Michigan case of bacterial bloodstream infection matches outbreak in Wisconsin

Infections caused by a bacteria called Elizabethkingia anophelis


DETROIT – The Michigan Department of Health and Human Services (MDHHS) has confirmed that a blood culture from a Michigan resident matches an ongoing outbreak of a bloodstream infection in Wisconsin.

MDHHS was notified by the Centers for Disease Control and Prevention (CDC) of the match on Friday.

The Wisconsin outbreak consists of bloodstream infections caused by a bacteria called Elizabethkingia anophelis. The Michigan case resulted in the death of an older adult with underlying health conditions in West Michigan.

“Michigan has worked closely with the CDC 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 MDHHS. “Timely diagnosis is key to ensuring patients receive appropriate treatment, and we will continue to provide updates and guidance as additional information becomes available.”

Wisconsin health officials said 17 people with infections caused by Elizabethkingia bacteria have died since the outbreak began in November. That's an increase of two deaths since last week. The number of cases in 12 Wisconsin counties has also grown, from 48 to 54. Health officials say the Wisconsin outbreak is the largest recorded in published literature. 

What is it? Signs and symptoms

Elizabethkingia is a genus of bacteria commonly found in the environment and has been detected in soil, river water and reservoirs. However, it rarely makes people sick. Illness associated with Elizabethkingia typically affects people with compromised immune systems or serious underlying health conditions. Most outbreaks associated with Elizabethkingia are healthcare-associated. There are few reports of community-acquired infections. 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.

How is it treated? 

Elizabethkingia infections are often difficult to treat with antibiotics.  These bacteria tend to be resistant to many of the antibiotics physicians may use to treat infections, so early recognition of the bacteria is critical to ensure patients receive appropriate treatment.

How it was detected in Michigan

After the call for cases from Wisconsin, the MDHHS sent a Health Alert to providers on Feb. 8, which asked providers and laboratories to review records for Elizabethkingia specimens identified since January 1, 2014.

On February 29, the MDHHS Bureau of Laboratories identified Elizabethkingia in a recently submitted blood sample. That isolate was then forwarded to CDC for additional testing. The MDHHS is facilitating medical record reviews and interviews.

The MDHHS will continue to work with the Wisconsin Division of Public Health and the CDC to identify the source of the bacteria. Providers and laboratories should continue to immediately report the isolation of Elizabethkingia to the MDHHS by calling 517-335-8165, and retain available isolates for confirmatory testing by MDHHS BOL and CDC.