What is
Cronobacter?

Cronobacter sakazakii is a germ that can live in very dry places. Cronobacter has been found in dry foods, like powdered infant formula, powdered milk, herbal teas, and starches. It has also been found in wastewater. 

Cronobacter infections are often very serious for babies; they can die. Cronobacter infection can also be very serious for older people and people whose bodies have trouble fighting germs, like people with HIV, organ transplants, or cancer.

Cronobacter sakazakii is not included in the U.S. Centers for Disease Control and Prevention’s (CDC) list of pathogens reported by hospitals, healthcare providers, and laboratories.

Not having mandatory reporting of the Cronobacter bacteria slows down outbreak investigations and delays getting tainted food off of store shelves. Lack of reporting also reduces the ability to properly discover incidents, identify clusters of illnesses, track down root causes of outbreaks,
and medically treat sick babies.

STOP is currently appealing to the FDA, the CDC, and the Council of State and Territorial Epidemiologists to add Cronobacter sakazakii to the Nationally Reportable Disease List.
Help us fight for an urgent and expedited response - sign the petition today:

Cronobacter illness is very rare,
but it is often deadly in young infants, occuring in the first days or weeks of life.

Typically, the CDC is informed of about 2­–4 cases of Cronobacter illness in infants each year, but reporting isn’t required in the US, except for in Minnesota. As a result, rates of Cronobacter infection in the United States are not well understood.

What are the symptoms
of a Cronobacter illness?

Sicknesses from Cronobacter look different depending on the person.

  • The first symptom of Cronobacter infection in infants (0–1 year old) is usually a fever, accompanied by poor feeding, excessive crying, or very low energy. Some infants may also have seizures. Infants with these symptoms should be seen by a medical provider as soon as possible.
  • Cronobacter germs can cause a dangerous blood infection (sepsis) or make the linings surrounding the brain and spinal cord swell (meningitis). Infections in infants usually occur in the first days or weeks of life. Infants 2 months of age and younger are most likely to develop meningitis if they are infected with Cronobacter.

Babies
(less than 1 year old)

  • In babies, especially babies less than 2 months old, Cronobacter germs usually get in the blood or make the lining of the brain and spine swell (meningitis).
  • Sickness from Cronobacter in babies will usually start with a fever and poor feeding, crying, or very low energy. Some babies may also have seizures. Babies with these symptoms should be taken to a doctor.
  • Babies with meningitis may develop serious, long-lasting problems in their brains. Up to 4 out of 10 babies with meningitis from Cronobacter can die.

People of all ages

  • Cronobacter can cause problems in cuts, scrapes, or places where people have had surgeries.
  • Cronobacter can also get into your urinary tract.
  • Older people and people with weakened immune systems (for example, people being treated with immune-suppressing drugs for cancer, organ transplants, or other illnesses, or those with HIV infection or genetic conditions that affect the immune system) may also get Cronobacter in their blood.
Almost all babies with Cronobacter have been fed powdered infant formula. Almost none have been fed only breast milk or liquid formula.

How does someone
get Cronobacter?

Cronobacter, which used to be called Enterobacter sakazakii, is a germ that can live in very dry places. Cronobacter has been found in dry foods, like powdered infant formula, powdered milk, herbal teas, and starches. It has also been found in sewer water.

How is it spread?

Sometimes powdered formula gets germs in it while it is being made at the factory. Other times, Cronobacter can get into powdered infant formula after it is opened at home or somewhere else.

Since Cronobacter germs live in the environment, there might be other ways babies can catch it. We do not know if Cronobacter infection can be spread from one person to another, but other types of bacteria spread this way, especially in hospitals if people do not wash their hands well.

How does powdered infant formula become contaminated with cronobacter?

Powder milk for baby and blue spoon on light background close-up. Milk powder for baby in measuring spoon on can. Powdered milk with spoon for baby. Baby Milk Formula and Baby Bottles. Baby milk formula on kitchen background

Powdered infant formula is not sterile. Manufacturers report that, using current methods, it is not possible to produce sterile powdered infant formula. At the factory, Cronobacter could get into formula powder if contaminated raw materials are used to make the formula, or if the formula powder touches a contaminated surface in the manufacturing environment.

Powdered infant formula can also be contaminated at home or elsewhere after the container is opened. For example, Cronobacter could get into the formula if formula lids or scoops are placed on contaminated surfaces and later touch the formula, or if the formula is mixed with contaminated water or in a contaminated bottle.

How do I know
if I have
a Cronobacter infection?

Cronobacter infection is diagnosed by a laboratory culture.

If a Cronobacter infection is diagnosed by a laboratory culture in an infant, CDC encourages physicians, hospitals, and laboratories to inform their local or state health department.

How is Cronobacter infection Managed?

Infants suspected of having Cronobacter sepsis or meningitis should undergo a full clinical evaluation for sepsis, including blood culture, urine culture, and cerebrospinal fluid culture, and should be given empiric therapy for sepsis immediately.

Antimicrobial sensitivity patterns of Cronobacter isolates should be determined because multidrug-resistant strains have been reported. Brain imaging studies of infants with meningitis can help detect brain abscesses and other complications. People with urinary tract infections or serious wound infections should also be treated with antibiotics. If a patient is colonized, rather than infected, with Cronobacter, treatment is not needed.

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STOP is currently appealing to the FDA, the CDC, and the
Council of State and Territorial Epidemiologists to add
Cronobacter sakazakii to the Nationally Reportable Disease List. 
Sign this petition today and help us fight for an urgent
and expedited response.

check out more from the CDC