Rare Bacteria Implicated in 18 Deaths, CDC Investigating Outbreak

The Elizabethkingia infection has been detected in 44 patients in Wisconsin
The Elizabethkingia infection has been detected in 44 patients in Wisconsin

An outbreak of infections in Wisconsin caused by Elizabethkingia  anophelis bacteria may be associated with 18 recent deaths in the state. The exact cause of the outbreak is currently unknown, and was first recognized by the Division of Public Health in Wisconsin in late December, 2015.

The Centers for Disease Control and Prevention (CDC) has sent 5 employees to investigate the outbreak, who will join their Wisconsin Department of Health Services (DHS) and Division of Public Health (DPH) counterparts who are already working to pinpoint the source of the outbreak.

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The Elizabethkingia infection has been detected in 44 patients with serious health conditions, confined to southeast and southern Wisconsin, and is associated with high mortality. The illness associated with Elizabethkingia typically affects people with compromised immune systems or serious underlying health conditions. Early detection and effective antibiotic treatment is critical to increase the probability of positive outcomes. Signs and symptoms can include fever, shortness of breath, chill or cellulitis; confirmation of illness requires lab testing.

Although the bacteria is considered multi-drug resistant, antimicrobial susceptibility testing (AST) of at least 6 isolates in Wisconsin shows that most are susceptible to trimethoprim/sulfamethoxazole, fluoroquinolones, and piperacillin/tazobactam. Combination treatment, rather than monotherapy, with these agents is most effective; adding vancomycin may benefit some cases

Although 18 patients have died who tested positive for the infection, it is currently unknown whether the cause of death was the infection, the patients underlying health condition, or a combination of both. The index of suspicion is greatest among patients with malignancy, diabetes, chronic renal disease or end-stage renal disease on dialysis, alcohol dependence, cirrhosis, and immune compromising conditions or those on immunosuppressive therapy.

Normally, the number of Elizabethkingia infection cases average between 5 to 10 per year, per state. The majority of those infected in the present outbreak are over 65-years old and none are children. Investigators are interviewing infected patients to find any common trends, while laboratory tests were conducted on health care products, water sources and the environment though none have found to be the source of the bacteria.

For more information visit DHS.Wisconsin.gov.