Papaya pathogen problems persist

Little appears to have changed since 2011 outbreak, despite efforts of U.S., Mexican governments

The CDC posted this photo with its outbreak notice, describing maradol papayas as large, oval fruits that weigh 3 or more pounds, with green skins that turn yellow when the fruit is ripe. The flesh inside the fruit is salmon-colored. Photo courtesy of CDC

Salmonella — the pathogen behind an ongoing foodborne illness outbreak that has sickened 173 people across 21 states, killing one — is a normal inhabitant of the intestinal tract of many birds, reptiles and mammals.

The possibility that an agricultural product such as papayas may be contaminated with Salmonella is impossible to eradicate; however, the risk of widespread contamination can be controlled through careful attention to current best sanitary practices in the cultivation, harvesting and packing of raw produce. Failure to do so can result in a vicious cycle of contamination in fields, packing houses and the distribution system.

Cultivation, harvesting and packing
The papaya is a fast-growing, tree-like herbaceous plant, which is at home in tropical and semi-tropical climates and is cultivated extensively across southeastern Mexico, according to a report issued by the University of Florida IFAS Extension Service. The most recent report from Mexico’s Secretaría de Agricultura, Ganadería, Desarrollo Rural, Pesca y Alimentación (Ministry of Agriculture, Livestock, Rural Development, Fisheries and Food) shows Mexico to be the fifth largest producer of papayas in the world.

Papaya trees are propagated from seeds. When seedlings are large enough, they are transplanted by hand into growing fields.

The papaya plant is propagated from seeds, with seedlings transplanted into fields when they are of sufficient size. The plant matures in six to nine months in warmer regions. Susceptible to a variety of plant diseases and pests, such as root rot, powdery mildew, papaya ringspot virus, fruit fly and white fly, papaya plants usually have an abbreviated commercial lifespan of two to three years, according to information from the University of Hawaii. It is not unusual for a papaya plant to only produce a single crop in its lifetime.

Once harvested and delivered to the packing house, each papaya is graded according to ripeness and size. Next, the fruit is sorted according to size a second time, as well as shape, and color. It is also examined for insect or mechanical damage.

The sorted fruit is generally washed in large vats of chlorinated tap water to remove dirt, debris and insect contamination. Depending upon the condition of the fruit and the expected final destination, it may be subjected to additional treatments, including a hot water bath or a fungicide dip. After air-drying, the fruit is packed for shipment.

2011 Salmonella Agona outbreak
In 2011, the Centers for Disease Control and Prevention and the Food and Drug Administration investigated a Salmonella Agona outbreak that was traced to contaminated papayas imported from Mexico. The papayas were grown and packed by Agromod SA de CV of Chiapas, Mexico, and distributed by Agromod Produce Inc. of McAllen, Texas.

The Agromod papaya plantation had an interconnected drainage ditch system, according to information presented in 2013 during the annual educational conference of the National Environmental Health Association (NEHA).

The marsh-like environment of the drainage ditches was a haven for waterfowl, frogs and other wildlife, and provided perfect growth conditions for pathogenic bacteria. During heavy rain and flooding, the ditches overflowed into the soil surrounding the trees, impregnating the soil with pathogens from the water.

During an on-site inspection of Agromod’s plantation and packing house, investigators from FDA recovered a full two dozen different types of Salmonella, including the Salmonella Agona outbreak strain. Salmonella-positive samples were drawn from fields where the papaya grew and from packing-house drains.

The crops at Agromod were harvested by two-person teams. One person worked at tree level, picking fruit and handing or tossing it to the other person below. The second person laid each papaya onto a piece of poly foam on the unprotected soil. The foam was wrapped around the fruit, which was loaded into foam-lined bins for transport to the packing house.

It was common practice at Agromod for the sheets of poly foam to be reused for up to 15 days before being discarded, helping to spread contamination from the fields to the fruit, packing house and back again.

