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Symptoms Of Melioidosis Explained Amid CDC Warning About ... - Newsweek

Doctors in the U.S. Have been told to look out for melioidosis symptoms after two people died from the rare infectious disease.

The U.S. Centers for Disease Control and Prevention (CDC) has confirmed four cases of melioidosis, which is also known as Whitmore's disease, among both adults and children in four states: Kansas, Georgia, Texas and Minnesota.

Two of the patients have no underlying health conditions. Diabetes, liver disease, renal disease, thalassemia, cancer, and chronic lung diseases can make people more susceptible to melioidosis.

Melioidosis symptoms are wide-ranging and can vary depending on the type of infection.

This means that the disease can be easily mistaken for other, more common illnesses, such as pneumonia, bronchitis, or tuberculosis.

Symptoms of a localized melioidosis infection include localized pain and swellings, fever, ulcers, and abscesses.

A pulmonary melioidosis infection, meanwhile, can cause completely different symptoms, such as a cough, chest pain, high fever, headache, and anorexia.

A melioidosis bloodstream infection can manifest itself as disorientation, a headache, fever, joint pain, respiratory discomfort, or abdominal pain.

Symptoms of a disseminated melioidosis infection include a fever, headache, weight loss, pains in the stomach, chest, muscles or joints, seizures, or an infection of the brain or central nervous system.

The bacteria that causes melioidosis, Burkholderia pseudomallei, can take weeks to make an infected person sick.

Melioidosis cases are rare in the U.S., with the disease more common in Australia and Southeast Asia. Most cases of melioidosis in the U.S. Tend to involve people who have recently visited these areas, but none of the four people who have been infected have traveled internationally.

Despite their geographical spread, genome sequencing suggests that the cases may be linked by a common source, the CDC has said.

Burkholderia pseudomallei is normally found in water or moist soil, but the CDC says it's possible that the bacteria could have contaminated food, drinks, medication, personal care or cleaning products.

However, of more than 100 samples extracted from products, soil and water and from around the four patients' homes, none have yet tested positive for the bacteria.

People can become infected by inhaling it in the form of dust or water droplets, ingesting it, or absorbing it through cuts on the skin.

The CDC says that it is "very rare" for people to get the disease from another person.

Melioidosis treatment commonly begins with between two and eight weeks of intravenous antimicrobial therapy, using either ceftazidime or meropenem.

This is usually followed by up to six months of oral antimicrobial therapy, using either trimethoprim-sulfamethoxazole or co-amoxiclav.

A close-up of the bacteria Burkholderia pseudomallei, which causes melioidosis, on a medium of chocolate agar. The bacteria can be inhaled, ingested or absorbed through cuts in the skin. A close-up of the bacteria Burkholderia pseudomallei, which causes melioidosis, on a medium of chocolate agar. The bacteria can be inhaled, ingested or absorbed through cuts in the skin. Smith Collection/Gado/Getty Images

Rare But Deadly Melioidosis Is A New Infectious Disease Threat

An analysis of soil and water samples in the southern United States has revealed the presence of a rare bacteria called Burkholderia thailandensis that is capable of causing potentially serious infections.

Investigators detected the microbe in water in Texas and Puerto Rico and soil in Mississippi, making it a public health risk, according to a recent report in Emerging Infectious Diseases, a publication from the Centers for Disease Control and Prevention (CDC).

This bacterium is closely related to Burkholderia pseudomallei, which can cause melioidosis, a disease with a fatality rate of 10 to 50 percent, according to the CDC. Although considered less virulent, B. Thailandensis can make people severely ill.

When Was Melioidosis First Discovered in the U.S.?

In 2022, the CDC put out a melioidosis health advisory after the first discovery of B. Pseudomallei in the environment in the continental United States. It was identified through sampling of soil and water in the Gulf Coast region of southern Mississippi during an investigation of two human melioidosis cases. A third case in Mississippi was identified in January of this year.

While the federal health agency is still investigating how widespread the bacteria are within the continental United States, the latest version of the CDC Yellow Book, which provides guidance for travel medicine, now warns that melioidosis is locally endemic in areas of the Mississippi Gulf Coast. Also, a May 2023 CDC report alerted laboratory staff that they may face an increased risk for B. Pseudomallei exposure.

Why Happens if You Get Melioidosis?

While rare, melioidosis is garnering attention because it is so dangerous. The discovery in the United States of the microorganisms that cause this disease was an unpleasant surprise.

"This is an environmental bacteria that is associated usually with freshwater and swampy areas, typically in Southeast Asia and northern Australia," says William Schaffner, MD, an infectious disease specialist and professor of preventive medicine and health policy at the Vanderbilt University School of Medicine in Nashville, Tennessee. "To have melioidosis show up here in the United States along the Gulf Coast is pretty unusual."

