Health officials: Outbreak of bloodstream infections caused by ?Elizabethkingia? in Wisconsin; case in Michigan; cases in Illinois

[Shiloh]

Source: http://fox6now.com/2016/03/02/healt...tions-caused-by-elizabethkingia-in-wisconsin/

Health officials: Outbreak of bloodstream infections caused by ?Elizabethkingia? in Wisconsin
Posted 5:36 pm, March 2, 2016, by Katie DeLong

The Wisconsin Department of Health Services (DHS), Division of Public Health (DPH) is currently investigating an outbreak of bloodstream infections caused by bacteria called Elizabethkingia.

?The Elizabethkingia infection has been detected in 44 patients located in southeastern and southern Wisconsin. The majority of patients are over the age of 65 years, and all have serious underlying health conditions,? said State Health Officer Karen McKeown. ?As soon as we were notified of the potential outbreak, Wisconsin?s disease detectives began working immediately to identify the source.?

Illness associated with Elizabethkingia typically affects people with compromised immune systems or serious underlying health conditions, and can lead to death. While 18 patients who tested positive for the Elizabethkingiainfection in this outbreak have died, it has not been determined if the cause is the bacterial infection, or the patients? other serious health conditions, or both...

 

[Pathfinder]

FOR IMMEDIATE RELEASE
March 2, 2016
CONTACT:
Jennifer Miller, 608-266-1683

Wisconsin Department of Health Services (DHS) Investigates Bacterial Bloodstream Infections

The Wisconsin Department of Health Services (DHS), Division of Public Health (DPH) is currently investigating an outbreak of bloodstream infections caused by bacteria called Elizabethkingia.
“
The Elizabethkingia infection has been detected in 44 patients located in southeastern and southern Wisconsin. The majority of patients are over the age of 65 years, and all have serious underlying health conditions,” said State Health Officer Karen McKeown. “As soon as we were notified of the potential outbreak, Wisconsin’s disease detectives began working immediately to identify the source.”

Illness associated with Elizabethkingia typically affects people with compromised immune systems or serious underlying health conditions, and can lead to death. While 18 patients who tested positive for the Elizabethkingiainfection in this outbreak have died, it has not been determined if the cause is the bacterial infection, or the patients’ other serious health conditions, or both.

DPH was first notified of six potential cases between December 29, 2015 and January 4, 2016 and set up statewide surveillance on January 5, 2016. DPH then alerted health care providers, infection preventionists, and laboratories statewide of the presence of the Elizabethkingia bacteria, and provided information as well as treatment guidance, which has led to a rapid identification of cases, and appropriate treatment.

“Determining the source of the bacteria affecting patients in Wisconsin is a complex process,” McKeown added. “While we recognize there will be many questions we cannot yet answer, we feel it is important to share the limited information we have about the presence of the bacteria, as we continue our work to determine the source.”

Following identification of the initial cluster, DPH staff initiated epidemiologic, laboratory and environmental investigations to further characterize demographic and epidemiologic features and determine risk factors and potential reservoirs for infection.

DHS and our partners are working closely on the investigation to determine the source of the bacteria, and are working diligently to contain the outbreak. A team of epidemiologists and laboratory partners from the Centers for Disease Control and Prevention (CDC) is on site assisting with the investigation. DHS is also working closely with state and local partners including the Wisconsin State Laboratory of Hygiene, infection preventionists, and clinicians in Wisconsin.

DHS will continue to offer updates as information is available, to help ensure the health and safety of those who may be vulnerable to bloodstream infections caused by the Elizabethkingia bacteria.

For more information go to: https://www.dhs.wisconsin.gov/diseas...bethkingia.htm.

https://www.dhs.wisconsin.gov/news/releases/030216a.htm

 

[Shiloh]

Source: http://www.jsonline.com/news/health...in-gaining-urgency-b99683892z1-371453501.html

Deadly infection outbreak in Wisconsin gaining urgency
By Raquel Rutledge of the Journal Sentinel
March 8, 2016 5:06 p.m.

Calling it the largest outbreak of its kind and stressing the urgency of finding the source, the CDC has identified two more suspected cases of deadly blood infections and sent additional investigators to Wisconsin.

