The U.S. Food and Drug Administration (FDA) has identified a Mexican papaya farm it believes may be the source of the deadly multistate salmonella outbreak, with the number of infected people having risen significantly since the last update. 

The FDA is advising consumers to avoid all varieties of papayas from the Carica de Campeche farm in the Yucatan Peninsula, after numerous positive salmonella detections were made.

The outbreak of the strains salmonella Kiambu and salmonella Thompson has left one person dead in New York and has now infected 108 others across 16 states, according to the Centers for Disease Control (CDC). 

So far 35 people have been hospitalized.

In the CDC's earlier update, it said 47 people had been infected across 12 states.

Last week, Texas-based papaya supplier Grande Produce initiated a limited recall of its products.

"The FDA is now advising that consumers avoid Caribeña brand Maradol papayas and all varieties of papayas from the Carica de Campeche farm located in Campeche, MX as a result of the FDA’s traceback investigation and testing," the FDA said in an update.

"The FDA is working to identify the brand(s) that these papayas are sold under and facilitate recall(s). Meanwhile, consumers should ask their retailers about the source of their papayas."

It said papayas from Carica de Campeche tested positive for salmonella Kiambu, salmonella Thompson, salmonella Agona, salmonella Senftenberg and salmonella Gaminara. 

Whole genome sequencing (WGS) is pending for these samples, and the Carica de Campeche farm has been added to Import Alert (IA) 99-35.

Since the CDC's earlier update, six more states have reported ill people: Connecticut, Delaware, Michigan, North Carolina, Oklahoma, and Wisconsin. 

Previously people have been infected in the states of Iowa, Kentucky, Maryland, Massachusetts, Minnesota, New Jersey, New York, Pennsylvania, Texas, Utah and Virginia. New York and New Jersey have seen the highest number of cases.

The FDA said it had increased testing of papayas from Mexico in an effort to see if fruit from other farms could be contaminated. If it finds salmonella in other shipments, those farms will also be added to the alert.

Since 2011 papayas from Mexico have not been allowed to enter the country without documentation that shows they have tested negative for the disease, it said.

"Farms/companies have been able to request addition onto the “green” list of IA 21-17 when they have had five consecutive shipments test negative for Salmonella," the FDA said.

"In contrast, farms/companies who want to request removal from the “red” list of IA 99-35 must present substantive documentation demonstrating that they have made corrections to prevent contamination, including, for example, a root cause analysis to identify potential sources and routes of contamination.

"The FDA traceback and traceforward investigation is still ongoing and additional brands may be identified; the FDA will update its advice as we learn more.

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