{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T18:24:44Z","timestamp":1790274284689,"version":"4.1.0"},"reference-count":26,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T00:00:00Z","timestamp":1568073600000},"content-version":"unspecified","delay-in-days":252,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2019]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:p>Foodborne salmonellosis causes approximately 1 million illnesses annually in the United States. In the summer of 2017, we investigated four multistate outbreaks of <jats:italic>Salmonella<\/jats:italic> infections associated with Maradol papayas imported from four Mexican farms. PulseNet initially identified a cluster of <jats:italic>Salmonella<\/jats:italic> Kiambu infections in June 2017, and early interviews identified papayas as an exposure of interest. Investigators from Maryland, Virginia and Food and Drug Administration (FDA) collected papayas for testing. Several strains of <jats:italic>Salmonella<\/jats:italic> were isolated from papayas sourced from Mexican Farm A, including <jats:italic>Salmonella<\/jats:italic> Agona, Gaminara, Kiambu, Thompson and Senftenberg. Traceback from two points of service associated with illness sub-clusters in two states identified Farm A as a common source of papayas, and three voluntary recalls of Farm A papayas were issued. FDA sampling isolated four additional <jats:italic>Salmonella<\/jats:italic> strains from papayas sourced from Mexican Farms B, C and D. In total, four outbreaks were identified, resulting in 244 cases with illness onset dates from 20 December 2016 to 20 September 2017. The sampling of papayas and the collaborative work of investigative partners were instrumental in identifying the source of these outbreaks and preventing additional illnesses. Evaluating epidemiological, laboratory and traceback evidence together during investigations is critical to solving and stopping outbreaks.<\/jats:p>","DOI":"10.1017\/s0950268819001547","type":"journal-article","created":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T05:54:28Z","timestamp":1568094868000},"source":"Crossref","is-referenced-by-count":33,"title":["Multistate outbreaks of <i>Salmonella<\/i> infections linked to imported Maradol papayas \u2013 United States, December 2016\u2013September 2017"],"prefix":"10.1017","volume":"147","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2032-6636","authenticated-orcid":false,"given":"R.","family":"Hassan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Whitney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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