Illnesses in Iowa, 1, Kentucky, 1, Louisiana, 1, Maryland, 5, Massachusetts, 1, Minnesota, 1, New Jersey, 12, New York, 13, Pennsylvania, 4, Texas, 1, Utah, 1 and Virginia, 6.

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

As of July 21, 2017, 47 people infected with the outbreak strain of Salmonella Kiambu have been reported from 12 states. A list of the states and the number of cases in each can be found on the Case Count Map page. WGS showed that isolates from people infected with Salmonella Kiambu are closely related genetically. This close genetic relationship means that people in this outbreak are more likely to share a common source of infection.

Illnesses started on dates ranging from May 17, 2017 to June 28, 2017. Ill people range in age from less than 1 year to 95, with a median age of 27. Among ill people, 67% are female. Among 31 people with available information, 18 (58%) are of Hispanic ethnicity. Among 33 people with available information, 12 (36%) report being hospitalized. One death was reported from New York City.

Epidemiologic and laboratory evidence collected to date indicate that yellow Maradol papayas are a likely source of this multistate outbreak. This investigation is ongoing.

An illness cluster in Maryland was identified. An illness cluster is defined as two or more people who do not live in the same household who report eating at the same restaurant location, attending a common event, or shopping at the same location of a grocery store in the week before becoming ill. In Maryland, several ill people reported eating papayas purchased from the same location of a grocery store. Salmonella Kiambu and Salmonella Thompson were isolated from samples collected from ill people. Investigating illness clusters provides critical clues about the source of an outbreak. If several unrelated ill people ate or shopped at the same location of a restaurant or store within several days of each other, it suggests that the contaminated food item was served or sold there.

The Maryland Department of Health collected papayas from the grocery store associated with the illness cluster to test for Salmonella. One sample yielded the outbreak strain of Salmonella Kiambu and another sample yielded Salmonella Thompson. Both samples were from yellow Maradol papayas. WGS showed that the Salmonella Kiambu papaya isolate is closely related genetically to the Salmonella Kiambu isolates from ill people. This result provides more evidence that people in this outbreak got sick from eating contaminated yellow Maradol papayas. CDC is working to collect additional information to determine whether the recent Salmonella Thompson illness in Maryland is part of this multistate outbreak.

Based on the available evidence, CDC recommends that consumers not eat, restaurants not serve, and retailers not sell yellow Maradol papayas until we learn more.

The FDA, CDC, MDH and other state and local officials are investigating Salmonella Kiambu and Salmonella Thompson illnesses linked to Caribeña brand Maradol papayas from Mexico distributed by Grande Produce in San Juan, TX.

FDA and state partners continue to investigate the distribution of the papayas involved in this outbreak. It appears the distribution pattern of Caribeña brand Maradol papayas does not explain all of the illnesses, meaning other firms likely have distributed contaminated Maradol papayas as well. At this time, the farm(s) producing these papayas appear to only be in Mexico.

CDC reports 47 cases, 12 hospitalizations and one death from 12 states in the Salmonella Kiambu outbreak. The states involved are IA, KY, LA, MA, MD, MN, NJ, NY, PA, TX, UT and VA. CDC is working to collect additional information to determine whether the recent Salmonella Thompson illness in Maryland is part of this multistate outbreak.

On June 26, 2017, the CDC notified the FDA about a Salmonella Kiambu cluster detected by PulseNet. All 47 cases have the same pattern by pulsed-field gel electrophoresis (PFGE). Whole Genome Sequencing (WGS) analysis was conducted on ten patient samples in the outbreak cluster and all were highly related. This indicates that the patients were likely sickened by the same type of food.

MDH informed the FDA, CDC and state partners that several ill people shopped at the same Baltimore retail location and purchased papayas. Records and samples of green and yellow papaya were collected. On July 17, 2017, Maryland reported that three of ten samples had preliminarily tested positive for Salmonella. All positive samples were Caribeña brand yellow Maradol papayas from Mexico; none of the green papayas were positive. However, as noted above, Maradol papayas are green before they ripen and turn yellow, so consumers should not eat Caribeña brand papayas regardless of the color.

On July 19, 2017, MDH issued an advisory warning consumers not to eat Caribeña brand yellow Maradol papayas. Further WGS testing linked one of the papaya samples to the Salmonella Kiambu outbreak and another to Salmonella Thompson.