The Illinois Department of Public Health (IDPH) is reporting that tests from an Illinois resident match those from a Wisconsin outbreak of Elizabethkingia anophelis. The Centers for Disease Control and Prevention (CDC), the Wisconsin Department of Health Services, and the Michigan Department of Health and Human Services have been investigating an outbreak of infections caused by a bacteria called Elizabethkingia anophelis, which is usually found in the environment.
“Illinois is working closely with the CDC and Wisconsin and Michigan health officials to investigate this outbreak and develop ways to prevent additional infections,” said IDPH Director Nirav D. Shah, M.D., J.D. “IDPH will continue to coordinate with hospitals and health care providers to quickly identify and report cases of Elizabethkingia.”
In early February, and again in March, IDPH sent alerts to hospitals requesting they report all cases of Elizabethkingia and save any specimens for possible testing at public health laboratories.
To date, Wisconsin is reporting 57 confirmed cases, including 18 deaths; Michigan is reporting one confirmed case, including one death; and Illinois is reporting one confirmed case, including one death.
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 age 65, and all have had underlying health conditions. It has not yet been determined whether the deaths associated with this outbreak were caused by the bacterial infection, the patients’ underlying health conditions, or both.
Although Elizabethkingia is a common organism in the environment (water and soil), it rarely causes infections. Health officials are testing samples from a variety of potential sources, including health care products, water sources, and the environment. To date, none of these has been identified as the source of the bacteria.
Elizabethkingia is a genus of bacteria commonly found in the environment worldwide and has been detected in soil, river water and reservoirs. However, it rarely makes people sick.
Cases are diagnosed through culture of body fluids, most often blood testing. Elizabethkingia has mostly caused meningitis in newborn babies and meningitis or bloodstream and respiratory infections in people with weakened immune systems.
About 5-10 cases per state per year are reported in the United States, with a few small, localized outbreaks reported in both the US and other countries, usually in healthcare settings.
Elizabethkingia are Gram-negative bacteria that tend to be naturally resistant to many of the antibiotics that physicians may typically use to treat infections. However, the strain responsible for most of the cases in the current outbreak can be treated with several other antibiotics, so early recognition of the bacteria is critical to ensure patients receive appropriate diagnosis and treatment.
Confirmation of the species Elizabethkingia anophelis and determination whether cases are part of the ongoing outbreak is done through MALDI-TOF (which detects the protein fingerprints of a microbe) and optical mapping at CDC.
For consultation or questions about confirmatory testing, please contact CDC’s Special Bacteriology Reference Laboratory at SBRL@cdc.gov.