"This is very much a real outbreak," said Michael Bell, Deputy Director of the Division of Healthcare Quality Promotion for the U.S. Centers for Disease Control and Prevention.

Investigators have not been able to find a medical product, single facility, food source or other means of exposure that could explain how dozens of people ? mostly elderly residents of central and southeastern Wisconsin ? have become ill from a bacterium named Elizabethkingia anophelis.

Isolated tests from the two suspected cases had not yet been confirmed and officials would not say whether the individuals were sickened or had died. As of Tuesday, the outbreak was tied to 44 confirmed cases, including 18 deaths...

 

[Emily]

http://www.wearegreenbay.com/news/local-news/more-cases-of-elizabethkingia-found-in-wisconsin

[h=1]More cases of Elizabethkingia found in Wisconsin[/h] Published 03/08 2016 06:52PM
Updated 03/08 2016 06:52PM


The Center for Disease Control has confirmed that two more suspected cases of Elizabethkingia have been found in Wisconsin.
Health investigators still have not been able to find a product, singlefacility, food source or other means of exposure that could explain how dozens of people, mostly elderly patients mostly from central and southern Wisconsin, have gotten sick from the virus.
The two new suspected cases have not been confirmed, but as of Tuesday, there are 44 confirmed cases in the Badger state, with 18 deaths.
So far, the only known common factors are that the majority of patients are 65 or older and had serious underlying health conditions...

 

[Shiloh]

Source: http://www.greenfieldreporter.com/v...f77840684dabf0ee30d/WI--Bloodstream-Infection


Another Wisconsin death tied to Elizabethkingia anophelis reported
3:32 p.m.
By Crocker Stephenson and Raquel Rutledge of the Journal Sentinel

Sixteen people with infections caused by Elizabethkingia bacteria have died since the outbreak began in Wisconsin in November, an increase of one from last week, the state Department of Health Services reported Wednesday.

The number of cases, which are spread across 12 counties, also increased, from 48 to 54.

A source for the outbreak has not been identified. Federal, state and local investigators are involved in the search...

 

[Shiloh]

Source: http://www.mlive.com/news/grand-rapids/index.ssf/2016/03/bacteria_outbreak_in_wisconsin.html


Michigan patient's mysterious infection matches deadly Wisconsin outbreak
Matt Vande Bunte
on March 17, 2016 at 9:35 AM, updated March 17, 2016 at 9:56 AM

WEST MICHIGAN - A bloodstream infection that matches an ongoing bacteria outbreak in Wisconsin has been identified in Michigan, according to the state's Department of Health and Human Services.

The state agency says a blood sample from "an older adult from West Michigan with underlying health conditions" has an infection caused by Elizabethkingia anophelis, which has affected 54 people in 12 Wisconsin counties across Lake Michigan, from Milwaukee west to Madison. So far, 15 people infected by the bacteria have died.

"Michigan has worked closely with the (Centers for Disease Control) and Wisconsin Health Department to alert our provider community about the Wisconsin outbreak and to ensure early recognition of potential cases in our state," said Dr. Eden Wells, chief medical executive of the Michigan Department of Health and Human Service, in a prepared statement...

 

[Shiloh]

Source: https://www.dhs.wisconsin.gov/disease/elizabethkingia.htm
[h=3]Wisconsin 2016 Elizabethkingia anophelis outbreak[/h] The Wisconsin Department of Health Services (DHS), Division of Public Health (DPH) is currently investigating an outbreak of bloodstream infections caused by Elizabethkingia.
The majority of patients acquiring this infection are over the age of 65, and all patients have a history of at least one underlying serious illness.
At this time, the source of these infections is unknown and the Department is working diligently to contain this outbreak.
As part of the outbreak investigation activities, DPH and the Centers for Disease Control and Prevention (CDC) are conducting site visits and collecting environmental samples from both private residences and health care facilities. CDC is also assisting Wisconsin with testing of samples from a variety of potential sources, including health care products, water sources and the environment. To date, none of these have been found to be a source of the bacteria.
The Department has alerted health care providers, infection preventionists and laboratories statewide and provided information as well as treatment guidance for this outbreak. After that initial guidance was sent, there has been a rapid identification of cases and healthcare providers have been able to treat and improve outcomes for patients.
[TABLE="align: center, border: 1, cellpadding: 1, cellspacing: 1, width: 70%"]
[TR]
Type of Cases Number of Cases [/TR]

