Mexican government dismisses as ‘premature’ CDC’s link of Salmonella outbreak to imported papayas

In a July 1, 2019 news release, El Servicio Nacional de Sanidad, Inocuidad y Calidad Agroalimentaria de Mexico / The National Service of Health, Safety and Agri-Food Quality (Senasica) has described as “premature” CDC’s June 28, 2019 report of a link between Mexican papayas and a current outbreak of Salmonella Uganda illnesses.

Senasica points out that the outbreak strain has not been recovered from a papaya sample, nor has Salmonella Uganda been isolated from papayas in Mexico.

According to Senasica, until the outbreak strain has been found in a papaya sample, Mexico does not consider CDC’s findings to be conclusive.

The outbreak under investigation comprises 62 illnesses in eight US states: Connecticut (14), Florida (1), Massachusetts (5), New Jersey (12), New York (24), Pennsylvania (4), Rhode Island (1), Texas (1). Twenty-three people have been hospitalized.

Two people who lived in different households got sick in Connecticut after eating papayas purchased from the same grocery store location in the week before becoming ill.

According to CDC, epidemiological evidence, including interviews conducted with some of the outbreak victims, points to papayas as the source of the outbreak.

FDA is conducting a traceback investigation to establish the source of the papayas. Early product distribution information indicates that they were imported from Mexico.

Senasica’s official response to CDC’s report is reminiscent of the initial Mexican response to the 2011 outbreak of Salmonella Agona illnesses caused by contaminated papayas imported from Mexico.

Back then, Mexico vehemently denied responsibility for the outbreak, even after FDA found the outbreak strain in samples of the imported papayas.

What will it take for Senasica to acknowledge reality?

And, what will it take for FDA to impose a complete embargo on the importation of papayas from Mexico?

What consumers should do

If you have purchased a papaya grown in Mexico, throw it away.
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.

What restaurants and retailers should do

In the event that restaurants, retailers and/or other food service operators are found to have handled potentially contaminated food in their facilities, they should:

Contact their local health department and communicate to their customers regarding possible exposure to a pathogen.
Wash the inside walls and shelves of the refrigerator, cutting boards and countertops, and utensils that may have contacted contaminated foods; then sanitize them with a solution of one tablespoon of chlorine bleach to one gallon of hot water; dry with a clean cloth or paper towel that has not been previously used.
Wash and sanitize display cases and surfaces used to potentially store, serve, or prepare potentially contaminated foods.
Wash hands with warm water and soap following the cleaning and sanitation process.
Conduct regular frequent cleaning and sanitizing of cutting boards and utensils used in processing to help minimize the likelihood of cross-contamination.

Papayas from Mexico blamed for another Salmonella outbreak

For the sixth time in eight years, papayas grown in Mexico have been linked to an outbreak of Salmonella.

The US Centers for Disease Control and Prevention (CDC) and the US Food and Drug Administration (FDA) are warning consumers in Connecticut, Massachusetts, New Jersey, New York, Pennsylvania, and Rhode Island to avoid eating any fresh papayas from Mexico until further notice.

No recall has been announced.

CDC reports 62 cases of Salmonella Uganda illnesses, including 23 hospitalizations, in eight states: Connecticut (14), Florida (1), Massachusetts (5), New Jersey (12), New York (24), Pennsylvania (4), Rhode Island (1), and Texas (1).

No deaths have been reported.

According to FDA, most people with salmonellosis develop diarrhea, fever, and abdominal cramps. More severe cases of salmonellosis may include a high fever, aches, headaches, lethargy, a rash, blood in the urine or stool, and in some cases may become fatal.

Children younger than five, the elderly, and people with weakened immune systems are more likely to have severe salmonellosis infections.

By the numbers

Epidemiological evidence gathered by CDC, and product distribution information obtained by FDA, point to papayas grown in Mexico and distributed in Connecticut, Massachusetts, New Jersey, New York, Pennsylvania, and Rhode Island.

