


An infection from Cronobacter sakazakii, the bacteria that can contaminate infant formula, could soon join the federal disease watchlist.
Cronobacter infections typically strike infants under 2 months old and can be fatal or permanently disabling.
The same germ is linked to a recall and nationwide shortage of powdered infant formula, according to the U.S. Centers for Disease Control and Prevention (CDC).
In June, the Council of State and Territorial Epidemiologists CSTE), a nonprofit organization that advocates for effective disease surveillance, is expected to decide if it will officially recommend adding Cronobacter infections to the list of nationally notifiable diseases to the CDC.
“When we look back at large-scale outbreaks over the course of the last year, many of those outbreaks were associated with diseases and conditions that were nationally notifiable, but not all of them,” said Janet Hamilton, executive director of the council. Cronobacter was one of the exceptions.
“So whenever we have something like that, that prompts the council to determine and assess whether we need to potentially be doing more.”
If the council votes to add Cronobacter infections to the National List of Notifiable Diseases, it will go to the CDC for approval. And if the CDC deems an illness to be notifiable, it’s up to state and local governments to adjust their reporting laws and develop processes for doctors to report cases to health departments, which then forward those reports to the CDC.
The earliest that data collection could start is the beginning of 2024, and it would most likely be well into the year, depending on state legislative sessions.
“Unless detailed studies are done, the diagnosis as a Cronobacter illness may be missed,” U.S. Food and Drug Administration (FDA) Commissioner Dr. Robert Califf wrote in a blog post. “The lack of mandatory reporting significantly hampers the ability to fully understand Cronobacter’s public health impact.”
Currently, only two states, Minnesota and Michigan, require doctors to report Cronobacter cases, which may be diagnosed more generically as sepsis or meningitis, conditions that can result from an infection.
In 2022, the CDC investigated that four babies were sickened, and two died from consuming formula produced at a facility in Sturgis, Michigan. The incidents triggered an extensive investigation by the FDA and ultimately stopped production at the facility for months. The shutdown worsened ongoing supply chain issues and threw the country into a nationwide shortage.
Ultimately, the FDA and the CDC could find no genetic links between Cronobacter samples from the facility and the bacteria found in the water and powder used to mix the formula the infants had consumed.
In recent months, Gerber infant formula, Enfamil baby formula, and Abbott baby formulas have been recalled due to concerns over the same kind of contamination.
Cronobacter is found naturally in the environment, including in water, soil, and dry foods such as powdered infant formula. According to the FDA, Cronobacter infections are rare but can be deadly for infants, particularly those “younger than two months old, premature, immunocompromised, or of low birthweight.”
Cronobacter can survive in these harsh environments for extended periods, making it difficult to control and eliminate. According to the CDC, the germ is known to cause severe sepsis or meningitis in newborns.
“The first symptoms of Cronobacter infection in infants are usually a fever, accompanied by poor feeding, excessive crying or very low energy,” the North Carolina Department of Health and Human Services noted. “If your child is experiencing these symptoms, you should notify your child’s medical provider and seek medical care for your child immediately.”
CNN Wire contributed to this report.