State and local health officials in Wisconsin are investigating an outbreak of bloodstream infections caused by bacteria called Elizabethkingia anophelis. In addition, a team of epidemiologists and laboratory partners from the Centers for Disease Control and Prevention (CDC) is on site assisting with the investigation.

Wisconsin map/National Atlas of the United States
Wisconsin map/National Atlas of the United States

“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 Elizabethkingia infection 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.