2016 United States Elizabethkingia outbreak

Last updated
2016 United States Elizabethkingia anophelis outbreak
Wisconsin in United States.svg
Wisconsin, in red, the location of 63 confirmed cases as of June 16, 2016
DateNovember 1, 2015 (2015-11-01) — present
Location Wisconsin, western Michigan, and Illinois, United States [1] [2]
TypeDisease outbreak
Cause Elizabethkingia anophelis
Casualties
  • Cases / Deaths(as of June 16, 2016) [3] [2]
  • Wisconsin: 63 / 18
  • Michigan: 1 / 1
  • Illinois: 1 / 1
Deaths20 [3]

An outbreak of Elizabethkingia anophelis infections centered in Wisconsin [4] [5] is thought to have led to the death of at least 20 people in Wisconsin, Michigan, and Illinois. [6] [7] [1] [2]

History

As of March 2016, it was reported to be the largest outbreak of Elizabethkingia anophelis -caused disease investigated by the Centers for Disease Control and Prevention (CDC). [8]

Human infections by E. anophelis involve the bloodstream. [4] Signs and symptoms can include fever, shortness of breath, chills, and cellulitis. [4] Confirmation requires a laboratory test. [4]

Statewide surveillance of the situation in Wisconsin was organized on January 5, 2016. [9] Cases had been reported from Columbia, Dane, Dodge, Fond du Lac, Jefferson, Milwaukee, Ozaukee, Racine, Sauk, Sheboygan, Washington, Waukesha, and Winnebago Counties); Illinois; and western Michigan as of April 13, 2016. [9] [1]

Between November 1, 2015 and March 30, 2016, 62 cases of E. anophelis infections were reported to the Wisconsin Department of Health Services, Division of Public Health. [4]

The severity of the outbreak is reflected in a statement by the CDC that "the agency sees a handful of Elizabethkingia infections around the country each year, but the outbreaks rarely involve more than a couple of cases at a time. To have dozens of cases at once — and more than a third of them possibly fatal — is startling". [10]

In 2017, genomics researchers determined that "a disrupted DNA repair mutY gene [...] probably contributed to the high evolutionary rate of the outbreak strain and may have increased its adaptability," but the source was not identified. [5]

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Elizabethkingia anophelis is a yellow-pigmented, rod-shaped, gram-negative bacterium in the Flavobacteriaceae family. Elizabethkingia is isolated from the midgut of Anopheles gambiae G3 mosquitoes reared in captivity. The genus Elizabethkingia, named for former US Centers for Disease Control and Prevention (CDC) microbiologist Elizabeth O. King, also includes E. meningoseptica which causes neonatal sepsis and infections in immunocompromised persons, E. endophytica, and E. miricola.

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Elizabethkingia is a genus of bacterium described in 2005, named after Elizabeth O. King, the discoverer of the type species. Before this genus being formed in 2005, many of the species of Elizabethkingia were classified in the Chryseobacterium genus. Elizabethkingia has been found in soil, rivers, and reservoirs worldwide.

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References

  1. 1 2 3 Sarah Kaplan (18 March 2016). "The mysterious infection that might be behind 17 deaths in Wisconsin has spread to a second state". Washington Post. Archived from the original on 18 March 2016. Retrieved 18 March 2016.
  2. 1 2 3 Gallardo, Michelle. "Illinois Death Linked to Elizabethkingia Outbreak That Killed 18". ABC 7 Eyewitness News. WLS-TV. Archived from the original on April 14, 2016. Retrieved April 14, 2016.
  3. 1 2 "Multistate Outbreak of Infections Caused by Elizabethkingia anophelis". Centers for Disease Control and Prevention (CDC). June 16, 2016. Archived from the original on April 15, 2016. Retrieved June 19, 2016.
  4. 1 2 3 4 5 Wisconsin Department of Health Services: "Wisconsin 2016 Elizabethkingia anophelis outbreak Archived 2023-04-27 at the Wayback Machine ", last revised: March 30, 2016.
  5. 1 2 Perrin, Amandine; Larsonneur, Elise; Nicholson, Ainsley C.; Edwards, David J.; Gundlach, Kristin M.; Whitney, Anne M.; Gulvik, Christopher A.; Bell, Melissa E.; Rendueles, Olaya; Cury, Jean; Hugon, Perrine; Clermont, Dominique; Enouf, Vincent; Loparev, Vladimir; Juieng, Phalasy; Monson, Timothy; Warshauer, David; Elbadawi, Lina I.; Walters, Maroya Spalding; Crist, Matthew B.; Noble-Wang, Judith; Borlaug, Gwen; Rocha, Eduardo P. C.; Criscuolo, Alexis; Touchon, Marie; Davis, Jeffrey P.; Holt, Kathryn E.; McQuiston, John R.; Brisse, Sylvain (24 May 2017). "Evolutionary dynamics and genomic features of the Elizabethkingia anophelis 2015 to 2016 Wisconsin outbreak strain". Nature Communications. 8 (1): 15483. Bibcode:2017NatCo...815483P. doi:10.1038/ncomms15483. ISSN   2041-1723. PMC   5458099 . PMID   28537263.
  6. "A mysterious infection may have killed 18 people in Wisconsin, and health officials aren't sure why". Msn.com. Archived from the original on March 13, 2016. Retrieved March 11, 2016.
  7. "Rare Elizabethkingia Bacteria Outbreak Infects 44 in Wisconsin, Killing 18 – ABC News". Abcnews.go.com. March 4, 2016. Archived from the original on March 11, 2016. Retrieved March 11, 2016.
  8. Ehlke, Gretchen. "Source of bloodstream infection in Wisconsin unknown". The Washington Post . Archived from the original on March 10, 2016. Retrieved March 11, 2016.
  9. 1 2 WISN 12 News: "Cases of blood infection reported in Southeast Wisconsin | 44 cases of Elizabethkingia anophelis reported since Nov. 1 Archived 2016-03-10 at the Wayback Machine ", March 3, 2016.
  10. "CDC offers new call to arms on nightmare bacteria". PBS NewsHour. 4 August 2015. Archived from the original on 11 March 2016. Retrieved March 11, 2016.