September 12, 2019

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

A total of 81 people infected with the outbreak strain of Salmonella Uganda were reported from nine 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 July 16, 2019. Most illnesses occurred since April 2019. Ill people ranged in age from less than one year to 90 years, with a median age of 62. Of ill people, 54% were female. Of 51 people with available information, 27 (53%) were hospitalized. No deaths attributed to Salmonella were reported. Of 48 ill people with available information, 31 (65%) were of Hispanic ethnicity.

Whole genome sequencing analysis of 66 bacterial isolates from ill people predicted antibiotic resistance to streptomycin and sulfisoxazole. Testing of four clinical isolates using standard antibiotic susceptibility testing methods by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) showed one isolate with resistance to streptomycin and three isolates with no resistance. This resistance does 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 were the 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 34 people who were interviewed, 25 (74%) reported eating papayas. This proportion was significantly higher than the proportion found on 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.

Two ill people in Florida and one ill person in Texas reported eating papayas during travel to the Northeast in the week before they got sick. This provided additional evidence that papayas were the likely source of this outbreak.

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, distributed by Agroson’s LLC of The Bronx, New York, N.Y., were sold at multiple grocery stores where ill people bought papayas.

As of September 12, 2019, this outbreak appears to be over.