In 2017 and 2019, five outbreaks of infections from multiple strains of Salmonella linked to the consumption of whole, fresh Maradol papayas were reported in the United States, resulting in 325 ill persons. Traceback, laboratory, and epidemiologic evidence indicated papayas as the likely vehicle for each of these outbreaks and identified the source of papayas. State and FDA laboratories recovered Salmonella from papaya samples from various points of distribution, including at import entry, and conducted serotyping, pulsed-field gel electrophoresis (PFGE), and phylogenetic analyses of whole genome sequencing (WGS) data. Federal and state partners led traceback investigations to determine the source of papayas. Four different suppliers of papayas were linked by traceback and laboratory results to five separate outbreaks of Salmonella infections associated with papayas. In 2017, multiple states tested papaya samples collected at retail, and Maryland and Virginia investigators recovered strains of Salmonella associated with one outbreak. FDA collected 183 papaya samples in 2017, and 11 samples yielded 62 isolates of Salmonella. Eleven serotypes of Salmonella were recovered from FDA papaya samples, and nine serotypes were closely related genetically by PFGE and WGS to clinical isolates of four outbreaks, including the outbreak associated with positive state sample results. Four farms in Mexico were identified and their names were released to the general public, retailers, and foreign authorities. In 2019, FDA collected 119 papaya samples, three of which yielded Salmonella; none yielded the 2019 outbreak strain. Investigators determined that papayas of interest had been sourced from a single farm in Campeche, Mexico through traceback. This information was used to protect public health through public guidance, recalls, and import alerts and helped FDA collaborate with Mexican regulatory partners to enhance the food safety requirements for papayas imported from Mexico.
A Series of Papaya-Associated Salmonella Illness Outbreak Investigations in 2017 and 2019 – A Focus on Traceback, Laboratory, and Collaborative Efforts
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Brooke Meredith Whitney, Monica McClure, Rashida Hassan, Mary Pomeroy, Sharon L Seelman, Lauren N Singleton, Tyann Blessington, Cerisé Hardy, Joseph Blankenship, Evelyn Pereira, Chelsea N Davidson, Yan Luo, James Pettengill, Phillip Curry, Terri McConnell, Laura Gieraltowski, Colin Schwensohn, Colin Basler, Kevin Fritz, Crystal McKenna, Kenneth Nieves, Janete Oliveira, Ana Lilia Sandoval, Alvin J Crosby, D'Ann Williams, Kia Crocker, Deepam Thomas, Tara Fulton, Loel Muetter, Lan Li, Enoma Omoregie, Kelsey Holloman, Christy Brennan, Nikeya Thomas, Amber Barnes, Stelios Viazis; A Series of Papaya-Associated Salmonella Illness Outbreak Investigations in 2017 and 2019 – A Focus on Traceback, Laboratory, and Collaborative Efforts. J Food Prot 2021; doi: https://doi.org/10.4315/JFP-21-082
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