Outbreak of Salmonella Infections Linked to Whole, Fresh Papayas Imported from Mexico

July 1, 2019

The Centers for Disease Control and Prevention (CDC), public health and regulatory officials in several states, and the U.S. Food and Drug Administration are investigating a multistate outbreak of Salmonella Uganda infections linked to whole, fresh papayas imported from Mexico and sold in Connecticut, Massachusetts, New Jersey, New York, Pennsylvania and Rhode Island.

Consumers in Connecticut, Massachusetts, New Jersey, New York, Pennsylvania, and Rhode Island who have whole, fresh papayas imported from Mexico in their homes should not eat them. Throw the papayas away, even if some of them were eaten and no one has gotten sick.

Do not eat fruit salads or other mixes that include papayas from Mexico.

If you aren’t sure the papaya you bought is from Mexico, you can ask the place of purchase. When in doubt, don’t eat the papaya. Throw it out.
Wash and sanitize places where papayas were stored: countertops and refrigerator drawers or shelves. Follow these five steps to clean your refrigerator.

The FDA strongly advises importers, suppliers, and distributors, as well as restaurants, retailers and other food service providers from all states to hold whole, fresh papayas imported from Mexico.

Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. PulseNet is the national subtyping network of public health and food regulatory agency laboratories coordinated by CDC. DNA fingerprinting is performed on Salmonella bacteria isolated from ill people by using techniques called pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS). CDC PulseNet manages a national database of these DNA fingerprints to identify possible outbreaks. WGS gives a more detailed DNA fingerprint than PFGE. WGS performed on bacteria isolated from ill people showed that they were closely related genetically. This means that ill people in this outbreak are more likely to share a common source of infection.

As of June 26, 2019, a total of 62 people infected with the outbreak strain of Salmonella Uganda have been reported from eight states. 

Illnesses started on dates ranging from January 14, 2019, to June 8, 2019. Most illnesses have occurred since April 2019. Ill people range in age from 1 to 86 years, with a median age of 60. Fifty-three percent of ill people are female. Of 35 people with available information, 23 (66%) have been hospitalized. No deaths attributed to Salmonella have been reported. Of 33 ill people with available information, 22 (67%) reported being of Hispanic ethnicity.

Illnesses might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 2 to 4 weeks. Please see the Timeline for Reporting Cases of Salmonella Infection for more details.

Whole genome sequencing analysis of 40 isolates from ill people predicted antibiotic resistance to streptomycin and sulfisoxazole. Testing of three clinical isolates using standard antibiotic susceptibility testing methods by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) is currently underway. This resistance will not affect the choice of antibiotic used to treat most people.

Source: CDC