Here & Now

CDC Specialist Explains Bacterial Outbreak In Wisconsin

THE OUTBREAK OF A RARE BLOOD INFECTION IN WISCONSIN HAS BROUGHT A TEAM FROM THE CENTERS FOR DISEASE CONTROL INTO THE STATE WORKING TO FIND THE SOURCE. SINCE NOVEMBER FIRST HEALTH OFFICIALS REPORT 48 CASES OF ELIZABETHKINGIA INFECTION IN THE STATE WITH 15 DEATHS. IT SPREAD TO 12 COUNTING AFFECTING ELDERLY PATIENTS WITH UNDERLYING HEALTH CONDITIONS. DR. MICHAEL BELL FROM THE CDC JOINS US NOW FROM ATLANTA WITH AN UPDATE. THANKS FOR BEING HERE.

MICHAEL BELL:

YOU’RE WELCOME. GOOD TO BE WITH YOU.

FREDERICA FREYBERG:

SO WHAT ARE THE LATEST NUMBERS OF CASES IN WISCONSIN?

MICHAEL BELL:

SO YOUR CASE COUNT IS CORRECT. IT’S 48 PATIENTS AND 15 DEATHS, ACCORDING TO THE WISCONSIN PUBLIC HEALTH WEBSITE.

FREDERICA FREYBERG:

SO HOW BIG OF AN OUTBREAK IS THIS?

MICHAEL BELL:

WELL, SO WE SEE ELIZABETHKINGIA INFECTIONS AROUND THE COUNTRY EVERY YEAR. THERE’S A HALF A DOZEN OR MORE IN EVERY STATE. BUT WE DON’T SEE 48 OF THE IDENTICAL ORGANISM CAUSING AN OUTBREAK LIKE THIS VERY OFTEN. IN FACT, THIS IS PROBABLY THE LARGEST ONE WE’VE SEEN.

FREDERICA FREYBERG:

WHAT EXACTLY IS THIS ELIZABETHKINGIA?

MICHAEL BELL:

ELIZABETHKINGIA IS A GROUP OF BACTERIA THAT ARE VERY COMMON IN THE ENVIRONMENT. SO WE FIND THE ORGANISM IN WATER, IN SOIL, IN THE ENVIRONMENT AROUND US PRETTY MUCH EVERYWHERE. IT’S A BACTERIA THAT ORDINARILY DOESN’T CAUSE INFECTIONS. WE CAN ASSUME THAT BACTERIA LIKE THIS ARE IN NORMAL TAP WATER, IN THE FOOD AND VEGETABLES THAT WE EAT REGULARLY, AND IT DOESN’T HARM US BECAUSE WE HAVE NATURAL DEFENSES. IT’S ONLY A PROBLEM WHEN THOSE DEFENSES ARE SOMEHOW COMPROMISED. SO PEOPLE WHO HAVE CANCER, PEOPLE WHO HAVE OTHER PROBLEMS WITH THEIR IMMUNE SYSTEM CAN HAVE SIGNIFICANT INFECTIONS, WITH EVEN GENERALLY HARMLESS ORGANISMS LIKE ELIZABETHKINGIA.

FREDERICA FREYBERG:

WHAT ARE THE SYMPTOMS?

MICHAEL BELL:

THE SYMPTOMS ARE VARIABLE. ALL OF THE PATIENTS THAT WE’RE SEEING IN THIS PARTICULAR OUTBREAK HAVE HAD INVASIVE INFECTIONS. IN OTHER WORDS, INFECTIONS OF THEIR BLOODSTREAM. THE PATIENTS IN SOME CASES HAVE HAD SOME SKIN INFECTIONS AT THE BEGINNING OF THE PROCESS. ONE PERSON HAD A JOINT INFECTION, I BELIEVE. BUT FOR THE MOST PART, THESE ARE BLOODSTREAM INFECTIONS. ANY BACTERIA IF IT GETS INTO YOUR BLOODSTREAM CAN CAUSE A SEVERE INFECTION. OUR HOST DEFENSES, OUR NATURAL DEFENSES THAT PREVENT BACTERIA FROM GETTING THERE, ARE WHAT KEEPS US SAFE.

