Federal and state officials are investigating another deadly Salmonella outbreak traced to papayas imported from Mexico, but they have not named retailers that sold the contaminated fruit.

At least 14 people across Arizona, California and Colorado have been confirmed with the outbreak strain of Salmonella Anatum, according to the Centers for Disease Control and Prevention. One person has died. At least five have required hospitalization.

A dozen of the victims live in California. At least four of them reported buying and eating papayas from the same retail chain before becoming ill. The Salmonella Anatum identified in lab samples collected from the victims match the strain of that type of Salmonella found by the Food and Drug Administration on papayas imported by Bravo Produce Inc. of San Isidro, CA. Bravo initiated a recall Sunday.

Neither the California retailer — which uses Bravo Produce as a supplier of papayas — nor any of the other retailers implicated in the other three ongoing outbreaks have been named by the FDA, which is overseeing papaya recalls by importers and distributors.

The FDA routinely cites laws regarding “confidential corporate information” as prohibiting the agency from revealing retailers that received recalled foods. In its advice regarding the current outbreaks and recalls, the FDA tells consumers on its website to ask retailers if they sold the suspect papayas.

Arguing that public health trumps corporate secrets, the Center for Science in the Public Interest (CSPI) asked FDA on Aug. 17 to provide the list of retailers that handled papayas linked to the ongoing outbreaks. The federal agency denied that request and CSPI filed an administrative appeal this past week under the framework of the Freedom of Information Act.

“The typical consumer isn’t going to recognize the brand of papaya they buy or the farm it was grown on, but they know where they bought it,” said CSPI chief regulatory affairs counsel Sarah Sorscher.

“The FDA is supposed to be helping Americans avoid foodborne illness. It could improve by consistently disclosing retailer names and locations, along with brand names, dates of sale, lot numbers, and other useful information when it communicates with the media or with the public about recalls.”

Relentless investigators
Together, the four papaya-related Salmonella outbreaks have sickened 215 people from the Atlantic to the Pacific. Illnesses have been reported in 26 states. Including the California death announced Monday, the outbreaks have killed two people.

The outbreak reported Monday actually began in December 2016, according to the CDC.

“This past spring, CDC investigated a multistate outbreak of Salmonella Anatum infections,” according to the Monday report.

“While the epidemiologic information indicated that papayas were the likely source of this outbreak at the time, investigators could not determine the specific source of contaminated papayas and the outbreak investigation ended after illnesses stopped.”

Whole genome sequencing (WGS) showed that all 14 victims were infected with the same strain of Salmonella Anatum bacteria, suggesting a common source of infection. That common denominator wasn’t confirmed until this month.

“FDA informed CDC that a sample from an imported papaya identified Salmonella Anatum on Sept. 4. …WGS showed that the isolate from the papaya and the isolates from the 14 people infected with Salmonella Anatum this past spring were closely related.”

The 14 confirmed victims had illness onset dates from Dec. 20, 2016, to April 8 this year. However, the CDC reported it is investigating at least six more cases of Salmonella Anatum infection to determine if they are also linked to the maradol papayas imported by Bravo Produce Inc.

As with the other three ongoing Salmonella outbreaks, the Salmonella Anatum outbreak has hit Hispanics particularly hard. Of 11 victims for whom ethnic information was available as of Monday, 10 of them were Hispanic. The CDC has theorized the disproportionate impact is because of the popularity of fresh papaya in Hispanic and Mexican cuisine.

Bravo Produce Inc. imported the papayas implicated in the Salmonella Anatum outbreak from a farm in Tijuana, Mexico. The farm, Productores y Exportadores de Carica Papaya de Tecomán y Costa Alegre, is the fourth specific growing operation identified by the FDA as having produced papayas contaminated with the outbreak strains of Salmonella.

Before Bravo received the fruit it went from the farm to a Mexican packing company, Frutas Selectas de Tijuana, S. de RL de CV. Bravo officials reported in their recall notice on Sunday that their recalled papayas have stickers with the Frutas Selectas name on them.

Advice to consumers, restaurants and retailers
State and federal public health officials recommend applying the golden rule of food safety regarding papayas on hand in homes and businesses — when in doubt, throw it out.

Additional recommendations from CDC include:

  • If you have had whole, fresh papayas in your home or business, wash and sanitize countertops, cutting boards and utensils, as well as drawers or shelves in refrigerators where papayas were stored, with a solution of one tablespoon of chlorine bleach to one gallon of hot water; dry with a clean cloth or new paper towel.
  • Wash your hands with running water and soap following the cleaning and sanitation process.

Anyone who has eaten fresh papaya recently and developed symptoms of Salmonella infection is urged to seek medical attention and tell their doctors about the possible exposure so the proper diagnostic tests can be performed.

Salmonella bacteria can cause diarrhea, vomiting, stomach pain and fever.

Symptoms usually begin between 12 to 36 hours after exposure, but they may begin as early as 6 hours or as late as 72 hours after exposure.

Symptoms can be mild or severe and commonly last for two to seven days. Salmonella can infect anyone, but young children, older adults and people with weakened immune systems are the most likely to have severe infections.

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