Wednesday, April 13, 2016

Multistate Outbreak of Infections Caused by Elizabethkingia anophelis

Multistate Outbreak of Infections Caused by Elizabethkingia anophelis

Current Case Counts

As of April 12, 2016 (Updated April 12, 2016)

State Number of confirmed cases (includes deaths)* Number of deaths among confirmed cases*
Wisconsin 57 18
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.