FREDERICA FREYBERG:

WHAT’S THE TREATMENT AND HOW EFFECTIVE IS IT?

MICHAEL BELL:

SO ANTIBIOTICS ARE USED TO TREAT BLOODSTREAM INFECTIONS, INCLUDING THOSE CAUSED BY THIS BACTERIA. IT’S IMPORTANT TO KNOW THAT ELIZABETHKINGIA AS A GROUP TENDS TO HAVE NATURAL DEFENSES AGAINST ANTIBIOTICS. SOME OF THE ORDINARY ANTIBIOTICS THAT WE WOULD USE TO TREAT A BLOOD INFECTION MIGHT NOT IMMEDIATELY KILL ELIZABETHKINGIA. BECAUSE OF THAT, WE’VE DONE EARLY TESTS ON THE PARTICULAR STRAIN CAUSING THE OUTBREAK AND THE INFORMATION FROM THAT IS NOW UP ON THE WISCONSIN WEBSITE SHOWING THAT THERE ARE CERTAIN ANTIBIOTICS THAT ARE EASILY AVAILABLE AND THAT WORK VERY WELL, WHICH DO SEEM TO TREAT THIS ORGANISM VERY EFFECTIVELY.

FREDERICA FREYBERG:

NOW, I KNOW THAT YOU TALKED SOME ABOUT POTENTIAL SOURCES OF THIS BACTERIA THAT’S MAKING PEOPLE SICK. SPECIFICALLY HERE IN WISCONSIN, WHAT’S BEING LOOKED AT IN TERMS OF TRYING TO GET TO THE SOURCE OF THIS OUTBREAK?

MICHAEL BELL:

CDC AND THE WISCONSIN HEALTH DEPARTMENT HAVE BEEN WORKING VERY HARD TO LOOK FOR THE POSSIBLE SOURCES OF THESE BACTERIA. THE FACT THAT THEY ALL HAVE ONE FINGERPRINT MAKES US THINK THAT IT COULD BE ONE ISOLATED SOURCE. SO FAR NOTHING THAT WE’VE CULTURED HAS SHOWN UP AS THE MAIN SOURCE. WE HAVE LOOKED AT TAP WATER. WE HAVE LOOKED AT CONSUMER PRODUCTS, MEDICAL PRODUCTS, THE HEALTH CARE ENVIRONMENT, EVEN THE ENVIRONMENT OF PEOPLE’S HOMES. AND SO FAR NOTHING HAS LIT UP AS THE DEFINITIVE SOURCE. WE’RE CONTINUING TO LOOK. AND IT’S IMPORTANT TO REALIZE THAT THESE ORGANISMS NEED TO HAVE SOME TIME IN THE LABORATORY BEFORE WE CAN CONFIRM THAT SOMETHING IS NOT CONTAMINATED WITH THE BACTERIA. THAT TAKES ABOUT TWO WEEKS SOMETIMES. AND SO THERE’S A LITTLE BIT OF A DELAY BEFORE WE CAN CALL AN ALL-CLEAR FOR A PARTICULAR THING. BUT SO FAR WE HAVEN’T FOUND THE SMOKING GUN, IF YOU WILL.

FREDERICA FREYBERG:

IS ELIZABETHKINGIA CONTAGIOUS BETWEEN PEOPLE?

MICHAEL BELL:

NO. THIS IS NOT SOMETHING WE SEE TRANSMITTED FROM PERSON TO PERSON. IT REALLY IS ABOUT THE NORMAL ORGANISMS, THE NORMAL BACTERIA IN THE ENVIRONMENT GETTING INTO A PATIENT WHO HAS COMPROMISED IMMUNE DEFENSES.

FREDERICA FREYBERG:

OKAY. WE LEAVE IT THERE. DR. MICHAEL BELL, THANK YOU VERY MUCH FOR JOINING US WITH YOUR INFORMATION.