Wisconsin 2016 Elizabethkingia anophelis Outbreak:
Elizabethkingia infections believed to be associated with this outbreak reported to DPH*
Case counts between November 1, 2015 and March 23, 2016​

[TR]
[TD]Confirmed[/TD]
[TD]52[/TD]
[/TR]
[TR]
[TD]Under investigation[/TD]
[TD]3[/TD]
[/TR]
[TR]
[TD]Possible cases**[/TD]
[TD]4[/TD]
[/TR]
[TR]
[TD]Total cases reported to Wisconsin DPH[/TD]
[TD]59[/TD]
[/TR]
[/TABLE]
Affected counties include Columbia, Dane, Dodge, Fond du Lac, Jefferson, Milwaukee, Ozaukee, Racine, Sauk, Sheboygan, Washington, Waukesha, and Winnebago.
*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 anophelis because the outbreak specimens are no longer available to test.



The Wisconsin Division of Public Health (DPH) continues to receive reports of bloodstream infections caused by a bacterium of the genus Elizabethkingia. Elizabethkingia are opportunistic pathogens preferentially causing illness among immune compromised individuals or patients with underlying medical conditions, and are associated with high mortality. Therefore, early detection and treatment with an effective antibiotic regimen is important to increase the probability of good outcomes.
The index of suspicion for Elizabethkingia infections should be high among patients with multiple co-morbid conditions, particularly malignancy, diabetes mellitus, chronic renal disease or end-stage renal disease on dialysis, alcohol dependence, alcoholic cirrhosis, immune-compromising conditions or immunosuppressive treatment.
Strain characterization
Antimicrobial resistance testing of Wisconsin strains
Infection control measures
Health care facility response measures



Last Revised: March 23, 2016

 

[Shiloh]

Source: http://wbay.com/2016/03/30/another-death-linked-to-elizabethkingia-outbreak-in-wisconsin/


Another death linked to Elizabethkingia outbreak in Wisconsin
By Rhonda Roberts Published: March 30, 2016, 4:47 pm

Another death has been linked to the outbreak of Elizabethkingia in Wisconsin, according to new numbers released by the Wisconsin Department of Health Services.

DHS says there have been 17 deaths among patients confirmed to have the bloodstream infection, and one death among possible cases for a total of 18.

Health officials do not know if the deaths were caused by the Elizabethkingia infection or pre-existing health problems.

There have been 56 confirmed cases of Elizabethkingia in Wisconsin between Nov. 1, 2015 and March 30, 2016.

Two cases are under investigation and four cases as listed as ?possible.?...

 

[Shiloh]

Source: http://www.wpr.org/wisconsins-elizabethkingia-outbreak-unusual-scale-uncertainty

Wisconsin's Elizabethkingia Outbreak Is Unusual In Scale, Uncertainty
How Has The Elizabethkingia Outbreak Unfolded in Wisconsin?
Wednesday, March 30, 2016, 11:00am
By Kristian Knutsen and Scott Gordon

Over the winter of 2015-2016, public health officials identified an outbreak of blood infections in Wisconsin caused by the bacteria Elizabethkingia anophelis. On March 2, the state's Department of Health Services announced officials were investigating a series of infections by the bacteria among 18 patients. Between Dec. 29, 2015 and Jan. 4, 2016, the agency's Division of Public Health was notified of six potential cases of Elizabethkingia infection, and initiated a statewide disease surveillance plan on Jan. 5. Upon initially identifying infections in Wisconsin, DHS officials coordinated with health care providers to locate and treat additional cases. The agency also called in help from the U.S. Centers for Disease Control and Prevention, which is assisting with the identification of infections and determination of a potential source for the outbreak...

