Typhoid Fever in Fruit Smoothies and Shakes: One Company, Seven Confirmed Cases, 11 States

Typhoid fever is very rare in the United States - and most cases are people who caught the potentially-lethal disease elsewhere.

Mamey Fruit Smoothies, Shakes, Typhoid Fever in America: An Overview

There's a small typhoid fever outbreak in the United States, spread by a tainted fruit product: Goya brand Mamey Pulp.

The product was distributed in these 11 states:

• Alaska
• Arizona
• California
• Colorado
• Hawaii
• New Mexico
• Nevada
• Oregon
• Texas
• Utah
• Washington state

The Goya brand Mamey Pulp which contains typhoid bacteria is in 14 ounce plastic packages.

These packages are not marked with lot numbers or expiration dates.

The UPC (Universal Product Code) is 041331090803.

(Food and Drug Administration recall notice)

Some Fruit Smoothies Cause Typhoid Fever: in the News

"Fruit Smoothies Linked to Outbreak of Typhoid Fever in U.S."
The Associated Press, via FOXNews (August 13, 2010)

" A rare U.S. outbreak of typhoid fever has been linked to a frozen tropical fruit product used to make smoothies, health officials reported Thursday.

"Seven cases have been confirmed — three in California and four in Nevada. Two more California cases are being investigated. Five people were hospitalized, according to the Centers for Disease Control and Prevention said.

"The CDC said five of the victims drank milkshakes or smoothies made with frozen mamey fruit pulp. Four of them used pulp sold by Goya Foods Inc. of Secaucus, N.J.

"Mamey is a sweet, reddish tropical fruit grown mainly in Central and South America. It is also known as zapote or sapote. It is peeled and mashed to make pulp, the CDC said...."

First, the good news: Nobody's died, that we know of, yet; and antibiotics work against typhoid fever.

Now, the bad news: even with antibiotics, typhoid fever is a potentially-lethal disease; and you could have a tainted smoothie or shake in your freezer.

Freezing doesn't kill the bacteria that causes typhoid fever, by the way.

More, from the CDC

"Investigation Announcement: Multistate Outbreak of Human Typhoid Fever Infections Associated with Frozen Mamey Fruit Pulp"
Centers for Disease Control and Prevention (August 12, 2010)

"CDC is collaborating with public health officials in two states and the U.S. Food and Drug Administration (FDA) to investigate an outbreak of Salmonella infections, serotype Typhi. Salmonella Typhi is the bacterium that causes typhoid fever. Typhoid fever is a very rare illness in the United States among non-international travelers and can cause serious symptoms, often times requiring hospitalization. Typhoid fever is contracted when food and water are contaminated by an infected individual and are then consumed by other people. Investigators are using DNA analysis of Salmonella bacteria obtained through diagnostic testing to identify cases of illness that may be part of this outbreak....

"...Clinical Features/Signs and Symptoms

"Most persons infected with Salmonella Typhi develop high and sustained fever, headache, constipation, malaise, chills, and myalgia 2 to 5 weeks after infection. Infection is usually diagnosed by a blood culture. The illness can last from 3 to 4 weeks and infections may be severe or fatal if untreated. Typhoid fever should be treated with appropriate antimicrobial medications. More general information about Salmonella Typhi can be found here.

"Advice to Consumers

• "Until further notice, do not eat or drink Goya brand frozen mamey fruit pulp.
• "Individuals who think they might have become ill from eating frozen mamey fruit pulp should consult their health care providers.

"General Information..."

Product Recall Information from the Food and Drug Administration (FDA)

"Goya Foods, Inc. Announces Voluntary Recall of Frozen Mamey Pulp Because of Potential Health Risk"
Recall -- Firm Press Release, Food and Drug Administration (August 11, 2010)

"Goya Foods, Inc. of Secaucus, NJ, is recalling its 14 ounce packages of Frozen Mamey Pulp, due to a potential health risk from Salmonella. No illnesses have been reported to date in connection with Goya brand Mamey Pulp.

Salmonella is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis.

"The recalled Goya brand Mamey Pulp was distributed in the states of AK, AZ, CA, CO, HI, NM, NV, OR, TX, UT, and WA through retail stores.

"The product comes in a 14 ounce plastic package and is not marked with a lot number or expiration date. The UPC is 041331090803...."

Typhoid Fever on Store Shelves, My Take

First, another excerpt from that CDC announcement:

"...Mamey, also called 'zapote' or 'sapote,' is a tropical fruit grown primarily in Central and South America. It is prepared by removing the inner seed and consuming the flesh raw, or adding it to milkshakes, jellies, or other foods or beverages. When preparing frozen mamey fruit pulp, it is peeled and mashed, and then consumed as a shake or smoothie. Frozen mamey fruit pulp can be purchased in grocery stores throughout the U.S., and packages have a 2-3 year shelf life...."

So far, those mamey smoothies sound like pretty good stuff. I like fresh fruit, myself. I also think it's a good idea to make sure that the fresh fruit product doesn't have unwanted bacteria in it.

From another page on the CDC website:

"Typhoid Fever"

"Typhoid fever is a life-threatening illness caused by the bacterium Salmonella Typhi....

"...Salmonella Typhi lives only in humans. Persons with typhoid fever carry the bacteria in their bloodstream and intestinal tract. In addition, a small number of persons, called carriers, recover from typhoid fever but continue to carry the bacteria. Both ill persons and carriers shed S. Typhi in their feces (stool).

"You can get typhoid fever if you eat food or drink beverages that have been handled by a person who is shedding S. Typhi or if sewage contaminated with S. Typhi bacteria gets into the water you use for drinking or washing food. Therefore, typhoid fever is more common in areas of the world where handwashing is less frequent and water is likely to be contaminated with sewage.

"Once S. Typhi bacteria are eaten or drunk, they multiply and spread into the bloodstream. The body reacts with fever and other signs and symptoms...."
[emphasis mine]

It's early days, and the investigation into this typhoid outbreak is still happening - but I suspect that we'll find that some folks working at Goya Foods, Inc. of Secaucus, New Jersey, weren't as careful as they could have been: either in deciding where they got their fruit, who they had handling it along the line, or how it was processed and packaged.

I've written about this sort of thing before:

"...About whose fault it is: My take on it is that the boss of a peanut provider, who decided to cut costs by sending out tainted peanuts, is around, or at, the top of the list. Ideally, the FDA would have noticed what's going on, as would have companies closer to consumers. Congress might have realized that food inspectors need to be paid, and allocated funds. But, having enough food inspectors to go around isn't something that gets attention - until something goes wrong.

"Enough." (February 26, 2009)

Related post:

• "Peanut Peril: Remembering"
  (February 26, 2009)