More Than Papayas – And What You Need To Know About Salmonella And Food Outbreaks

The CDC expanded its warning to not eat Maradol papayas imported from the Carica de Campeche farm in Mexico today, after three more states reported illnesses.

The papayas are sold under the brand names of  Caribeña, Cavi, and Valery. So far, 141 people have been infected with either the Salmonella Kiambu strain or S. Thompson. Of these, 45 have required hospitalization and one person has died.

While the illnesses began as early as May 17, the reported cases have been increasing and the geographic area of cases has widened, ranging from Texas through the northeast U.S.

One of the major advances in tracking food-borne outbreaks is the use of  whole genome sequencing (WGS) to study the DNA fingerprint of the strains. This enables investigators to precisely match isolates from the infected people to the suspected source.

We have a robust food safety program through the CDC’s “PulseNet,” a network of public health and food regulatory agency laboratories coordinated by CDC.

Because of such a match in FDA’s testing, Agroson’s LLC recalled certain Cavi brand Maradol papayas grown and packed by Carica de Campeche. Other brands are being examined.

HLB Specialties, a US papaya importer, was helpful in issuing information explaining the difference between various types of papayas, to educate the public and to avoid a disaster to the industry. There are three types of papaya commonly available, they explained:

Maradol papayas are large, weighing about three pounds. They have a yellow skin when ripe. Formosa, or Tainung papayas, are similar to Maradol in size and weight, but are greener and ready to eat before they fully turn yellow. The  Brazilian Golden papaya weighs only a pound.

Distributors Agroson’s, LLC, Grande Produce, and Freshtex Produce, LLC, have also issued alerts.

Food outbreaks

This type of food recall is common. Foodborne outbreaks kill about 2 million people each year globally.

Multistate outbreaks like this cause 56% of deaths in all reported foodborne outbreaks.

An average of 24 multistate outbreaks are reported a year, each involving from 2 to 37 states.

One in six people in the U.S. gets sick from eating contaminated food each year and 1 million people get sick from eating food contaminated with Salmonella, per the CDC.

There are 19000 hospitalizations and 380 deaths. Their care costs $365 million in medical expenses alone. The CDC adds that for each identified case, about 30 more are unconfirmed.

Salmonella warnings

Salmonella can contaminate many kinds of foods, with breaches occurring anywhere from the fields to processing to peoples kitchens.

It’s not just from raw eggs or chickens. There was even a notable outbreak due to peanut butter. Besides food, there are episodic outbreaks from pet turtles.

Typically, symptoms of diarrhea, fever, and abdominal cramps begin 12 to 72 hours after infection, and the illness resolves on its own after  4 to 7 days.

People at particular risk are the very young and elderly, and those with immunosuppression.

Prevention

The standard advice is to avoid raw eggs and milk, and to cook poultry and meat thoroughly. You should also know that even the inside of eggs can be infected although the shell looks intact, as the Salmonella can be passed into the egg from the hen.

Be especially careful with feeding people at the extremes of age or who have underlying immune problems.

Washing the outside of fruit may not be enough to prevent all infections, though it will reduce them. A 1999 outbreak of Salmonella enterica was traced to a single farm in Brazil. The fruit was treated with a hot water dip to reduce fruit flies, then cooled. The cooling caused the fruit to contract, drawing in pathogens from the water.

Clean kitchen work surfaces and utensils thoroughly immediately after they have been in contact with raw meat or poultry. Despite the brouhaha last week about germy kitchen sponges, researchers did not find foodborne pathogens on the sponges they tested after use, and the prior recommendations for cleaning sponges with microwaving or clorox, or running through the laundry, have been shown to kill 99% of germs.

Also, wash hands thoroughly after handling reptiles, birds, or baby chicks.

Economic impact

It’s critically important that investigators identify the source of outbreaks accurately. Theeconomic losses to industry, including farmers, are estimated at over $75 billion per year.  One notable example of this was an outbreak of the parasite Cyclospora in the U.S. and Canada. The Texas Department of Health erroneously identified the source as California strawberries. This cost California growers at least $16 million in sales in one month alone, before the likely source of the outbreak was correctly identified.

Conclusion

While this recall of papayas is concerning, it needs to be kept in perspective. This outbreak is limited to fruit from a specific farm in Mexico. Papaya is a healthy fruit, packed with vitamins and antioxidants.

Continue to enjoy them, but read the labels for information on their origin.

In the grand scheme of things, this outbreak is a relatively small concern. And this outbreak is just one more example of why this administration’s proposals to gut the FDA and CDC are endangering us all. We need public health and oversight.

My book, “Conducting Clinical Research: A Practical Guide,” can be found here. For more medical/pharma news and perspective, follow me on Twitter @drjudystone or here at Forbes

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