 

[Shiloh]

Source: http://patch.com/illinois/chicago/d...same-bacterial-infection-wisconsin-outbreak-0


Dead Illinois Resident Had Same Bacterial Infection as Wisconsin Outbreak
Illinois has one confirmed case of Elizabethkingia anophelis, and health officials are still searching for its source.

Chicago, IL
By Morgan Searles (Patch Staff) - April 12, 2016 5:09 pm ET

A deceased Illinois resident was infected with a bacteria linked to the deaths of 18 people in Wisconsin and one person in Michigan.

This person had the only confirmed case of an Elizabethkingia anophelis infection in Illinois, though 57 in Wisconsin have been affected by the outbreak, according to the Illinois Department of Public Health.

Most of the people who have been infected by the bacteria are older than 65 and already had a serious illness. Heath officials don't know if the deaths of people with Elizabethkingia were caused by the bacterial infection, by their other health conditions or both...

 

[Roehl_JC]

A bacterium that has killed 19 people in Wisconsin and Michigan has now spread to Illinois, according to health officials.
[h=1]Illinois death linked to Elizabethkingia bacterium[/h] [h=2]Person had underlying health issues[/h] According to an Associated Press report, an Illinois resident died after contracting an infection from the Elizabethkingia bacterium.
The resident was from the northern part of the state and had underlying health issues, the AP story said.
The rarely seen bloodstream infection has sickened dozens in Wisconsin since November, reports CNN, and was identified in a Michigan resident last month.
According to a CNN report, the bacteria are commonly found in soil, river water and reservoirs but do not commonly cause illness in humans. People with compromised immune systems or serious underlying health conditions are more at risk of infection. Previous outbreaks have been associated with health care settings.
The infection is often antibiotic resistant and therefore difficult to treat.

http://www.wcvb.com/national/illinois-death-linked-to-elizabethkingia-bacterium/38989034

 

[Shiloh]

Source: http://www.news8000.com/news/illinois-identifies-cluster-of-bloodstream-infection-cases/39128720


Illinois identifies cluster of bloodstream infection cases
Illinois health officials are reporting a cluster of cases of a rare bloodstream infection they detected while investigating a Wisconsin outbreak
Published On: Apr 20 2016 02:43:21 PM CDT
Dr. Saptarshi/ WikiMedia
SPRINGFIELD, Ill. (AP) -

Illinois health officials are reporting a cluster of cases of a rare bloodstream infection they detected while investigating a Wisconsin outbreak.

The Illinois Department of Public Health announced Wednesday an additional 10 cases of infection from the bacterium Elizabethkingia, including six deaths. The strain is different from the one in Wisconsin, however...

 

[Shiloh]

Source: http://www.who.int/csr/don/21-april-2016-elizabethkingia-usa/en/ [h=1]Elizabethkingia ? United States of America[/h] Disease outbreak news
21 April 2016

On 11 April 2016, the National IHR Focal Point of the United States of America notified PAHO/WHO of an outbreak caused by Elizabethkingia anophelis.
From 1 November 2015 to 30 March 2016, a total of 57 cases were reported from Wisconsin (56) and Michigan (1), including 18 deaths. The majority of the cases had E. anophelis isolated from the bloodstream. Other cases had the bacterium isolated from other sites, including respiratory systems and joints.
Most cases are over the age of 65 years and all have serious underlying health conditions. It has not yet been determined whether the deaths associated with this outbreak were caused by the bacterial infection, the patients? comorbidities, or both.
Many potential sources of the bacteria have been assessed, including water sources, health care facilities, medications and personal care products, though no common source has been identified to date. Investigations are ongoing.
[h=3]Public health response[/h] Health authorities in the United States are taking the following measures:

• administering antibiotic treatment to those with E. anophelis infections,
• providing information about infection control and antimicrobial susceptibility patterns to all health care providers, infection prevention specialists and laboratories state-wide.