Once in the packing house, the fruit was washed in large vats of water. The level of chlorine in the wash water was not properly monitored or controlled, allowing Salmonella to spread throughout an entire batch of papayas.

The wash water was discharged into the drainage ditch system, returning Salmonella to the fields in a vicious cycle of contamination.

Import Alert
In response to the extent of Salmonella contamination brought to light during the investigation of the 2011 outbreak, FDA instituted Import Alert #21-17, “Countrywide Detention Without Physical Examination Of Papaya From Mexico.” Firms that provided documentation of five consecutive Salmonella-negative commercial shipments qualified for an exemption from the automatic detention at the U.S. border.

Concurrent with FDA’s initiation of the Import Alert, Mexico’s Servicio Nacional de Sanidad, Inocuidad y Calidad Agroalimentaria (National Service for Health, Safety and Agrifood Quality) (SENASICA ) unveiled a plan to assist that country’s papaya growers, packers and shippers in addressing the issues of safe growing and handling of the fruit.

History repeats
Notwithstanding the efforts of multiple agencies in both countries, the United States is once again in the throes of an outbreak of Salmonella that is associated with consumption of fresh, whole papayas imported from Mexico.

To view a larger version of the map on the CDC’s website, please click on the image.

As of Aug. 18 when the CDC posted it’s most recent outbreak update, 173 people had been confirmed sick across 21 states, with 58 hospitalizations, and one death on New York City. The CDC warns that the number of confirmed illnesses is likely to increase.

Thus far FDA has identified one farm in connection with the contaminated papaya. That farm, Carica de Campeche, has been supplying papayas to the U.S. market under an Import Alert exemption since 2015.

According to a spokesperson from FDA, at present there are no specific ongoing testing or inspection requirements that a producer must meet in order to maintain an exemption from automatic detention, although a firm is expected to “… continue to provide the commodity in a wholesome manner and follow all the regulatory requirements of FDA.”

The FDA revoked the exemption granted to Carica de Campeche under Import Alert 21-17 on Aug. 7.

This article first appeared in Food Safety News and is reposted here with permission.

Second Papaya Recall issued as Salmonella Outbreak Grows

One person dead, 35 hospitalized, 109 ill.

A second recall has been issued for Maradol papayas from Mexico as a result of the ongoing investigation into a Salmonella outbreak that has grown to 109 confirmed illnesses.

Agroson’s LLC (Bronx, NY) has recalled 2,483 boxes of Cavi brand Maradol Papayas, grown and packed by Carica de Campeche. The recalled papayas were supplied to wholesalers in New York, Connecticut and New Jersey from July 16 to 19, 2017.

The papayas were available for sale until July 31, 2017. Consumers can identify the papayas by PLU sticker, cavi MEXICO 4395.

According to the recall notice, Agroson’s has ceased importing papayas from Carica de Campeche.

The US Centers for Disease Control and Prevention (CDC) reported earlier today that the Salmonella outbreak linked to consumption of Maradol papayas imported from Mexico has more than doubled in size, and has spread to six additional states.

Most of the increase is due to the addition of cases from a second outbreak strain.

In addition to Salmonella Kiambu, CDC has confirmed a strain of Salmonella Thompson from a sample of papaya is genetically similar to Salmonella Thompson cultures recovered from patients. In all, Salmonella Kiambu has been found in 48 outbreak cases, and Salmonella Thompson in 61.

Confirmed outbreak cases have been reported from 16 states, including: Connecticut (4), Delaware (1), Iowa (2), Kentucky (2), Louisiana (1), Maryland (6), Massachusetts (3), Michigan (1), Minnesota (4), North Carolina (2), New Jersey (26), New York (36), Oklahoma (2), Pennsylvania (7), Virginia (11) and Wisconsin (1).

Texas, which was indicated to have reported a single outbreak cases in CDC’s initial announcement, has been removed from the list of affected states.

