HWN Suggests

A forgotten disease

Diagnosis is difficult, as symptoms of the infection mimic those of many other diseases. To confirm melioidosis, a bacterial culture test, where bacteria are isolated from blood, sputum or urine of suspected cases is still employed. Results can take several days to come back, by which time, the patient has often died from the infection... Despite the global burden of melioidosis, the disease is not well recognized. The impacts of the condition are likely to worsen as rates of diabetes, which is a major risk for melioidosis, increase in low- and middle-income countries. Climate change may also affect the disease, as cases have clustered with severe weather events.

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  Melioidosis Explained: A Rare but Dangerous Disease

Melioidosis is a rare but deadly disease caused by Burkholderia pseudomallei, a bacterium found in soil and water in tropical regions. Symptoms include fever, coughing, soreness in the chest area, and loss of body mass. The disease is also known as Whitmore’s disease after Alfred Whitmore, who discovered the disease-causing bacteria... Ceftazidime, given every 6 to 8 hours, or meropenem, administered every 8 hours, are common choices for intravenous therapy.

 A New Rapid Diagnostic for Melioidosis

Symptoms of melioidosis overlap with other viral and parasitic diseases which has made it difficult to diagnose, and, in turn, hindered treatment efforts. Melioidosis is frequently misdiagnosed as sepsis, and the standard therapies used to treat sepsis are ineffective for B. pseudomallei.

 What is melioidosis and why do cases spike after flooding and heavy rainfall?

Melioidosis is a rare but potentially fatal bacterial disease which occurs when people have significant contact with contaminated water or soil.

Articles of Interest

Potentially Deadly Bacteria Detected in U.S. Soil for First Time

The bacteria, Burkholderia pseudomallei, was found along the Gulf Coast region of Southern Mississippi. Previously, it had been detected in parts of Asia and Australia.

This Germ Can Live Decades In Distilled Water, Kill Humans In 48 Hours

Melioidosis is a disease that strikes fear in those who've heard of it. Doctors in Southeast Asia and Northern Australia know it as a stubborn, potentially deadly infection that causes pneumonia, abscesses and, in the most severe cases, organ failure. Without treatment, it can kill within 48 hours. Military officials worry it could be converted into an agent of terror. But for decades, melioidosis seems to have lurked under the radar of global public health organizations. "For everybody, it was a disease of southeastern Asia and Australia," says Dr. Eric Bertherat of the World Health Organization. "But we are discovering that this disease is present in many other regions worldwide."

A Rare Case of Melioidosis in the Bronx

Melioidosis is caused by a gram-negative bacillus Burkholderia pseudomallei (B. pseudomallei), which is found in water and soil in endemic areas. There are indicators that B. pseudomallei is increasing in endemic regions and expanding into new locations. It is unclear whether this is because of expanded boundaries or improved detection capabilities. It is even theorized to be endemic in certain parts of the USA. The most common medical risk factor is diabetes mellitus, and it frequently presents as acute pneumonia, and often progresses to bacteremia.

Contaminated water, soil tied to rare tropical disease melioidosis in 3 men in same Mississippi county

Over a 3-year period, three men in Mississippi were infected with a newly identified strain of the bacterium that causes melioidosis after contact with contaminated water and soil, the first known cases of environmental transmission in the continental United States...

Diseases: Viet Nam’s Time Bomb

Melioidosis has the unpleasant ability to lie dormant in a victim for as long as six years. When it flares up, death occasionally follows within a few days or weeks. The “Vietnamese time bomb,” as it has been grimly nicknamed, can be effectively treated by Chloromycetin. The drug, which is used against typhoid, must be given in large doses for at least a month. The prolonged period is essential but not without risk of side effects (including possibly fatal anemia). Since little or no effect is noted at the beginning of treatment, the doctor must be confident enough of his diagnosis to continue the dosage.

Here’s what you need to know about melioidosis, the deadly infection that can spread after floods

The bacteria that causes the disease, Burkholderia pseudomallei, is a hardy bug that lives around 30cm deep in clay soil. Events that disturb the soil, such as heavy rains and floods, bring B. pseudomallei to the surface, where it can enter the body through through a small break in the skin (that a person may not even be aware of), or by other means. Melioidosis may cause an ulcer at that site, and from there, spread to multiple sites in the body via the bloodstream. Alternatively, the bacterium can be inhaled, after which it travels to the lungs, and again may spread via the bloodstream. Less commonly, it’s ingested.

