Sunday, April 17, 2016

Let's Discuss Elizabethkingia


This is Elizabethkingia Anophelis in a culture.


  Elizabethkingia is a gram negative bacterium which only rarely sickens humans. It is named for Elizabeth O. King, who discovered this organism.   It can cause a cellulitis, or a respiratory infection. Fever and chills may be the first symptoms. The causative organism is most correctly Elizabethkingia Anophelis. I am mentioning it here today because surprisingly, very recently there has been an outbreak of the illness in both Michigan and Wisconsin, and now Illinois.  It is an organism that may be present in some species of fish and some frogs. It has been demonstrated to survive cleaning with alcohol and it can survive in alcohol. It is also resistant to a fair number of antibiotics. Before this most recent three state outbreak, outbreaks were rare and small and occurred most often in compromised patients in a health care setting.

              There are four species of this organism

 E. anophelis 
E. endophytica 
E. meningoseptica 
E. miricola

  It most often impacts those older than 65 and those with at least one other pre-existing illness.  Don't let this make you too comfortable because the organism can afflict anyone, and it can mutate as it wishes. Recent cases in the two aforementioned states took 20 lives, and there were 61 confirmed cases. There are several other cases under investigation. There are likely to be many more. Death when it occurs, is usually due to sepsis.  Although this organism is found in dirt, no one yet knows the commonality by which all these cases are connected. The personal products of all of those afflicted are being cultured to see how these cases may have been connected.
                This disease killed yet another person as few as three days ago, and we still have no idea as to how it is spreading.

                This is a public health issue which demands our attention.  All that we can do presently, is the following:

1. Keep any and all known chronic illnesses under control.  Diabetes with hyperglycemia, COPD poorly controlled, and other chronic issues leave the patient vulnerable to infections from all sources.

2. Although I realize that good hygiene is boring, and makes most of us think of the nineteen thirties, it works. Hand washing with regular soap, before eating, before handling food, after using the bathroom,after handling pets, being obviously soiled, and on coming home after being out or outside, goes a long way to preventing sickness from organisms with which we come in contact. I don't usually use anti-bacterial soaps as a strategy of avoiding resistant organisms, although I have used them for specialized purposes occasionally.

3. Any child under two who develops a fever greater than 101F needs to see a physician. Children dehydrate quickly and may become septic more quickly than older children.

4. Anyone over 65 who develops a fever and chills with a temp of 102F or higher should be seen that day by a physician.

5. Get enough sleep. Our immune systems work best if we are optimally rested.

Please keep alert to any additional happenings with regard to this infection.