Elizabethkingia Q&A with UW Health Infectious Disease Specialist Nasia Safdar
Madison, Wisconsin - With the Elizabethkingia outbreak in the news, Nasia Safdar, MD, a UW Health infectious disease specialist and UW Hospital medical director of infection control, answers some basic questions about the bacteria:
Q. What is Elizabethkingia?
A. It's actually a new name for something that has been known for a long time and was previously referred to as Flavobacterium or Chryseobacterium.
Q. Where does the bacteria found?
A. The bacteria is ubiquitous - it's everwhere in the environment, the water, the soil. It's not surprising that it is around, but it rarely causes human disease, so that's why this is a particularly concerning outbreak - that there have been so many affected by it.
It is a water-based bacteria, so a hospital or health care environment is one place you would find it such as in fluids being administered to someone, sinks, faucets - something to do with water.
Q. Is it contagious?
A. No. It cannot be transmitted from person to person. This bacteria has always affected humans, but is an opportunistic pathogen. It doesn't affect healthy humans who are otherwise doing well. Those at risk are individuals who are very immune compromised for a number of reasons such as age, or they've had a transplant or are on dialysis. In the case of this outbreak, all of the individuals affected have been described to have had at least one other serious medical condition.
There is no danger to the community.
Q. What are symptoms?
A. The symptoms are very non-specific and are the same for any infection. You might have fever because you have bacteria in the bloodstream, or redness at the site of the wound for a wound infection. It is an acute bacterial infection. The symptoms come to attention quickly. After that, if treatment is started, most recover although those who are very frail may take longer to do so.
Q. What does the bacteria do?
A. It causes infections - blood, skin, respiratory, or a combination.
Q. Is it treatable?
A. There is a treatment. It is a small group of antibiotics that can be effective. If someone has an infection we test the antibiotics to see if the bacteria is susceptible to it. The thing to remember, however, is that it can be fairly antiobiotic-resistant.
Q. What is the cause of this current outbreak?
A. There are two possibilities:
One is a point source outbreak, meaning it happened from a particular source whether it was something administered to patients or part of their care such as IV fluids or respiratory fluids, or it was in the environment of the facility. When you look at previous outbreaks - when it was under the old name - there was something going on with the environment of the facility. Sinks were contaminated for example.
The other possibility is that we were just seeing more Elizabethkingia around because there are more immuno-compromised people around, but that doesn't seem to be the case. These infections occur within a specific time frame during which the Department of Health has seen increased cases. There hasn't been a gradual increase, which is why we are calling it an outbreak.
As to the cause, we don't want to speculate. We just don't have enough information at this time.
Date Published: 03/03/2016