Midwestern Infection Mystery?

2 min

You’re referring to the recent cluster of illnesses caused by Elizabethkingia bacteria, named after the late Elizabeth O. King, a bacteriologist who, for many years, worked for the U.S. Centers for Disease Control and Prevention (CDC). These infections, which usually affect the bloodstream, are rare. Normally, the CDC sees only 5 to 10 cases per state per year, nothing on the scale that has been occurring in Wisconsin – plus one case each in neighboring Michigan and 10 patients in Illinois, 6 of whom have died. The Wisconsin infections were first reported in November 2015 and continued to occur into the spring of 2016. At this writing, 63 people have been infected and 18 have died. Health authorities aren’t sure whether the infections by themselves were to blame for the deaths, since all the patients were over 65 and had serious, underlying health problems and weakened immune systems.

Symptoms of Elizabethkingia infections are fever, shortness of breath and chills, but a lab test is needed to confirm the cause. The patients infected in Wisconsin lived in a dozen different counties in southern parts of the state, some at home and some in nursing homes. Others were infected in a hospital. Antibiotic treatment is certainly warranted in all cases, and the germs are resistant to some – but not all – of the drugs.

Elizabethkingia bacteria are common in soil and water. Usually, they do not infect people. When they have in the past, they have mostly caused meningitis in newborn babies and meningitis or bloodstream and respiratory infections in people with weakened immune systems.

So far, the CDC and health officials in the affected states haven’t been able to determine where the infections are coming from. They do know that the Wisconsin bacteria involved share an identical genetic fingerprint, which suggests that the cases stem from a common source. The bacterial strain in Illinois is different, but the one responsible for the single (fatal) case in Michigan was the same as that in Wisconsin.

Water has been ruled out as the source of infection in Wisconsin, since the patients there didn’t use the same water supply, and no signs of contamination have been seen in the various water sources, including wells. Water is a natural suspect, because it can be contaminated by Elizabethkingia, which then can linger in sinks and on nearby surfaces.

Investigators are now focusing on personal care and medical products the patients may have used in common, such as skin creams, as well as food, restaurants and other possible links. Medical devices and procedure don’t appear to be the source.

Andrew Weil, M.D.

Source:
About Elizabethkingia, U.S. Centers for Disease Control and Prevention, http://www.cdc.gov/elizabethkingia/outbreaks/index.html, accessed April 28, 2016.