Laboratory diagnosis of melioidosis: Past, present and future

Melioidosis is an emerging, potentially fatal disease caused by Burkholderia pseudomallei, which requires prolonged antibiotic treatment to prevent disease relapse. However, difficulties in laboratory diagnosis of melioidosis may delay treatment and affect disease outcomes. Isolation of B. pseudomallei from clinical specimens has been improved with the use of selective media. However, even with positive cultures, identification of B. pseudomallei can be difficult in clinical microbiology laboratories, especially in non-endemic areas where clinical suspicion is low.

Melioidiosis Fact Sheet

Melioidosis, also called Whitmore's disease, is an infectious disease caused by the bacterium Burkholderia pseudomallei. Melioidosis is clinically and pathologically similar to Glanders disease, but the ecology and epidemiology of Melioidosis are different from Glanders disease. The bacteria causing Melioidosis are found in contaminated water and soil and are spread to humans and animals through direct contact with the contaminated source. Glanders is contracted by humans from infected domestic animals.

Melioidosis

Burkholderia pseudomallei is a Gram-negative environmental bacterium and the aetiological agent of melioidosis, a life-threatening infection that is estimated to account for ~89,000 deaths per year worldwide. Diabetes mellitus is a major risk factor for melioidosis, and the global diabetes pandemic could increase the number of fatalities caused by melioidosis. Melioidosis is endemic across tropical areas, especially in southeast Asia and northern Australia.

Melioidosis: An Emerging Infection with Fatal Outcomes

According to the Centers for Disease Control and Prevention, from being nonendemic for melioidosis, India has now become endemic for the disease since 2012. Until then, melioidosis cases were being reported sporadically from India. There have been isolated case reports from few states across the country for the past few years. Most of the times, Burkholderia pseudomallei may be misreported as Pseudomonas species, especially in resource-poor laboratories. Due to its varied clinical presentation, the specific clinical diagnosis can be difficult, thereby making laboratory diagnosis mandatory.

Melioidosis: An updated review

The clinical features of melioidosis mimic many other diseases (eg sepsis/septic shock, community-acquired pneumonia [CAP] and tuberculosis), resulting in frequent misdiagnosis of the condition. Consequently, melioidosis is known as the ‘great mimicker’.

Melioidosis: Epidemiology, Pathophysiology, and Management

Melioidosis, caused by the gram-negative saprophyte Burkholderia pseudomallei, is a disease of public health importance in southeast Asia and northern Australia that is associated with high case-fatality rates in animals and humans. It has the potential for epidemic spread to areas where it is not endemic, and sporadic case reports elsewhere in the world suggest that as-yet-unrecognized foci of infection may exist.

Travel-associated melioidosis: a narrative review

This burden of disease is at a level similar to that of recognized neglected tropical diseases such as intestinal nematodiasis, leptospirosis and schistosomiasis. Despite this, melioidosis probably remains underdiagnosed in many geographical areas. Melioidosis is known to be endemic in nearly 50 countries worldwide, with countries in Southeast Asia accounting for the largest burden of disease

Resources

Burkholderia pseudomallei

Burkholderia pseudomallei is a Gram negative, facultative intracellular bacterium that resides in the rhizosphere of tropical soils. B. pseudomallei causes melioidosis, which is transmitted by cutaneous entry, ingestion, or inhalation of contaminated soil or water. Infection with B. pseudomallei can cause a wide array of clinical symptoms such as pneumonia, bone, joint, skin, genitourinary, and central nervous system infections, as well as parotid abscesses in children.

CDC

Melioidosis is a bacterial infection in people and animals. Melioidosis is spread through contact with contaminated soil, air, or water. Cases may increase after hurricanes, heavy rain, and other severe weather events. The disease is often confused for other conditions, making diagnosis difficult.

GARD

Melioidosis is an infectious disease caused by the bacteria Burkholderia pseudomallei that are commonly found in the soil and water. Melioidosis is a rare disease in the United States, but it is common in tropical or subtropical areas of the world, including Southeast Asia, Africa, and Australia. The signs and symptoms of the disease can vary greatly and may mimic those of tuberculosis or common forms of pneumonia.