2016 United States Elizabethkingia outbreak

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]

2016 United States Elizabethkingia anophelis outbreak

Wisconsin, in red, the location of 63 confirmed cases as of June 16, 2016
Date	November 1, 2015 (2015-11-01) — present
Location	Wisconsin, western Michigan, and Illinois, United States[1][2]
Type	Disease outbreak
Cause	Elizabethkingia anophelis
Casualties
Cases / Deaths (as of June 16, 2016)[3][2] Wisconsin: 63 / 18 Michigan: 1 / 1 Illinois: 1 / 1
Deaths	20[3]

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]