Mysterious Bacterial Outbreak Reported in Wisconsin

Hospitals should be alert for signs of infection, expert says

Hospital officials should be aware of an unusual bacterial outbreak taking place in Wisconsin that has yet to be explained and could pose a threat elsewhere, according to an article posted on the Hospitals & Health Networks website.

Ten Illinois residents have also been diagnosed with infection caused by a strain of the bacteria that is different from the outbreak in Wisconsin, according to the Illinois Department of Public Health.

As of April 13, the outbreak of Elizabethkingia anophelis bacteria in Wisconsin had caused at least 18 deaths out of the 59 confirmed cases, and another death related to four possible cases reported since November 1, 2015, according to the Wisconsin Department of Health Services.

The nature of the outbreak, which is focused in the southeastern part of the state, should motivate hospital infection-control specialists to act if there are any signs of an Elizabethkingia bacterial infection in a patient, according to Wisconsin health officials.

“Because this [type of bacteria] isn’t necessarily on the radar of many places, if you were to get a sporadic case or two, you might just think this is unusual, but not something to worry about,” said Nasia Safdar, MD, medical director for infection control at the University of Wisconsin Hospital and Clinics. “What health care systems need to realize is that this is a much larger outbreak. If they get even a single case of Elizabethkingia, they should contact public health, retrieve the specimen that was positive, and send it to the state lab––in Wisconsin’s case—or to the CDC [Centers for Disease Control and Prevention], if necessary.”

The outbreak is notable for the type of bacteria involved and for the apparent lack of a common source for the reported infections. “Elizabethkingia is generally not considered to be very virulent or a highly pathogenic organism,” Safdar said.

Advancements in capabilities now allow infection control specialists to identify the species of the bacteria involved, and the one involved is relatively new, Safdar said. That means this particular strain—E. anophelis—could be more aggressive in humans than the broader Elizabethkingia bacteria are known to be. In addition, it is likely coming from a single source in the community.

Safdar added that health care is not the likely source, because although some of the infected patients have had health care exposure, many have not. More test results are pending that could help to identify the source, she said.

Meanwhile, the CDC continues to investigate. 

Source: H&HN; April 22, 2016.