[h=3]WHO risk assessment[/h] Although Elizabethkingia anophelis is commonly found in the environment, particularly in soil and water, it rarely causes illness in humans. A few small, localized outbreaks were reported before, usually in healthcare settings. The current outbreak in the United States is the largest known outbreak of Elizabethkingia on record. Since the transmission route of the bacteria remains unknown and bacteria primarily infects people with serious underlying health conditions further cases can be expected. PAHO/WHO continues to monitor the epidemiological situation and conduct risk assessment based on the latest available information.
[h=3]WHO advice[/h] PAHO/WHO encourages national public health authorities to report any cluster of E. anophelis and the potential identified cause by using the established communication channels under the International Health Regulations (2005).

 

[Shiloh]

Source: http://abcnews.go.com/Health/rare-e...newborn-shed-light-outbreak/story?id=38760445

Rare Elizabethkingia Bacterial Infection in Newborn Could Shed Light on Outbreak Mystery
By Gillian Mohney
Apr 29, 2016, 2:20 PM ET

Wisconsin health officials are investigating if a suspected case of the rare bacterial infection called Elizabethkingia at a children's hospital could be related to an ongoing outbreak that has infected at least 61 people in three states.

The newest suspected case at the Wisconsin Children's Hospital was diagnosed in an infant in the Neonatal Intensive Care Unit, according to hospital officials. The bacterial infection has infected 59 people from Wisconsin alone, of which 18 people have died, according to health officials. Two other fatal cases were reported in Michigan and Illinois, according to the U.S. Centers for Disease Control and Prevention.

A sample from the infected patient has been sent to the state health department to determine whether this is the same strain of the virus that has infected dozens of others...

 

[Shiloh]

Source: http://www.wisn.com/health/elizabet...al-not-related-to-outbreak-officials/39355180

Elizabethkingia case at Children's Hospital not related to outbreak, officials say
Strain involved in outbreak infects nearly 60 people in Wisconsin
UPDATED 9:59 AM CDT May 03, 2016

MILWAUKEE ?A case of Elizabethkingia bacterium reported last week at Children's Hospital of Wisconsin is not associated with an outbreak that's infected nearly 60 people throughout the state, health officials said Tuesday morning...

 

[Pathfinder]

FOR IMMEDIATE RELEASE
May 3, 2016
CONTACT:
Julie Lund, 608-266-1683


DHS Update: Elizabethkingia Anophelis Outbreak


Latest tests confirm no children affected, DPH responds to Democrat concerns


The Department of Health Services (DHS) today provided an update regarding its investigation of the Elizabethkingia anophelis outbreak and responded to Democratic legislators who shared concerns about DHS’ investigation into the outbreak.

The Wisconsin State Lab of Hygiene (WSLH) has completed testing of laboratory specimens of two suspected casesof Elizabethkingia submitted last week, and determined one of those cases is related to the outbreak, bringing the number of confirmed cases of Elizabethkingia anophelis associated with this outbreak to 60. Most of the people affected by this outbreak are over 65, and all have serious, underlying health conditions. None of the confirmed cases associated with this outbreak are children.

According to State Health Officer Karen McKeown, this is the largest known outbreak of this strain in the United States. “Disease detectives in our Division of Public Health (DPH) have been working aggressively, with assistance from the Centers for Disease Control and Prevention (CDC), to locate the source of the outbreak,” said McKeown. “Since the onset of the Elizabethkingia anophelis outbreak, we have worked diligently to provide accurate, comprehensive information, and to prevent the spread of misleading information that can lead to unwarranted fear among the public. Our top priority is the health and safety of the people we serve.”

Late last week, Governor Scott Walker received a letter from Democratic legislators expressing concerns about the DPH investigation of this outbreak. Today, DPH, the lead agency in the Elizabethkingia anophelis investigation,responded to the letter (PDF, 52 KB).

DPH staff first received reports of infected patients between December 29, 2015, and January 4, 2016. DPH immediately reached out to CDC for guidance on January 5, 2016, as this appeared to be an outbreak with a unique organism, and immediately launched the investigation with CDC’s guidance and assistance, and reached out to health care partners to request and share information.

“Our civil service employees (who include nationally recognized scientists) within DPH are committed to protecting the health and wellness of all Wisconsinites, and this is reflected in the work they have done investigating theElizabethkingia anophelis outbreak,” said McKeown. “We will continue to work in collaboration with our partners at CDC, WSLH, local health departments, and with health care facilities and clinicians, to determine the source of theElizabethkingia anophelis outbreak and provide appropriate treatment guidance.”

