This article is more than 5 years old. Information may no longer be current.
Global burden of lethal B. pseudomallei ‘substantial, increasing’
Click Here to Manage Email Alerts
Melioidosis — a difficult-to-diagnose disease caused by the highly pathogenic bacterium Burkholderia pseudomallei — is likely endemic in far more countries than previously believed, according to a study published in Nature Microbiology.
When treated with ineffective antibiotics, melioidosis has a fatality rate exceeding 70%, according to researchers. B. pseudomallei is often found in the soil in Southeast Asia and northern Australia.
“Knowledge about the global burden of melioidosis and its potential to become established in nonendemic areas is poor,” Direk Limmathurotsakul, MD, PhD, of the Wellcome Trust Centre for Human Genetics at the University of Oxford, and colleagues wrote. “Previous maps of melioidosis simply displayed countries that had reported melioidosis cases and therefore provided no information on areas where melioidosis could be endemic but undiagnosed.”
Limmathurotsakul and colleagues mapped 22,338 documented human and animal melioidosis cases worldwide in addition to published reports of B. pseudomallei. These data were combined with a statistical modeling framework to estimate the global burden of the disease.
The researchers estimated that up to 165,000 people (95% CI, 68,000-412,000) among the 3 billion living in endemic areas developed melioidosis in 2015. Deaths last year were estimated at 89,000 (95% CI, 36,000–227,000), with the highest risk zones identified in Southeast and South Asia, tropical Australia, Western sub-Saharan Africa and South America. Risk zones of varying size also were seen in Central America, Southern Africa and the Middle East. According to the researchers, high rainfall and temperature, as well as anthrosol and acrisol soil types, are strongly associated with the presence of B. pseudomallei.
The researchers predicted that only 40% of all melioidosis cases occur in East Asia and the Pacific region, where the disease is considered highly endemic. Conversely, 44% of the burden falls on South Asia, due to large populations living in areas contaminated with B. pseudomallei, they said. Overall, the researchers identified 45 countries in which melioidosis is known to be endemic but underreported, and 34 additional countries where the disease is probably endemic but has never been reported.
“The global burden of melioidosis is likely to be substantial and increasing due to population and pathogen movements increasing the likelihood of establishment in new areas, fueled by an increase in anthrosol and the marked rise in the prevalence of diabetes mellitus globally,” Limmathurotsakul and colleagues wrote. “This wide and potentially increasing geographical distribution and burden, combined with the high [case fatality rate], particularly when melioidosis patients are undiagnosed and treated with ineffective antimicrobials, highlight the need for public health officials and policymakers to raise the priority of this disease.” – by Jason Laday
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts