Elizabethkingia

General information

Elizabethkingia are bacteria that are rarely reported to cause illness in humans, and are uncommon colonizers of the respiratory tract.

The signs and symptoms of illness that can result from exposure to the bacteria can include fever, shortness of breath, chills or cellulitis. Confirmation of the illness requires a laboratory test.

Wisconsin 2016 Elizabethkingia anophelis outbreak

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

The majority of patients who acquired these infections were over 65 years old, and all patients had a history of at least one underlying serious illness.

The Department quickly identified effective antibiotic treatment for Elizabethkingia, and alerted health care providers, infection preventionists, and laboratories statewide. The initial guidance was sent on January 15. After that, there was a rapid identification of cases and healthcare providers treated and improved outcomes for patients. DHS provided updates of outbreak-related information that included laboratory testing, infection control, and treatment guidance.

The source of these infections is still unknown. Disease detectives from the Department and the CDC (Centers for Disease Control and Prevention) conducted a comprehensive investigation which included:

• 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.

Counties with confirmed cases 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.
*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.