The bloodstream infection Elizabethkingia is rarely seen but it has already sickened dozens and killed a number in Wisconsin. Now it has been identified in a resident of another state, Michigan, the state health department confirms.

The rare infection, caused by the bacteria Elizabethkingia anophelis, has led to the death of the patient, an older adult with underlying medical conditions.

The Wisconsin Department of Health Services has so far received 54 cases of Elizabethkingia infection from Nov. 1 to March 16, and is now working with the U.S. Centers for Disease Control and Prevention and the Michigan health department to alert the public about the outbreak and ensure early detection.

The majority of the patients who acquired the infection are older than 65 and with a history of at least one serious underlying disease, revealed the Wisconsin agency in a statement.

Seventeen of the 54 patients have died, but until now the exact cause of death or underlying illnesses have not been confirmed.

Elizabethkingia – bacteria typically found in soil, reservoirs and rivers – rarely make humans sick but can affect those with compromised immune function or serious medical conditions. Named after the CDC microbiologist who first isolated the bacterium, the infection can occur in ones or twos in hospitals, particularly in those who already have weak immunity.

Infection symptoms include fever, chills, shortness of breath and cellulitis, and diagnosis is confirmed by a laboratory test. The bacteria, too, are hardly contained by antibiotics because they tend to be resistant to many commonly employed antibacterial treatments.

“Timely diagnosis is key to ensuring patients receive appropriate treatment, and we will continue to provide updates and guidance as additional information becomes available,” assures Dr. Eden Wells, chief medical executive of the Michigan Department of Health and Human Services, in a separate statement.

The link between the Wisconsin cases and the one in Michigan is proving difficult to determine, as not all of the patients visited the same medical facility or even went to a hospital at all. Some stayed in their own houses or in nursing homes.

This makes the current outbreak – one of the largest seen and investigated – quite difficult to solve, according to Michael Bell, deputy director of CDC’s Division of Healthcare Quality Promotion.

“That leaves us looking at a huge number of potential risk factors,” he told the Washington Post, referring to medications, food and environmental factors as some potential causes.

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