Friday, April 29, 2016

Wisconsin: Infant At Children's Hospital Tests Positive For Elizabethkingia


For the past two months we've been following a multi-state community outbreak of Elizabethkingia bacterial infection among mostly elderly residents in Wisconsin, Illinois and Michigan. 

Although it isn't immediately clear whether this is connected to the larger outbreak we've been following - or is even the same strain - overnight local media are reporting an Elizabethkingia infection in an infant at the neonatal unit of Children's Hospital. 

The genus Elizabethkingia includes not only E. Anophelis , but also  E. meningoseptica,  E. miricola, and E. endophytica. Most cases in the literature have involved HAI's (Hospital Acquired Infections), and community outbreaks are rare. 

This from the Milwaukee News. 

Updated: Yesterday 10:15 p.m.
A strain of the Elizabethkingia bacteria has been found in an infant being treated in the neonatal intensive care unit at Children's Hospital of Wisconsin, the hospital confirmed Thursday.

It appears to be the first case involving a child in what has become the largest known outbreak of its kind in the country.

To date, 18 people have died, most of them over the age of 65. All had severe chronic conditions, such as cancer, renal disease, cirrhosis and diabetes.

Children's Hospital said there was no indication that the child's infection is serious, and that no additional precautions are necessary because the bacteria is not easily transmitted from person to person.

(Continue . . . )

Hopefully we'll get a clarification on this case in the next few days.  In the meantime, the latest Wisconsin DOH update adds two additional cases.

Wisconsin 2016 Elizabethkingia anophelis outbreak

The Wisconsin Department of Health Services (DHS), Division of Public Health (DPH) is currently investigating an outbreak of bacterial infections caused by Elizabethkingia anophelis.

The majority of patients acquiring these infections are over 65 years old, and all patients have a history of at least one underlying serious illness.

The Department quickly identified effective antibiotic treatment for Elizabethkingia, and has alerted health care providers, infection preventionists and laboratories statewide. Since the initial guidance was sent on January 15, there has been a rapid identification of cases and healthcare providers have been able to treat and improve outcomes for patients. DHS continues to provide updates of outbreak-related information that includes laboratory testing, infection control and treatment guidance.

At this time, the source of these infections is still unknown, and the Department continues to work diligently to control this outbreak.  Disease detectives from the Department and the Centers for Disease Control and Prevention (CDC) are conducting a comprehensive investigation which includes:

  • Interviewing patients with Elizabethkingia anophelis infection and/or their families to gather information about activities and exposures related to healthcare products, food, water, restaurants, and other community settings.
  • Obtaining environmental and product samples from facilities that have treated patients with Elizabethkingia anophelis infections. To date, these samples have tested negative and there is no indication the bacteria was spread by a single healthcare facility.
  • Conducting a review of medical records.
  • Obtaining nose and throat swabs from individuals receiving care on the same units in health care facilities as a patient with a confirmed Elizabethkingia anophelis to determine if they are carrying the bacteria.  To date, all of these specimens tested negative, which suggests the bacteria is not spreading from person to person in healthcare settings.
  • Obtaining nose and throat swabs from household contacts of patients with confirmed cases to identify if there may have been exposure in their household environment.
  • Performing a “social network” analysis to examine any commonalities shared between patients including healthcare facilities or shared locations or activities in the community.


Affected counties include Columbia, Dane, Dodge, Fond du Lac, Jefferson, Milwaukee, Ozaukee, Racine, Sheboygan, Washington, Waukesha and Winnebago.

There have been 18 deaths among individuals with confirmed Elizabethkingia anophelis infections and an additional 1 death among possible cases for a total of 19 deaths. It has not been determined if these deaths were caused by the infection or other serious pre-existing health problems. Counties where these deaths occurred are: Columbia, Dodge, Fond du lac, Milwaukee, Ozaukee, Racine, Sheboygan, Washington and Waukesha.

*This investigation is ongoing. Case counts may change as additional illnesses are identified and more cases are laboratory confirmed.
**These are cases that tested positive for Elizabethkingia, but will never be confirmed as the same strain of Elizabethkingia anophelis because the outbreak specimens are no longer available to test.

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