Multistate Outbreak of Infections Caused by Elizabethkingia anophelis
Current Case Counts
As of April 12, 2016 (Updated April 12, 2016)
StateNumber of confirmed cases (includes deaths)*Number of deaths among confirmed cases*
Michigan 1 1
Illinois 1 1
*Case counts will be updated weekly on Wednesdays
CDC, the Wisconsin Department of Health Services (WDHS), the Michigan Department of Health and Human Services (MDHHS), and the Illinois Department of Public Health (IDPH) are investigating an outbreak of infections caused by a bacterium called Elizabethkingia anophelis, which is usually found in the environment. The majority of the infections identified to date have been bloodstream infections, but some patients have had Elizabethkingia isolated from other sites, such as their respiratory systems or joints.
The majority of the patients who have had Elizabethkingia infections as part of this outbreak are over the age of 65 years, and all have had serious underlying health conditions. It has not been determined whether the deaths associated with this outbreak were caused by the bacterial infection, the patients’ underlying health conditions, or both.
Wisconsin was first notified of six potential cases between December 29, 2015 and January 4, 2016 and set up statewide surveillance on January 5, 2016. CDC issued a nationwide call for cases on January 20, 2016, via the Emerging Infections Network and again on March 2, 2016, via the Epidemic Information Exchange system, also known as Epi-X. These alerts asked states to look for any infections similar to the ones reported in Wisconsin, and to send isolates from any potential cases to CDC for testing to determine if they match the bacteria causing infections in Wisconsin.
In response to the outbreak of Elizabethkingia infections in Wisconsin, Michigan sent a state health alert on February 8 , 2016 asking providers and laboratories to review records for Elizabethkingia specimens identified since January 1, 2014. On February 29, 2016, the MDHHS Bureau of Laboratories received an Elizabethkingia from a recently submitted blood sample and forwarded the isolate to CDC for additional testing, where it was determined to match the bacteria causing the outbreak in Wisconsin.
Illinois sent alerts to hospitals on February 10 and March 29, 2016 requesting they report all cases of Elizabethkingia and save any specimens for possible testing at public health laboratories. To date, only one isolate from Illinois has matched the bacteria causing the outbreak in Wisconsin.
Although Elizabethkingia is a common organism in the environment (water and soil), it rarely causes infections. CDC is assisting with testing samples from a variety of potential sources, including healthcare products, water sources and the environment; to date, none of these have been found to be a source of the bacteria.
CDC will continue to work with WDHS, MDHHS, and IDPH to identify the source of the bacteria and develop ways to prevent these infections.
Collaborative investigative efforts of state, local, and federal public health and regulatory officials indicate that raw milk produced by Miller's Organic Farm in Bird-In-Hand, Pennsylvania, is the likely source of this outbreak.
Two people infected with the outbreak strain of Listeria were reported from California (1) and Florida (1). Both illnesses occurred in 2014.
Both people were hospitalized, and the ill person in Florida died as a result of listeriosis.
Although the two illnesses occurred in 2014, the source of these illnesses wasn't known until January 29, 2016, when the U.S. Food and Drug Administration informed CDC that whole genome sequencing of Listeria bacteria from raw chocolate milk produced by Miller's Organic Farm showed that it was closely related genetically to Listeria bacteria from the two ill people described above.
Because Listeria was recently found in raw milk produced by Miller's Organic Farm, CDC is concerned that conditions may exist at the farm that may cause further contamination of raw milk and raw dairy products distributed by this company and make people sick.
Raw milk is milk from cows or other animals that has not been pasteurized to kill harmful bacteria. This raw, unpasteurized milk can carry dangerous bacteria such as Listeria, Salmonella, E. coli, and Campylobacter, which are responsible for causing numerous foodborne illnesses and outbreaks.
The CDC recommends that people drink and eat only pasteurized dairy products (including soft cheese, ice cream, and yogurt).
Pasteurization is the process of heating milk to a high enough temperature for a long enough time to kill dangerous bacteria.
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