Outbreak of Salmonella Infections Linked to Cavi Brand Whole, Fresh Papayas

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Published on July 5, 2019 at 4:30 PM ET

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administrationexternal icon are investigating a multistate outbreak of Salmonella Uganda infections linked to Cavi brand whole, fresh papayas distributed by Agroson’s LLC.

Advice to Consumers, Restaurants, Retailers, and Suppliers/Distributors
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At A Glance
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Consumers in the U.S. should not eat any Cavi brand whole, fresh papayas. Restaurants and retailers should not sell or serve Cavi brand papayas.

  • With the exception of Cavi brand whole, fresh papayas, consumers no longer need to avoid papayas imported from Mexico.
  • Consumers who have any Cavi brand whole, fresh papayas in their homes should not eat them. Throw the papayas away, even if some of them were eaten and no one has gotten sick.
    • Do not eat fruit salads or other mixes that include any Cavi brand papayas.
    • If you aren’t sure the papaya you bought is Cavi brand, you can ask the place of purchase. When in doubt, don’t eat the papaya. Throw it out.
    • Wash and sanitize places where Cavi brand papayas were stored: countertops and refrigerator drawers or shelves. Follow these five steps to clean your refrigerator.
  • 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.
  • Importers, suppliers, and distributors should not sell Cavi brand papayas, which are distributed by Agroson’s LLC. Distributors do not need to withhold papayas from distribution, with the exception of the Cavi brand.

Take action if you have symptoms of a Salmonella infection:

  • Talk to your healthcare provider.
  • Write down what you ate in the week before you started to get sick.
  • Report your illness to the health department.
  • Assist public health investigators by answering questions about your illness.
Latest Outbreak Information
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  • Since the last update on June 28, 2019, 9 ill people have been added to this investigation.
  • A total of 71 people infected with the outbreak strain of Salmonella Uganda have been reported from 8 states.
    • Illnesses started on dates ranging from January 14, 2019, to June 16, 2019. Most illnesses have occurred since April 2019.
    • Twenty-seven people have been hospitalized. No deaths attributed to Salmonella have been reported.
  • Epidemiologic and traceback evidence indicates that Cavi brand whole, fresh papayas distributed by Agroson’s LLC are a likely source of this outbreak.
  • This investigation is ongoing. CDC will provide updates when more information is available.
Symptoms of Salmonella Infection
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  • Most people infected with Salmonella develop diarrhea, fever, and stomach cramps 12 to 72 hours after being exposed to the bacteria.
  • The illness usually lasts 4 to 7 days, and most people recover without treatment.
  • In some people, the illness may be so severe that the patient needs to be hospitalized. Salmonella infection may spread from the intestines to the bloodstream and then to other places in the body.
  • Children younger than 5 years, pregnant women, adults 65 and older, and people with weakened immune systems are more likely to have a severe illness.
Investigation Details

July 5, 2019

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA)external icon are investigating a multistate outbreak of Salmonella Uganda infections.

As of July 3, 2019, a total of 71 people infected with the outbreak strain of Salmonella Uganda have been reported from 8 states. A list of the states and the number of cases in each is on the Map of Reported Cases page.

Illnesses started on dates ranging from January 14, 2019, to June 16, 2019. Most illnesses have occurred since April 2019. Ill people range in age from less than one year to 90 years, with a median age of 60. Fifty-two percent of ill people are female. Of 45 people with available information, 27 (60%) have been hospitalized. No deaths attributed to Salmonella have been reported. Of 40 ill people with available information, 28 (70%) reported being of Hispanic ethnicity.

Illnesses might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 2 to 4 weeks. Please see the Timeline for Reporting Cases of Salmonella Infection for more details.

Whole genome sequencing analysis of 43 isolates from ill people predicted antibiotic resistance to streptomycin and sulfisoxazole. Testing of three clinical isolates using standard antibiotic susceptibility testing methods by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) is currently underway. This resistance will not affect the choice of antibiotic used to treat most people.

Investigation of the Outbreak

Epidemiologic and traceback evidence indicates that Cavi brand whole, fresh papayas imported from Mexico are a likely source of this outbreak.

In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Of 26 people who were interviewed, 20 (77%) reported eating papayas. This proportion was significantly higher than results from a survey pdf icon[PDF – 787 KB] of healthy Hispanic people in the months of January through June in which 13% reported eating papayas in the week before they were interviewed.

The FDA and regulatory officials in several states collected records from grocery stores where ill people reported buying papayas. These records showed that Cavi brand papayas were sold at multiple grocery stores where ill people bought papayas. Cavi brand papayas distributed by Agroson’s LLC of Bronx, New York, would have been available for purchase by cases in the time prior to illness at these stores.

Consumers should not eat Cavi brand whole, fresh papayas imported from Mexico. This investigation is ongoing, and CDC will provide updates when more information is available.

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