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Biological Health Hazard – Update (fatal) Elizabethkingia anophelis: Wisconsin, Illinois, USA

2016/04/14

ELIZABETHKINGIA ANOPHELIS – USA (10): (WISCONSIN, ILLINOIS) FATAL, COMMUNITY ACQUIRED
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Published Date: 2016-04-13 19:54:39
Subject: PRO/EDR> Elizabethkingia anophelis – USA (10): (WI, IL) fatal, community acquired
Archive Number: 20160413.4158063

In this update:
[1] Wisconsin
[2] Illinois

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[1] Wisconsin
Date: Wed 13 Apr 2016
Source: Wisconsin Department of Health Services [edited]

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 15 Jan 2016, 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 CDC are conducting a comprehensive investigation, which includes:

– Interviewing patients with _Elizabethkingia anopheles_ 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 anopheles_ 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 whether 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 whether 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.

Wisconsin 2016 _Elizabethkingia anopheles_ Outbreak:
Case counts between 1 Nov 2015 and 13 Apr 2016
———————————-
Confirmed = 59
Under investigation = 0
Possible cases = 4
Total cases reported to Wisconsin DPH = 63

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 anopheles_ infections and an additional one death among possible cases for a total of 19 deaths. It has not been determined whether these deaths were caused by the infection or other serious pre-existing health problems.

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 anopheles_ because the outbreak specimens are no longer available to test.

Communicated by:
ProMED-mail
<promed@promedmail.org>

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[2] Illinois
Date: 13 Apr 2016
Source: CBS News [edited]

A bacterial infection called Elizabethkingia has already claimed at least 20 lives in Wisconsin and Michigan. Now, the 1st case has been confirmed in Illinois and has taken another life, reports CBS Chicago.

A 52-year-old woman from Lake Villa, Illinois is the 1st person in that state to contract the mysterious bacteria and die from it. It’s unknown right now exactly how she was infected with Elizabethkingia.

“It’s a bacterium that exists normally in the environment,” said Dr. Nirav Shah, director of the Illinois Department of Public Health. “It exists in water and soil. It’s everywhere around us.” Shah says the bacterium is relatively new.

Elizabethkingia infections 1st appeared in Wisconsin last fall. There have been 57 [now 59] confirmed cases of illness there and 19 deaths, according to the Wisconsin Department of Health Services. There has also been one confirmed case and death in Michigan.

“It is an area of intense scientific investigation right now,” Shah said. “We are working very closely with the Wisconsin Department of Health.”

Infectious disease expert Dr. James Malow with Advocate Medical Group in the Chicago area said: “Even with the CDC up there working with the Wisconsin Department of Health, they haven’t found where it’s coming from.”

The bacterium poses greater risk for older people and those with serious underlying health problems. “The majority of individuals who are affected are over the age of 65, and almost all of them have some prior health condition,” Shah said. “As a result of that, we don’t think that this is a bacterium that poses a general risk to the population.”

A family member of the latest victim told CBS Chicago that the victim had an underlying health issue. Doctors said the bacteria are not transmitted person to person.

There are still more questions than answers, Shah said. “How it is transmitted? How is it spread? What sort of diseases does it cause, and how can we manage it? Those are very intense areas of investigation right now.”

The CDC confirms that the Illinois case’s test results show the same strain as the cases in Wisconsin.

Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[Two more cases have been added to this list in Wisconsin, one new and one just confirmed and additional death listed. No new cases have been reported in Michigan, which has one confirmed case, but now a fatal case is reported from Lake County, Illinois. Lake County is the northeastern-most county in Illinois, and its northern border is Wisconsin.

In Wisconsin, Winnebago county is still the newest and the northernmost county to be affected. It is due north of Fond du Lac county and can be seen on a map of the state’s counties at http://wisconsindot.gov/PublishingImages/travel/road/hwy-maps/counties.gif. With Winnebago and Sheboygan counties being the newest on the list, it may be the case that the cluster is moving northward (and southward into Illinois), but without a timeline of cases and their locations, the spread cannot be truly represented. – Mod.LL

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/216.]

See Also

Elizabethkingia anophelis – USA (09): (WI) fatal, community acquired 20160408.4146997
Elizabethkingia anophelis – USA (08): (WI) fatal, community acquired 20160331.4129125
Elizabethkingia anophelis – USA (07): (WI,MI) fatal, community acq 20160324.4116626
Elizabethkingia anophelis – USA (06): (WI,MI) fatal, community acq 20160322.4110826
Elizabethkingia anophelis – USA (05): (WI,MI) fatal, community acquired 20160318.4104623
Elizabethkingia anophelis – USA (04): (WI) fatal, community acquired 20160317.4099438
Elizabethkingia anophelis – USA (03): (WI) fatal, community acquired 20160311.4083895
Elizabethkingia anophelis – USA (02): (WI) fatal, community acq., comment, RFI 20160309.4080818
Elizabethkingia anophelis – USA: (WI) fatalities, community acquired, RFI 20160303.4067424
………………………………………….sb/ll/msp/dk

Source:
A ProMED-mail post
ProMED-mail is a program of the International Society for Infectious Diseases


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