The first victim fell ill May 17th; the most illness developed on July 22nd. The youngest outbreak victim was less than one year old; the oldest was 95. Approximately two-thirds of the victims were female, and 68% were of Hispanic ethnicity.

The death was reported from New York City.

Initial investigtions identified Caribeña brand Maradol papayas as a source of the Salmonella Kiambu outbreak. On July 26th, Grande Produce (San Juan, Texas) issued a limited recall of papayas shipped to a Maryland distributor.

Traceback investigations carried out by the US Food and Drug Administration (FDA) have identified the Carica de Campeche farm (Campeche, Mexico) as the likely source of the outbreak. According to FDA, papayas from Carica de Campeche tested positive for Salmonella Agona, Salmonella Senftenberg, and Salmonella Gaminara in addition to the outbreak strains of Salmonella Kiambu and Salmonella Thompson.

As a result of its findings, FDA has added Carica de Campeche to Import Alert 99-35 (Detention without physical examination of fresh produce that appears to have been prepared, packed or held under insanitary conditions) and has removed the farm from the Green List of entities exempt from Import Alert 21-17 (Countrywide Detention Without Physical Examination of Papaya from Mexico).

Carica de Campeche was granted an exemption from this detention notice in 2015.

FDA has stepped up testing of papayas from other farms in Mexico to determine whether they may be contaminated. If Salmonella is found in papaya from a farm, that entity will be added to the Import Alert 99-35 detention list.

What CDC wants consumers to know:

CDC recommends that consumers not eat, restaurants not serve, and retailers not sell Maradol papayas from Mexico until we learn more.

At this time, Caribeña brand papayas from Mexico have been identified as one brand linked to the outbreak.
- Consumers should not eat, restaurants should not serve, and retailers should not sell recalled papayas.
- Additional brands will be announced as the information becomes available.
Maradol papayas have a green skin that turns yellow as the fruit ripens.
A sticker on the Maradol papaya should say if the papaya is Caribeña brand and if it is from Mexico.
If you aren’t sure if the papaya you bought is a Maradol papaya from Mexico, you can ask the place of purchase. Restaurants and retailers can ask their supplier.
When in doubt, don’t eat, sell, or serve them and throw them out.
Wash and sanitize countertops as well as drawers or shelves in refrigerators where papayas were stored.

Contact a healthcare provider if you think you got sick from eating contaminated papaya.

Most people infected with Salmonella develop the following signs and symptoms 12-72 hours after being exposed to the bacteria:
- Diarrhea
- Fever
- Abdominal cramps

Salmonella Outbreak Exposes Flaw in FDA ‘Import Alert’ System

The Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), the Maryland Department of Health (MDH) and other state and local agencies continue to investigate the outbreak of Salmonella Kiambu illnesses, which has sickened 47 people and has already claimed one life.

The CDC posted this photo with the outbreak notice, describing maradol papayas as large, oval fruits that weigh 3 or more pounds, with green skins that turn yellow when the fruit is ripe. The flesh inside the fruit is salmon-colored.” Photo courtesy of CDC

Based on sampling and analysis reported by MDH, the outbreak appears to be linked to consumption of Maradol papayas, imported from Mexico. On July 26, 2017, Grande Produce (San Juan, TX) recalled Caribeña brand Maradol papayas that were shipped to an unnamed Maryland distributor center between July 10 and July 19.

The introduction of Salmonella-contaminated papayas into the US retail market occurred despite the issuance in August 2011 of Import Alert 21-17, COUNTRYWIDE DETENTION WITHOUT PHYSICAL EXAMINATION OF PAPAYA FROM MEXICO.

What is an Import Alert?

An Import Alert informs “…FDA field staff and the public that the agency has enough evidence to allow for Detention Without Physical Examination (DWPE) of products that appear to be in violation of FDA laws and regulations.” It can be very narrow (apply to a single company or importer) or extremely broad, as in the case of Import Alert 21-17. The purpose of the Import Alert is to place the burden of proving product safety on the shoulders of the producer or importer. The first Import Alert was issued in 1974.