Just over one-half of the victims are female, and approximately two-thirds of those interviewed are of Hispanic ethnicity. Ages of outbreak victims range from one to 86 years.

Of those victims who were interviewed, 76% reported having eaten papaya in the week before becoming ill.

The Florida victim reported having traveled to Connecticut in the week before becoming ill. It is unknown at this time whether the Texas victim had traveled to one of the six states to which the papayas were shipped.

FDA has not yet identified a source or grower of the contaminated papayas.

History

This is the sixth in a series of Salmonella outbreaks linked to papayas grown in Mexico and imported into the USA in the last eight years.

In 2011, Mexican papayas contaminated with Salmonella Agona were the source of a 25-state outbreak that sickened 106 individuals, sending 10 of them to hospital.

In 2017, history repeated itself four-fold. A total of 251 individuals were infected with one of several different strains of Salmonella after eating Mexico-grown papayas. Seventy-eight of the outbreak victims were hospitalized and two people died.

If history is any guide, it is likely that the number of cases and hospitalizations in this outbreak will increase.

What should consumers do?

If you have purchased a papaya grown in Mexico, throw it away.
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.

What should restaurants and retailers do?

In the event that restaurants, retailers and/or other food service operators are found to have handled potentially contaminated food in their facilities, they should:

Contact their local health department and communicate to their customers regarding possible exposure to a pathogen.
Wash the inside walls and shelves of the refrigerator, cutting boards and countertops, and utensils that may have contacted contaminated foods; then sanitize them with a solution of one tablespoon of chlorine bleach to one gallon of hot water; dry with a clean cloth or paper towel that has not been previously used.
Wash and sanitize display cases and surfaces used to potentially store, serve, or prepare potentially contaminated foods.
Wash hands with warm water and soap following the cleaning and sanitation process.
Conduct regular frequent cleaning and sanitizing of cutting boards and utensils used in processing to help minimize the likelihood of cross-contamination.

Multistate E. coli O26 outbreak linked to flour

Flour manufactured by ADM Milling and sold by Aldi has been linked to 17 cases of E. coli O26 illness in eight states.

Three people have been hospitalized.

ADM Milling and Aldi have jointly recalled all lots and date codes of the following product:

Bakers Corner All Purpose Flour (5-lb bag; UPC 041498130404)

The recalled product was sold in Connecticut, Delaware, Massachusetts, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Vermont and West Virginia.

According to CDC, illnesses associated with this outbreak have been reported in California (1), Connecticut (1), Missouri (1), New Jersey (1), New York (5), Ohio (5), Pennsylvania (2), and Rhode Island (1).

Illnesses started on dates ranging from December 11, 2018 to April 18, 2019. Ill people range in age from 7 to 86 years, with a median age of 23. Sixty-five percent of the outbreak victims are female.

DNA analysis of an E. coli O26 recovered from an unopened bag of flour revealed a close genetic relationship to the outbreak strain, according to FDA.

Individuals infected with E. coli O26 may experience symptoms that include severe stomach cramps, diarrhea, fever, nausea, and/or vomiting. Some infections can cause severe bloody diarrhea and lead to life-threatening conditions, such as a type of kidney failure called hemolytic uremic syndrome (HUS), or the development of high blood pressure, chronic kidney disease, and neurologic problems.

Symptoms may not develop until as long as nine days follwoing infection.

Anyone experiencing symptoms of E. coli O26 infection should consult a healthcare provider.

FDA offers the following recommendations to consumers and food handlers:

DO NOT use or eat flour from five-pound bags of Baker’s Corner All Purpose Flour packed for ALDI, that includes all lot codes and all Best If Used By Dates distributed in Connecticut, Delaware, Massachusetts, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Vermont and West Virginia.
DO NOT eat any raw cake mix, batter, or any other raw dough or batter product that is supposed to be cooked or baked.
WASH hands, work surfaces, and utensils thoroughly after contact with flour and raw batter or dough products.
KEEP raw foods separate from other foods while preparing them to prevent any contamination that may be present from spreading. Be aware that flour or cake mix may spread easily due to its powdery nature.