4 Things Pharmacists Should Know About Elizabethkingia

Three states are reporting an outbreak of a rare bloodstream infection caused by Elizabethkingia anophelis bacteria.

Wisconsin has been hit the hardest with 59 confirmed cases, including 18 deaths, according to the US Centers for Disease Control and Prevention (CDC). In addition, Michigan and Illinois have each reported 1 death potentially linked to Elizabethkingia.

A few other Wisconsin samples have tested positive for Elizabethkingia, but it’s not yet known whether they’re connected to the original outbreak because that E. anophelis strain is no longer available for testing, Contagion reported.

CDC spokesperson Melissa Bower told Pharmacy Times that the agency couldn’t identify a role that pharmacists can play in preventing the infection at this time, mostly because the culprit behind the outbreaks is still unknown. The CDC also didn’t have any predictions about potential Elizabethkingia outbreaks in other states.

Bower noted that the pathogen normally doesn’t make individuals sick. In fact, it’s a common organism found in the environment.

The CDC is currently testing samples from health care products and water sources, but so far, none of the samples have turned out to be the source of the bacteria.

The CDC stated on its website that it’s continuing to assist the Wisconsin Department of Health Services, the Michigan Department of Health and Human Services, and the Illinois Department of Public Health to uncover the sources of the bacteria and investigate ways to prevent further infections.

Here are 4 facts pharmacists should know about the Elizabethkingia outbreak.

1. The majority of cases are bloodstream infections.

However, there have been some other cases where patients had Elizabethkingia in their joints or respiratory systems, according to the CDC.

2. Most infected patients are older and have other serious health conditions.

The majority of patients infected with Elizabethkingia are 65 years or older and have other illnesses.

The CDC said it isn’t sure whether the fatalities were directly caused by the bacterial infection or the patients’ other illnesses.

3. Wisconsin’s outbreak, which has been circulating since December 2015, raised awareness of the bacteria in other states.

Wisconsin reported 6 potential cases of infection in late 2015. In early January 2016, it set up a statewide surveillance, and the CDC encouraged other potential cases to be reported via 2 systems: the Emerging Infections Network and the Epidemic Information Exchange system.

Michigan then sent out a state health alert in February, and later that month, the CDC discovered that one of the samples the state sent for testing matched the bacteria causing the outbreak in Wisconsin.

Likewise, Illinois sent alerts in February and March, and 1 sample matched the Wisconsin outbreak bacteria.

4. Fever, shortness of breath, chills, and cellulitis are some symptoms of Elizabethkingia-related illness.

The Wisconsin Department of Health Services noted that confirmation of illness is conducted via laboratory tests.

“Early detection and treatment with an effective antibiotic regimen is important to increase the probability of good outcomes,” the department wrote on its website.

It encouraged heightened suspicion of Elizabethkingia among patients with multiple comorbid conditions, such as malignancy, diabetes, chronic renal disease, end-stage renal disease on dialysis, alcohol dependence, alcoholic cirrhosis, immune-compromising conditions, or immunosuppressive treatment.