Elizabethkingia Outbreak Spreads from Wisconsin to Michigan

The Centers for Disease Control (CDC) are keeping close tabs on a disturbing multistate outbreak of Elizabethkingia anophelis, an emerging infectious disease that has sickened 59 people, killing 18, in southeast and southern Wisconsin since November 2015. This little-known illness has now taken the life of a west Michigan resident and an Illinois resident as well; the CDC is providing weekly updates of case counts on its website.

Elizabethkingia (EK) bacteria, although commonly found in the environment, poses a serious threat to immune-compromised patients when it proliferates in hospital environments. Most of the victims of this most recent outbreak have been over the age of 65 and have had serious underlying medical conditions such as diabetes, kidney disease, cancer, or alcoholism. While Elizabethkingia anophelis typically causes bloodstream infections (such as blood poisoning / sepsis), in a few of these victims, the disease struck their joints or respiratory systems. Mortality rates can range as high as 41%.

What perplexes the CDC and local health departments is that a common source for the water-borne disease has not been isolated, despite the unprecedented numbers of cases within the last five months. In conjunction with Wisconsin and Michigan state health departments, it is thus currently continuing its sampling of potential sources, including private residence and healthcare facility water sources, healthcare products, and the environment.

Timeline of the Current Elizabethkingia Outbreak

According to the CDC, the striking number of cases in Wisconsin has prompted a nationwide call on the Emerging Infections Network and the Epidemic Exchange System (1).  Here is the timeframe for the outbreak:

  • January 5, 2016: Wisconsin health department officials set up statewide surveillance of Elizabethkingia cases following reports of six potential cases between December 29, 2015 and January 4, 2016.
  • January 20, 2016: The CDC sent out its first call for cases on the Emerging Infections Network; it issued a second call on the Epidemic Information Exchange System (Epi-X) on March 2, 2016.
  • February 8, 2016: Michigan issued a state health alert to medical providers and laboratories requesting that they review their records for EK specimens isolated since January 1, 2014.
  • February 29, 2016: The Michigan Department of Health and Human Services (MDHHS) Bureau of Laboratories received and forwarded an EK isolate from a submitted blood sample to the CDC for testing. It matched the specific bacterial strain responsible for the Wisconsin outbreak.

Elizabethkingia in Healthcare Facilities

Although a common source of the current Elizabethkingia anophelis outbreak has not as yet been identified, the vast majority of previous EK outbreaks were nosocomial – acquired at healthcare facilities.

Because Elizabethkingia bacteria is antibiotic-resistant, early diagnosis is vital so that an appropriate treatment plan can be initiated. Typical symptoms of infection include a flu-like fever, chills, shortness of breath, and / or cellulitis.

Bacteria Testing

Source:

  1. Press Release. “Multistate Outbreak of Infections Caused by Elizabethkingia anophelis.” Centers for Disease Control and Prevention. Web. 30 Mar. 2016

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