Elizabethkingia anophelis are bacteria that are rarely reported to cause illness in humans, but can cause infection that may be life threatening among people with compromised immune systems. DHS maintains a webpage that includes the latest number of cases related to, or potentially related to, the Elizabethkingia anophelis outbreak currently under investigation in Wisconsin. DHS will continue to share accurate information related to this investigation as it is available.

In early April, after meeting with DPH about the Elizabethkingia anophelis investigation, as well as other public health issues, Governor Walker approved the addition(link is external) of nine (9) project positions so that DPH may continue to work aggressively to locate the source of the outbreak, and continue its work on all other outbreaks that affect public health.
For more information go to the DHS Elizabethkingia webpage.

https://www.dhs.wisconsin.gov/news/releases/050316.htm

 

[Pathfinder]

Wisconsin 2016 Elizabethkingia anophelis Outbreak:
Elizabethkingia infections believed to be associated with this outbreak reported to DPH*
Case counts between November 1, 2015 and May 3, 2016 [TABLE="align: center, border: 1, cellpadding: 1, cellspacing: 1, width: 595, height: 22"]
[TR]
[/TR]
[TR]
[TD]Confirmed[/TD]
[TD]60[/TD]
[/TR]
[TR="bgcolor: #CCCCCC"]
[TD]Under investigation[/TD]
[TD]0[/TD]
[/TR]
[TR]
[TD]Possible cases**[/TD]
[TD]4[/TD]
[/TR]
[TR="bgcolor: #CCCCCC"]
[TD]Total cases reported to Wisconsin DPH[/TD]
[TD]64[/TD]
[/TR]
[/TABLE]
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 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.
*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 ofElizabethkingia anophelis because the outbreak specimens are no longer available to test.



https://www.dhs.wisconsin.gov/diseas...bethkingia.htm

 

[Shiloh]

Source: http://www.jsonline.com/news/health...thkingia-infection-b99732517z1-380858561.html


State confirms new case of Elizabethkingia infection
Yesterday 2:35 p.m.
By Crocker Stephenson of the Journal Sentinel

The Wisconsin Department of Health Services reported another case of Elizabethkingia infection, bringing the total number of confirmed cases in Wisconsin to 61.

The number of people who have died of confirmed cases of the infection remains at 18.

The number of unconfirmed cases remains at four. The number of people who have died of unconfirmed cases remains at one...

 

[Shiloh]

Source: http://www.jsonline.com/news/health...n-with-2-new-cases-b99740901z1-382284921.html

Elizabethkingia outbreak continues in Wisconsin with 2 new cases
4:52 p.m.
By Shelby Lyon of the Journal Sentinel

The Wisconsin Department of Health Services reported two new cases of Elizabethkingia infection on Wednesday.

One of the confirmed cases was previously reported as under investigation last week. The other case is new.

These latest cases bring the total number of infections in Wisconsin to 67, including four diagnosed Elizabethkingia infections in which the strain could not be identified and confirmed as being the same as the outbreak strain...

 

[Shiloh]

Source: http://www.medscape.com/viewarticle/871233


Source of Elizabethkingia Outbreak Eludes Investigators
Caroline Helwick
November 01, 2016

NEW ORLEANS ? An epidemiologic investigation into the recent outbreak of Elizabethkingia infection in Wisconsin underscores the importance of statewide infection surveillance systems and highlights challenges faced by epidemiologists trying to track down the source of such rare infections.

"This is the largest reported outbreak of Elizabethkingia infections, and the source of the outbreak strain of E anophelis remains unknown," said Lina Elbadawi, MD, from the Bureau of Communicable Diseases at the Wisconsin Division of Public Health in Madison and the Office of Public Health Preparedness and Response at the Centers for Disease Control and Prevention (CDC).

Dr Elbadawi described the epidemiologic investigation conducted by the Wisconsin Division of Public Health and the CDC here at IDWeek 2016...