preparation surfaces and food cutting utensils that may have come in contact with potentially contaminated papayas, it is very important that the consumers thoroughly clean and sanitize these areas and items.

Consumers should follow these simple steps: 

  • Wash the inside walls and shelves of the refrigerator, cutting boards and countertops; then sanitize them with a solution of one tablespoon of chlorine bleach to one gallon of hot water; dry with a clean cloth or new paper towel.
  • Wash hands with warm water and soap for at least 20 seconds before and after handling food. 
  • Wipe up spills in the refrigerator immediately and clean the refrigerator regularly. 
  • Always wash hands with warm water and soap following the cleaning and sanitization process.

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Who Should be Contacted?

If you think you might have become ill from eating potentially contaminated papayas, talk to your health care provider. Contact your health care provider if you have diarrhea that lasts for more than 3 days, or is accompanied by high fever, blood in the stool, or so much vomiting that you cannot keep liquids down and you pass very little urine.

The FDA encourages consumers with questions about food safety to call 1-888-SAFEFOOD Monday through Friday between 10 a.m. and 4 p.m. Eastern Time, or to consult the fda.gov website: http://www.fda.gov.

Additional Information

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Page Last Updated: 08/11/2017
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