History of Import Alert 21-17

Mexican papayas were the source of a Salmonella Agona outbreak that sickened 106 people in 25 US states between January 1 and August 25, 2011. The outbreak was traced to several brands of papayas distributed in the USA and Canada by Agromod Produce, Inc.

During the investigation into the source of the outbreak, FDA analyzed 211 samples of Mexican papayas, finding Salmonella in 33 (15.6 percent) of them. The positive samples came from 28 different firms and nearly all the major papaya-growing regions of Mexico. In response to the extent of the contamination, FDA issued Import Alert 21-17 on August 25, 2011.

Are there any exceptions to the Import Alert?

FDA policy allows for exemptions to an Import Alert, if a company can provide evidence that their products are likely to remain in compliance with FDA laws and regulations. In the case of Import Alert 21-17, FDA considers Salmonella-negative test results from five consecutive shipments over a period of time to be evidence of probable compliance. Entities able to meet these criteria may apply for an exemption. If accepted, they are added to the Green List appended to the Import Alert.

How does the Green List Work?

At last count, FDA has granted 98 exemptions in the nearly six years during which the Import Alert has been in force. Once granted, exemptions remain in effect unless FDA receives evidence of lack of compliance, such as a result of a consumer complaint, a Salmonella-positive routine retail surveillance sample. There is no requirement for inspection of the exempt entity’s operations, for routine or periodic submission of lab test results, or for any other form or recertification. A Green-listed entity under Import Alert 21-17 has carte-blanche to ship papayas from Mexico into the USA.

What Happens to Detained Shipments under Import Alert 21-17?

Entities whose products are detained without physical examination may apply to have those products released by submitting evidence from a third-party laboratory that the product is not contaminated with Salmonella. Otherwise, the product either will be refused entry into the USA, or will be destroyed.

The action taken last week by Grande Produce represents the second time in recent years that Caribeña brand Mexican papayas have been recalled due to Salmonella contamination. The first recall took place in May 2012 after routine testing by Caribe Produce, LTD CO discovered Salmonella contamination.

A recent search of Texas Secretary of State corporate filings revealed Raul Cano to be both the registered agent for Caribe Produce and a Managing Member/Director of Grande Produce. Both companies currently share the same street address. According to a May 2017 article published in Texas Border Business, Grande Produce is owned jointly by Raul Cano and his brother, Juan Cano.

While the identity of the Mexican grower who supplied the recalled papayas has not been determined, Chiapas-based Finca Monte Verde identifies its US distributor to be Grande Produce and identifies Caribe Produce as its contact point in the USA. Finca Monte Verde is on the Import Alert 21-17 Green List and, therefore, is exempt from automatic detention.

There is no information on either the Finca Monte Verde or the Grande Produce websites to indicate whether or not Finca Monte Verde is the sole supplier of papayas to Grande Produce. While FDA is conducting a traceback investigation of the recalled Caribeña papayas, its investigators also are working with CDC and state agencies to determine whether other brands of papayas may be implicated in the Salmonella outbreak.

Although the investigating state and federal agencies have not yet determined the origin of the contaminated papayas, or the point in the tree-to-table distribution chain at which they may have become contaminated, one thing is certain. Either the papayas entered the USA under the aegis of a Green-Listed entity or the produce was admitted as a result of a third-party lab analysis certifying a Salmonella-negative result.

As food safety advocate Bill Marler pointed out in his recent opinion piece, ‘Why the US imports tainted food that can kill you,’ FDA’s ability to carry out proactive inspections of foreign growers and packers is severely limited by budget constraints, forcing the agency to rely on the good faith and probity of these entities and of their third-party testing laboratories to deliver a safe product to US consumers.

In this case, it seems the outcome was a large gap in the food safety border wall—maybe large enough to drive a refrigerated 18-wheeler through.

This article first appeared on Food Safety News and is reposted here with permission. Attorney Bill Marler is the publisher of Food Safety News.