Perspective

Multistate Salmonella outbreak linked to imported papayas

Laura Gieraltowski, PhD
Laura Gieraltowski

For the second time in 2 years, a multistate outbreak of Salmonella has been linked to papayas imported from Mexico. This one is being caused by Salmonella Uganda, a rare serotype, an expert said.

According to the CDC, between January and June, there were 71 reported infections in Connecticut, Florida, Massachusetts, New Jersey, New York, Pennsylvania, Rhode Island and Texas. Among these cases, 27 hospitalizations have occurred, and no deaths have been reported. Information was available for 40 cases, and 28 of these patients reported being of Hispanic ethnicity, the CDC reported.

The agency has advised United States consumers to avoid purchasing or eating Cavi brand whole, fresh papayas, which evidence showed are “a likely source” of the infections. The CDC said restaurants, retailers and other food service providers from all states should not sell or serve any Cavi brand papayas, which are distributed by Agroson’s LLC.

Salmonella Uganda is a rare type of Salmonella, but we do see it occasionally,” Laura Gieraltowski, PhD, MPH, who leads the CDC’s Foodborne Outbreak Response Team, told Infectious Disease News. “We had a large outbreak linked to papayas imported from Mexico in 2017. It really wasn't that much of a surprise to see papayas were linked to another outbreak in 2019.”

The hospitalization rate is approximately 67% among patients with information available — about three times what is normal, according to Gieraltowski, who attributed the particularly high rate to the older age of those affected.

“Most of the sick people are adults older than 60, and older adults are more likely to have a severe Salmonella infection, so we think that might be why we're seeing a high hospitalization rate,” Gieraltowski said.

Produce growers, harvesters, packers and handlers can avoid future outbreaks by following the FDA’s produce safety rule, whereas doctors can help by taking symptoms of potential Salmonella infection seriously and hospitalizing patients who are infected, Gieraltowski said. – by Joe Gramigna

Reference:

CDC. Outbreak of Salmonella infections linked to Cavi brand whole, fresh papayas. https://www.cdc.gov/salmonella/uganda-06-19/index.html. Accessed July 8, 2019.

FDA. FSMA final rule on produce safety. https://www.fda.gov/food/food-safety-modernization-act-fsma/fsma-final-rule-produce-safety. Accessed July 8, 2019.

Disclosure: Gieraltowski reports no relevant financial disclosures.

Laura Gieraltowski, PhD
Laura Gieraltowski

For the second time in 2 years, a multistate outbreak of Salmonella has been linked to papayas imported from Mexico. This one is being caused by Salmonella Uganda, a rare serotype, an expert said.

According to the CDC, between January and June, there were 71 reported infections in Connecticut, Florida, Massachusetts, New Jersey, New York, Pennsylvania, Rhode Island and Texas. Among these cases, 27 hospitalizations have occurred, and no deaths have been reported. Information was available for 40 cases, and 28 of these patients reported being of Hispanic ethnicity, the CDC reported.

The agency has advised United States consumers to avoid purchasing or eating Cavi brand whole, fresh papayas, which evidence showed are “a likely source” of the infections. The CDC said restaurants, retailers and other food service providers from all states should not sell or serve any Cavi brand papayas, which are distributed by Agroson’s LLC.

Salmonella Uganda is a rare type of Salmonella, but we do see it occasionally,” Laura Gieraltowski, PhD, MPH, who leads the CDC’s Foodborne Outbreak Response Team, told Infectious Disease News. “We had a large outbreak linked to papayas imported from Mexico in 2017. It really wasn't that much of a surprise to see papayas were linked to another outbreak in 2019.”

The hospitalization rate is approximately 67% among patients with information available — about three times what is normal, according to Gieraltowski, who attributed the particularly high rate to the older age of those affected.

“Most of the sick people are adults older than 60, and older adults are more likely to have a severe Salmonella infection, so we think that might be why we're seeing a high hospitalization rate,” Gieraltowski said.

Produce growers, harvesters, packers and handlers can avoid future outbreaks by following the FDA’s produce safety rule, whereas doctors can help by taking symptoms of potential Salmonella infection seriously and hospitalizing patients who are infected, Gieraltowski said. – by Joe Gramigna

Reference:

CDC. Outbreak of Salmonella infections linked to Cavi brand whole, fresh papayas. https://www.cdc.gov/salmonella/uganda-06-19/index.html. Accessed July 8, 2019.

FDA. FSMA final rule on produce safety. https://www.fda.gov/food/food-safety-modernization-act-fsma/fsma-final-rule-produce-safety. Accessed July 8, 2019.

Disclosure: Gieraltowski reports no relevant financial disclosures.

    Perspective
    Herbert L. DuPont

    Herbert L. DuPont

    Fruit shipped from Mexico linked to outbreaks of Salmonella is not a new story. In previous well-described outbreaks, melons were contaminated on the surface. Unlike noroviruses and Shigella, Salmonella is not transmitted in very low doses, except for infants. Although I would support CDC recommendations, careful washing of the fruit’s surface before cutting into it could be helpful. Federal authorities will examine their hazard analysis and critical control points plan of the growers and suppliers to decide if the fruit can be resent to the U.S. once safety is ensured. 

    • Herbert L. DuPont, MD, MACP
    • Infectious Disease News Editorial Board member
      Professor of epidemiology and infectious diseases
      University of Texas Health Science Center at Houston

    Disclosures: DuPont reports no relevant financial disclosures.

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