By: Eva Frederick

As of Friday, 109 people have been sickened with confirmed cases of Salmonella in an outbreak that has spread swiftly across the U.S. in the past few weeks. Of the 109 people infected, 35 have been hospitalized and one person in New York City has died.

The CDC tracked the source of the outbreak to yellow Maradol papayas imported from Mexico, and officials have issued a recall and warn consumers not to consume Caribena brand Maradol papayas until the outbreak is resolved.

So far, the outbreak has affected people in 16 states from Massachusetts to Oklahoma, the Center for Disease control reported Friday. People started falling ill on May 17, and cases have quickly added up; between July 21 and August 4, 64 more people from 15 states were added to the ongoing investigation. The outbreak affected people ranging in age from age 1 to age 95.

When CDC researchers tested yellow Maradol papayas at the stores where people affected by the outbreak purchased them, they found several strains of salmonella that were closely genetically related to the bacteria found in patients.

Yellow Maradol papayas are large fruit, often weighing between two and eight pounds, with greenish-yellow skin, orange flesh, and many small black seeds. They are generally imported from Mexico, in contrast to some other kinds of papayas often sold in grocery stores which are grown in Hawaii or Belize.

The papayas in this outbreak were grown at the Carica de Campeche papaya farm in Mexico, and are sold under the Caribena and Cavi brands, according to the Food and Drug Administration. Papayas from these brands that were distributed between July 10 and July 19 were recalled, according to the Center for Disease Control.

“If you aren’t sure if the papaya you bought is a Maradol papaya from Mexico, you can ask the place of purchase,” the Center for Disease Control wrote on their website. “When in doubt, don’t eat, sell, or serve them and throw them out.”

Salmonella infection, also called salmonellosis, can cause fever, diarrhea and abdominal cramps. More cases of salmonellosis are reported in summer than in the colder seasons, which could be because salmonella bacteria thrive in higher temperatures. The infection is more likely to affect people over the age of 70 or under the age of 20, with children being the most commonly affected population.

In severe cases, Salmonella can be deadly if the infection spreads from the intestines to the bloodstream. This is most likely to happen to pregnant women, young children, elderly people or people with weakened immune systems.

Salmonellosis usually develops between 12 to 72 hours after infection, and the illness can last up to seven days. Although the infection generally clears up on its own, the diarrhea can lead to dehydration so severe that it requires hospitalization. In rare cases, infected people may develop reactive arthritis, a condition which can lead to chronic arthritis later on.

Because salmonella bacteria live in the intestinal tracts of animals, people generally contract them from eating food contaminated with animal feces. Some types of Salmonella are more common in poultry and eggs, while others live more often in the stomachs of cows, whose manure is often used as fertilizer.

The investigation in this outbreak has identified several primary kinds of salmonella, called serotypes, from those infected. Although salmonella bacteria all look pretty much the same under a microscope, they can be separated into distinct groups based on differences in their surface structures. These groups are called serotypes, and researchers have been using them to track the source and spread of salmonella outbreaks since the 1960s, according the the Center for Disease Control.

Because salmonella is relatively common — the CDC estimates that around 1 million people in the U.S. are sickened annually with the bacteria, and 19,000 of those cases lead to hospitalization — it can be difficult to recognize and stop an outbreak in a timely fashion. That’s where the serotypes come in: when doctors notice a spike in occurrences of a certain strain, they can begin investigating common links between the cases. More than 2,500 different Salmonella serotypes have been identified in the past, but only around 100 of these account for most human cases, according to the CDC.

In this case, CDC investigators polled patients with reported cases of salmonellosis caused by  Salmonella Kiambu, Salmonella Thompson, Salmonella Agona, Salmonella Senftenberg, and Salmonella Gaminara.

The FDA has increased screenings on imported fruit to make sure that papayas from other farms are safe, and the Carica de Campeche farm has been placed on an import alert list and will not be removed until it proves it has made substantial corrections and is no longer producing unsafe food.

If you or someone you know might have purchased contaminated papayas, the FDA recommends that extra care be taken to sanitize any part of the kitchen that may have come into contact with the fruit. Here are their recommendations for making sure your kitchen is salmonella-free.

  • Wash the inside walls and shelves of the refrigerator, cutting boards and countertops; then sanitize them 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 hands with warm water and soap for at least 20 seconds before and after handling food.
  • Wipe up spills in the refrigerator immediately and clean the refrigerator regularly.
  • Always wash hands with warm water and soap following the cleaning and sanitization process.

For more information on this outbreak as it unfolds, visit the FDA’s or the CDC’s outbreak pages. If you experience symptoms of Salmonella poisoning, especially extreme diarrhea and vomiting or blood in stool or vomit, contact your healthcare provider. If you have further questions about food safety in general, you can call the FDA food safety information line at  1-888-SAFEFOOD Monday through Friday between 10 a.m. and 4 p.m. Eastern Time, or to consult the fda.gov website: http://www.fda.gov.