The Salmonella outbreak traced to whole, fresh papayas from a farm in Southern Mexico continues to spread, with a 25 percent increase in victims in the past week.

Two more states are reporting confirmed illnesses in the outbreak, Missouri and Tennessee, bringing the total to 21 states involved with 173 victims, including one in New York who has died.

As of today, four types of Salmonella bacteria have been confirmed in lab work from outbreak victims, according to an update from the Centers for Disease control and Prevention.

The four types of Salmonella confirmed by the CDC are Kiambu, Thompson, Agona and Gaminara.

The Food and Drug Administration has confirmed all four of those types, as well as Salmonella Senftenberg, on papayas from the Carica de Campeche farm in Mexico.

“The FDA is advising that consumers avoid Caribeña, Cavi and Valery brands of Maradol papayas, and all varieties of papayas from the Carica de Campeche farm located in Campeche, Mexico, as a result of the FDA’s traceback investigation and testing,” according to the agency’s outbreak investigation update today.

“Thus far, Salmonella strains matching the outbreak patterns by PFGE (pulsed-field gel electrophoresis) were only isolated from papayas from the Carica de Campeche farm.”

All papayas from the implicated farm have been under an Import Alert from FDA since Aug. 8, meaning they are being held at the border and not allowed into the U.S.

However, because of the relatively long shelf life of the whole, fresh fruit, there may still be recalled papayas in consumers’ homes. Both FDA and CDC are urging consumers to throw out maradol papayas or the three recalled brands.

If consumers, retailers, restaurants or other foodservice operators aren’t sure of the brand, farm of origin, and variety of papayas they have on hand, they should not eat or serve them: When in doubt, throw it out is the advice from public health officials.

“The FDA and state partners continue to investigate the distribution of the papayas involved in this outbreak and are working to ensure that there are no other brand(s) that these papayas may have been sold under,” FDA reported today.

“The FDA increased testing of papayas from Mexico in an effort to see if fruit from other farms could be contaminated. If the FDA finds Salmonella in other shipments, those farms will also be added to Import Alert 99-35.”

Illnesses in the ongoing outbreak started on dates ranging from May 17 through July 31, 2017. Ill people range in age from less than 1 year to 95, with a median age of 38. Some information is not available for all of the ill people, according to the CDC.

However, for those with available information, two-thirds are Hispanic. Out of 136 victims whose status is known, almost half — 43 percent — have had symptoms so severe that they had to be hospitalized.

Health officials expect more victims to be identified because people who became ill after July 18 might not be reported yet because of the time it takes between when a person becomes ill and when the illness is reported, CDC reported. This takes an average of two to four weeks.

The 21 states involved so far, and the number of outbreak victims in each state, are as follows: Connecticut 6, Delaware 4, Iowa 2, Illinois 3, Kentucky 4, Louisiana 1, Maryland 8, Massachusetts 8, Michigan 1, Minnesota 4, Missouri 1, North Carolina 5, New Jersey 36, New York 50, Ohio 1, Oklahoma 4, Pennsylvania 8, Tennessee 1, Texas 9, Virginia 16, Wisconsin 1.

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