2017 Salmonella Urbana Infections Linked to Imported Maradol Papayas (Final Update)
Posted November 3, 2017 3:00 PM ET
This outbreak appears to be over. This outbreak was one of four separate multistate outbreaks identified in 2017 linked to imported Maradol papayas from four different farms in Mexico. For information on the other outbreaks, please visit the Reports of Salmonella Outbreak Investigations from 2017 webpage.
- Read the Advice to Consumers, Restaurants, and Retailers>>
- This outbreak appears to be over.
- CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) investigated a multistate outbreak of Salmonella Urbana infections.
- Epidemiologic and laboratory evidence indicated that Maradol papayas from the El Zapotanito farm in La Huerta, Jalisco, Mexico were the likely source of this outbreak.
- Seven people infected with the outbreak strain of Salmonella Urbana were reported from three states.
- Illnesses started on dates ranging from July 23, 2017 to August 14, 2017.
- Four people were hospitalized. No deaths were reported.
- The same strain of Salmonella Urbana was found in samples collected from papayas and from ill people.
Introduction
CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) investigated a multistate outbreak of Salmonella Urbana infections linked to Maradol papayas from the El Zapotanito farm in La Huerta, Jalisco, Mexico.
Public health investigators used the PulseNet system to identify illnesses that may have been part of this outbreak. Seven people infected with the outbreak strain of Salmonella Urbana were reported from three states. A list of the states and the number of cases in each can be found on the Case Count Map page. Whole genome sequencing (WGS) showed that isolates from people infected with Salmonella were closely related genetically. This close genetic relationship means that people in this outbreak were more likely to share a common source of infection.
Illnesses started on dates ranging from July 23, 2017 to August 14, 2017. Ill people ranged in age from less than 1 year to 57, with a median age of 1. Four (57%) were female. Five (71%) of the seven ill people were of Hispanic ethnicity. Four (57%) of the seven ill people reported being hospitalized. No deaths were reported.
WGS identified antimicrobial resistance genes in isolates from two ill people. The presence of these resistance genes correlated with results from standard antibiotic susceptibility testing methods used by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory conducted on clinical isolates from three ill people in this outbreak. All three isolates tested were resistant to streptomycin and had intermediate resistance to tetracycline. Antibiotic resistance may limit treatment options and may be associated with increased risk of hospitalization, bloodstream infections, and treatment failures in patients.
Investigation of the Outbreak
Epidemiologic and laboratory evidence indicated that Maradol papayas were the likely source of this multistate outbreak.
In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Three (60%) of five people interviewed reported eating papayas. This proportion was significantly higher than results from a survey [PDF – 29 pages] of healthy Hispanic people in which 22% reported eating papayas in the week before they were interviewed during the summer months.
As a result of the other outbreak investigations linked to papayas in 2017, FDA increased testing of papayas from Mexico to see if papayas from other farms were contaminated with Salmonella. Through this increased testing, FDA identified Salmonella Urbana on papayas from El Zapotanito in La Huerta, Jalisco, Mexico. Investigators compared pulsed-field gel electrophoresis (PFGE) and WGS results of Salmonella isolates from the papayas to isolates from ill people in the CDC PulseNet database. These results showed the Salmonella Urbana papaya isolate shared the same DNA fingerprint as the Salmonella Urbana isolates from ill people. This result provided more evidence that people in this outbreak got sick from eating contaminated Maradol papayas.
FDA reported that the shipment of contaminated papayas was destroyed and not distributed for sale in the United States. Papayas from El Zapotanito farm were distributed in the United States earlier in the summer, but FDA reported that no shipments of papayas from the farm were on the market in the United States when the outbreak was identified because they were past their shelf life.
This outbreak appears to be over. This outbreak was one of four separate multistate outbreaks identified in 2017 linked to imported Maradol papayas from Mexico. For information on the other outbreaks, please visit the Reports of Salmonella Outbreak Investigations from 2017 webpage.
Previous Outbreak Announcements
Maradol Papaya: Maradol papayas are a large, oval fruit that weighs 3 or more pounds, with green skins that turn yellow when the fruit is ripe. The flesh inside the fruit is salmon-colored.