Dr. Schaffner stresses that the disease can be very serious. According to the Cleveland Clinic, the illness can cause fever, weight loss, vomiting, stomach or chest pain, muscle or joint pain, headache, seizures, and rash on the trunk, abdomen, or face. It can infect the lungs, skin, and blood and affect many organs at once, including the heart, brain, liver, kidneys, joints, and eyes.

In severe cases, the disease may lead to pneumonia, multiple abscesses (collections of pus accompanied by swelling and inflammation), and life-threatening septicemia (blood infection).

How Is Melioidosis Treated?

Doctors generally prescribe a long course of antibiotics for melioidosis. Treatment generally starts with intravenous (within a vein) antimicrobial therapy for a minimum of two weeks (but up to eight weeks depending on extent of infection), followed by three to six months of oral antimicrobial therapy.

Prompt diagnosis can improve the chances of recovery. Schaffner suggests that a person who shows symptoms and lives in the Gulf Coast may want to request a lab test to confirm whether the illness is melioidosis.

"The microbiology laboratory is your friend," he says. "Once we have the appropriate diagnosis, then we can treat you."

How Do People Get Melioidosis?

Humans may develop melioidosis by inhaling contaminated dust or water droplets, swallowing contaminated water, ingesting soil-contaminated food, or exposing skin abrasions or open wounds to contaminated soil.

The CDC emphasizes that the disease rarely spreads person-to-person.

Specific health conditions such as diabetes, chronic kidney disease, chronic lung disease, or excessive alcohol use may put some individuals at higher risk, the CDC notes. Schaffner points out that drinking to excess can cause chronic liver impairment, which leaves a person susceptible to serious sickness.

How Can You Reduce the Risk of Getting Melioidosis?

Environmental conditions of the Gulf Coast states appear to be conducive to the growth of the bacteria that cause melioidosis. For those who live in that area, the CDC recommends these precautions:

Wear waterproof boots when gardening or doing yard work or agricultural work, particularly after flooding or storms, to prevent infection through the feet and lower legs.

Avoid contact with soil or muddy water, especially after heavy rains, and protect open wounds with waterproof dressings.

Wear gloves to safeguard the hands when working directly with soil.

In addition, CDC health authorities note that a cluster of four melioidosis cases in four U.S. States in 2021 were linked to an imported contaminated aromatherapy spray.

Because injuries can open the door to severe infection, Schaffner advises thoroughly washing any injury (such as a cut or abrasion) with soap and water and seeking medical attention.

"If you start to see an infection develop at your local site of injury, definitely have it looked at," he says.

CDC Warns Of Rare, Deadly Bacterial Disease Melioidosis Found In ... - UPI

A bacteria that causes a rare but serious disease has been discovered in soil and water samples in the Gulf Coast region of Mississippi after two people who live near each other fell ill.

In a notice issued Wednesday, the U.S. Centers for Disease Control and Prevention advised Gulf Coast residents, particularly those with certain health conditions, to take precautions against Burkholderia pseudomallei and prevent a disease it causes called melioidosis.

Symptoms of melioidosis can include fever, joint pain and headaches. It can also cause pneumonia, abscesses and blood infections.

Melioidosis is fatal in about 10% to 50% of people who are infected worldwide, and it typically surfaces in tropical and subtropical areas, such as South and Southeast Asia, northern Australia, Puerto Rico and parts of Central and South America.

Unfortunately, the environmental conditions found in the Gulf Coast states are conducive to the growth of this bacteria, the CDC noted.

Though it is a serious illness, risk to the general population still remains low, the CDC added.

One of the two known cases happened in 2022. The other occurred two years earlier. That they lived in close geographic proximity but were unrelated to each other prompted state health officials and the CDC to test household products, soil and water in and around both patients' homes, with their permission.

Three of the samples from soil and puddle water in 2022 tested positive for the bacteria. Public health officials now believe the bacteria has been present in the area since at least 2020.

People who live in that area and have health conditions such as diabetes, chronic kidney disease, chronic lung disease or consume excessive amounts of alcohol should avoid contact with soil or muddy water, especially after heavy rains, the agency said.

They should protect open wounds with waterproof dressings, and protect against infection in the feet and lower legs by wearing waterproof boots whenever gardening, doing yard work or doing agricultural work. Wear gloves to protect hands if working with soil, the CDC said.

The agency is alerting clinicians throughout the country that they should check for melioidosis when patients appear with symptoms consistent with the condition.

Melioidosis is caused by direct contact with the bacteria. While about a dozen people in the United States contract it each year, most have recently traveled to a country where it is endemic. The illness has also been linked to contaminated commercial products imported from disease-endemic countries, including a 2021 case involving imported contaminated aromatherapy spray that sickened four people in four states.

The CDC and its partners will continue to investigate the geographic spread of the bacteria.

More information

The Genetic and Rare Diseases Information Center has more on melioidosis.

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