The Center for Infectious Disease Research & Policy (CIDRAP) just issued a release that some tropical fruit has been cited in a U.S. typhoid fever outbreak. Federal and state health agencies say that frozen mamey fruit pulp is the probable cause of seven confirmed and two suspected cases of<"http://www.yourlawyer.com/practice_areas/food_poisoning"> typhoid feverâ€”Salmonella Typhi infectionsâ€”in California and Nevada.
The Centers for Disease Control and Prevention (CDC) also just announced the outbreak and said epidemiologic evidence points to mamey fruit pulp produced by Goya Foods, Inc., Secaucus, New Jersey. We recently wrote that Goya recalled its 14-ounce packages of the tropical fruit product on August 11.
Typhoid fever is common in the developing world, but only about 400 cases occur in the United States annually, with about 75 percent of them in international travelers, according to the CDC. The infection causes high and sustained fever, headache, constipation, malaise, chills, and myalgia, and it can be severe or fatal if not treated. It typically spreads through contaminated food or water.
The CDC said the outbreak, to date, includes three confirmed and two probable cases in California and four confirmed cases in Nevada. Confirmation is based on a DNA fingerprint matching the outbreak strain; probable cases have not been genetically matched but have strong epidemiologic links to the outbreak.
For cases with available information, illnesses began between April 10 and July 23, the CDC said. Patients range from four to 31 years of age, and all report Hispanic ethnicity. Five of seven patients with clinical information were hospitalized, and five of six patients interviewed reported no international travel in the two months before falling ill.
In a case-control study, five of seven patients interviewed said they consumed frozen mamey fruit pulp in a milkshake or smoothie, while none of 33 healthy people had consumed the product, the CDC reported. Further investigation showed that four of five patients had consumed Goya brand frozen mamey and that no other food was associated with illness.
The CDC said mamey, also called zapote or sapote, is mainly grown in Central and South America. Frozen mamey pulp can be bought in grocery stores throughout the United States, and packages have a shelf life of two to three years.
In its recall announcement, Goya Foods said the mamey fruit pulp comes in 14-ounce plastic packages not marked with a lot number or expiration date. The UPC number is 041331090803. The product is distributed in retail stores in Alaska, Arizona, California, Colorado, Hawaii, New Mexico, Nevada, Oregon, Texas, Utah, and Washington.
The company said it issued the recall because one package of mamey pulp collected in Las Vegas and tested by the U.S. Food and Drug Administration (FDA) was found to contain Salmonella. A CDC official just contacted by CIDRAP News could not say if the specific outbreak strain of Salmonella Typhi was found in any Goya product.
Typhoid vaccines are available and recommended for travelers, according to the CDC. But because the vaccines are not completely effective, travelers should also avoid risky foods and potentially contaminated water, officials said.