Four infants have been sickened by an uncommon environmental bacterium called Cronobacter sakazakii in November and December. A single case has occurred in four states: Missouri, Illinois, Oklahoma and Florida. CDC is working with state and local health departments to investigate, but at this time there does not appear to be a connection. Two of the infants died of the infection and a DNA fingerprint analysis for the cases did not suggest a common link. Investigators in Missouri were able to identify Cronobacter in opened containers of powdered infant formula, premixed formula and a bottle of water. How the contamination occurred is as yet unknown but unopened samples of formula and water with the same lot numbers have reassuringly tested negative.
Cronobacter is not a reportable disease in New York unless several cases are recognized as being linked. The State and City Health Departments sent notices last week to hospital physicians, nurses and laboratories asking them to report any positive cultures in infants. No suspect cases have been reported in NYC.
Cronobacter mostly affects people with weakened, or in the case of neonates, undeveloped immune systems. Because it exists in the environment there are multiple opportunities for the bacteria to contaminate food, however, heat does destroy the bacteria. Ordinarily CDC learns of 4-6 cases per year but in 2011 there were 12 in infants. Whether this represents a contamination of a commercial product or just better recognition is not known, but under investigation. There have been outbreaks in the past connected to powdered formula. Affected infants are generally less than a month old and have fever, irritability or listlessness and poor feeding. Medical consultation for infants with these symptoms should be sought without delay.
The World Health Organization recommends that whenever feasible infants be exclusively breastfed until the age of six months.
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