Cronobacter Enterobacter Sakazakii Refreshed Warning Of The Risks To Infant Health

The US Centers for Disease Control and Prevention (CDC) have issued another warning about the severity of infections caused by the bacteria Cronobacter sakazakii [i] in their circular of April 13th, 2016  Learn about Cronobacter infection

The CDC circular was reported on by media as a ‘refreshed warning’:

The CDC warning notes that « Getting sick from Cronobacter does not happen very often, but it is often deadly in young infants. It usually occurs in the first days or weeks of life. Cronobacter bacteria can cause severe blood infections (sepsis) or meningitis (an inflammation of the membranes that protect the brain and spine). Infants 2 months of age and younger are most likely to develop meningitis if they are infected with Cronobacter. Infants born prematurely and those with weakened immune systems are also at increased risk for serious sickness from Cronobacter. »

Urgent need for mandatory reporting of these infections

There is urgency because, as CDC repeats,  « Powdered Infant Formula is Not Sterile.  Manufacturers report that, using current methods, it is not possible to get rid of all germs from powdered infant formula in the factory. Powdered infant formula can also be contaminated after the containers are opened. Very young infants, infants born prematurely, and infants whose bodies have trouble fighting off germs are at the highest risk. »

However, despite the severity of sickness, reporting is not obligatory : « Typically, CDC is informed of about 4-6 cases of sickness from Cronobacter in infants each year, but reporting isn’t required. » Therefore, while Minnesota is the only US State to require mandatory reporting, other states such as Texas  merely encourage prompt reporting :

In their « Expanded Information on Cronobacter » CDC states « 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. » But the CDC then notes that  « reporting is not required except in one state, Minnesota. As a result, rates of Cronobacter infection in the United States are not well understood. »

Given the number of cases of formula contaminated by bacteria around the world, and given the fact that there is significant under-reporting in many countries, IBFAN maintains that mandatory reporting of such cases of infection is vitally important. ‘Encouraging reporting’ is not sufficient.

Safer ways to feed your baby

First and foremost, CDC recommends breastfeeding « Breastfeed. Breastfeeding helps prevent many kinds of sicknesses among infants. »

For babies who are not breastfed the critical requirement is that manufacturers place an explicit warning notice on product labels of powdered formula. This warning must explain the risk of infection and  provide clear instructions, including preparation with water first boiled and then cooled to no less than 70°C, 158°F, to reconstitute the powdered formula.  

In 2007 the World Health Organization, WHO, issued Guidelines on safe preparation, storage and handling of powdered infant formula in six languages

This guidance is further explained in the article : Are the bacteria in formula friendly or unfriendly ?  

Forty years of lessons learned – and how many infant lives have been put at risk ?

Forty years ago, scientist John Farmer isolated an organism he identified as Enterobacter sakazakii from his dog’s bowl. This world authority on the bacteria  explains the lessons learned, the myths debunked and provides recommmendations in his article « My 40-year history with Cronobacter/Enterobacter sakazakii »


[i] Formerly called Enterobacter sakazakii