The Centers for Disease Control and Prevention (CDC) has issued an official health advisory for Burkholderia pseudomallei (melioidosis) infections, based on three cases that are not associated with travel, and said it is assisting the Kansas Department of Health and Environment, the Texas Department of State Health Services and the Minnesota Department of Health.
Based on genomic analysis, these three cases (one male, two females; two adults and one child) may share a potential common source of exposure, the CDC said. The first case, identified in March 2021, was fatal. Two other patients were identified in May 2021, one of whom is still hospitalized. One has been discharged to a transitional care unit. None of the patients’ families reported a history of traveling outside of the continental United States.
Melioidosis, also called Whitmore's disease, is an infectious disease that can infect humans or animals. The disease is caused by the bacterium Burkholderia pseudomallei and is primarily a disease of tropical climates, especially in Southeast Asia and northern Australia.
Melioidosis is confirmed by culture and with testing conducted by trained personnel since some automated identification methods in clinical laboratories may misidentify B. pseudomallei as another bacterium. In contrast to other healthcare personnel, laboratory staff members are at risk because some procedures may aerosolize particles and release B. pseudomallei into the air. Laboratory personnel can reduce their risk of exposure by following good laboratory practices. Laboratory staff who may have been exposed to B. pseudomallei should refer to existing CDC guidance.
Mortality varies, depending on disease severity and clinical presentation, with case fatality ranging between 10 to 50%. People with certain conditions are at higher risk of disease when they come in contact with the bacteria, the CDC said. The most common factors that make a person more likely to develop disease include diabetes, kidney disease, chronic lung disease and alcoholism.
Melioidosis is not considered to be transmitted person-to-person via air or respiratory droplets in non-laboratory settings. There have only been a few documented cases of person-to-person transmission; percutaneous inoculation is probably the most frequent route for natural infection.