Salmonella Outbreak Linked with Maradol Papayas Infects Individuals in 12 States

A recent Salmonella outbreak that has sickened several individuals in a total of 12 states has been linked with Maradol papayas imported from Mexico. Health officials from the Centers for Disease Control and Prevention (CDC) have been working closely with the US Food and Drug Administration (FDA), as well as local and public health departments to identify new cases associated with the outbreak.

A total of 47 cases of Salmonella Kiambu associated with the outbreak, were reported as of July 27, 2017, as well as 1 associated death in New York City. The CDC is reporting that that 12 individuals have been hospitalized due to related illness.

Each year, Salmonella infections are responsible for about 1 million food-borne illnesses throughout the United States, as well as 19,000 hospitalizations and 380 deaths. This is the second time this year that the disease-causing bacteria has made headlines. There are also ongoing multistate outbreaks (10) of human Salmonella infections that have been linked with live poultry in backyard flocks. The case count for this outbreak has reached triple digits: 790.

The time from when an individual has been exposed to Salmonella to confirmation that that individual is part of an outbreak typically ranges from 2 to 4 weeks. The CDC reports that "the illnesses started on dates ranging from May 17, 2017 to June 28, 2017." Those infected range in age from less than 1 year old to 95 years old, with the median age being 27. The majority of those infected (67%) are female.

Epidemiologic and laboratory evidence enabled health officials to link the multistate outbreak back to Maradol papayas. Outbreak investigators conducted several interviews with those who had fallen ill to see what foods were consumed and if they had any other related exposures. A total of 25 interviews were conducted and 11 of the infected individuals reported consuming papayas.

Furthermore, officials were able to glean more information from an “illness cluster” that sprung up in Maryland. The CDC defines an illness cluster as “2 or more individuals who do not live in the same household who report eating at the same restaurant location, attending a common event, or shopping at the same location of a grocery store in the week before becoming ill.” Several of those fell ill in Maryland reportedly consumed papayas that had been purchased from the same grocery store. Two different strains of Salmonella were identified in isolates that had been taken from the ill individuals: Salmonella Kiambu and Salmonella Thompson.

The Maryland Department of Health collected papaya samples from the grocery store associated with the illness cluster to test for the presence of Salmonella. One sample contained the outbreak strain Salmonella Kiambu, and another sample tested for Salmonella Thompson. Both samples were Caribeña brand Maradol papayas that had been imported from Mexico. According to the CDC, whole genome sequencing found that the Salmonella Kiambu papaya isolate “is closely related genetically” to the Salmonella Kiambu isolated from the infected individuals. “The result provides more evidence that people in this outbreak got sick from eating contaminated Maradol papayas,” the CDC states.

The CDC is in the process of gathering additional data “to determine whether the recent Salmonella Thompson illness in Maryland is part of this multistate outbreak.”

In the meantime, Grande Produce issued a voluntary recall on Wednesday for Caribeña brand Maradol papayas with distribution dates between July 10, 2017 and July 19, 2017. As such, the Maryland Department of Health and the CDC have issued warnings to consumers to not consume any Caribeña brand Maradol papayas. The CDC is also warning restaurants to avoid serving the papayas in their establishments, and retailers not to sell them. If consumers have the papayas in their households, the FDA is advising that they should dispose of them immediately.

Health officials are continuing laboratory surveillance to identify any additional infected individuals and the FDA is working with regulatory officials to pinpoint the exact point in the supply chain that allowed for contamination.

To see which states have been hit by the multistate Salmonella outbreak, be sure to check the Contagion^® Outbreak Monitor.