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Melioidosis cases increase slightly in US
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About two-thirds of reported melioidosis cases in the United States between 2008 and 2013 involved people who traveled abroad to areas where the disease is endemic, according to research published in MMWR. Some of the areas with the highest endemicity include northern Australia, northeast Thailand, Singapore and much of the Indian subcontinent.
“Melioidosis is a bacterial infection caused by Burkholderia pseudomallei (formerly known as Pseudomonas pseudomallei or Whitmore’s bacillus), which is found in many tropical regions of the world,” Tina J. Benoit, MPH, epidemiologist in the division of high-consequence pathogens and pathology, National Center for Emerging and Zoonotic Infectious Diseases at the CDC, and colleagues wrote. “B. pseudomallei have been designated as a tier 1 overlap select agent, which can affect humans and animals. Select agents have the potential to pose a severe threat to public, animal, or plant health or to animal or plant products.”
Pneumonia is the most common clinical presentation of melioidosis, although those with the disease also may experience ulcers and other skin lesions, sepsis and gastrointestinal ulceration. The disease may be hard to diagnose because symptoms can resemble those of tuberculosis and other diseases, the researchers wrote.
U.S. jurisdictions are not required to report melioidosis cases to the Bacterial Special Pathogens Branch (BSPB) of the CDC; therefore, reports are received on a voluntary basis. Of the 47 suspected infections reported to the BSPB during the study period, 37 were confirmed by laboratory testing, including 34 in humans, two in macaques and one in an iguana.
Eleven confirmed melioidosis cases were detected in California, with no more than two cases reported in any other state. There were 261 people who were identified as at-risk for exposure to B. pseudomallei due to occupational activities, according to the researchers, but none of these ultimately led to infections. Three people with no history of travel to areas where melioidosis is endemic were infected.
“The small number of melioidosis cases reported in the United States has been increasing slightly each year since 2008,” Benoit and colleagues wrote. “This might reflect an increase in travel to locations endemic for melioidosis with patients developing disease after their return to the United States or could represent unidentified foci of locally acquired B. pseudomallei infections in the United States.
“Given the slight increase in the number of melioidosis cases reported since 2009, melioidosis might be considered an emerging disease in the United States, and standardized reporting could enable a better understanding of the incidence and prevalence of the disease in the United States.” – by David Jwanier
Disclosure: Infectious Disease News was unable to confirm relevant financial disclosures at the time of publication.
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