CDC Warns of Melioidosis, Tropical Disease That Has Killed Two. Should Americans Be Worried?

Earlier this week, the Centers for Disease Control and Prevention (CDC) released a statement confirming a new fatal case of a rare and serious disease called melioidosis in Georgia.

The CDC said the case is linked to three previous cases in different states, including Kansas, Texas and Minnesota, one of whom died.

But should the average American be concerned about the recent emergence of melioidosis cases?

According to Daniel Lucey, M.D., a fellow of the Infectious Disease Society of America, the answer is no.

"The average American does not need to be worried at this time about being exposed to the bacteria that causes melioidosis because there have been only a total of four patients with this infection in four states over the past five months," Lucey told Newsweek.

Melioidosis is an infectious disease caused by the bacteria, Burkholderia pseudomallei, which can affect humans and animals.

The bacteria can be found in contaminated water and soil. Infections occur when humans and susceptible animals come into direct contact with contaminated material, according to the CDC.

For example, contaminated dust or water droplets can be inhaled, and contaminated water or food containing small bits of contaminated soil can also be ingested. In addition, infections may occur when skin abrasions come into contact with contaminated soil.

"Burkholderia pseudomallei is a hardy organism. It normally exists in environmental soil and water in endemic areas. It can also survive for well over a decade in distilled water and even in some common beverages for days to weeks," T. Eoin West, a professor of medicine at the University of Washington, told Newsweek.

The fatality rate for the disease is high, ranging widely between 10 and 50 percent depending on the specific set of symptoms that a patient experiences, although some people are at higher risk than others.

"Melioidosis is most commonly an infection of patients with underlying medical conditions," West said. "For example, diabetes is a major risk factor. However, infection can occur in patients without underlying medical conditions."

Melioidosis is endemic to tropical and subtropical climates, being particularly prevalent in Southeast Asia and northern Australia. Around a dozen cases of the disease are recorded in the United States every year, usually in people who have returned to the country from these areas.

But none of the four cases recently identified by the CDC had reported traveling internationally. The health agency said, though, that the bacterial strains that infected the individuals closely matched each other, indicating that there was a common source.

The bacterial strains appear to be closely related to those found in Asia, particularly South Asia.

"So far the explanation is not known for why all four patients are reported by the CDC to have a closely matched strain of the bacteria that is closely related to strains particularly in South Asia. It is an enigma that must be solved soon," Lucey said.

The CDC has collected and tested more than 100 samples from soil, water and products in and around the homes of the four individuals. But none have tested positive for the B. pseudomallei bacteria.

At present, the agency believes the most likely source of the infections is an imported product—such as a food, drink, personal care or cleaning product, or a medicine. While the bacteria is normally found in water and moist soil, it has also been documented in wet or moist products in areas where it is prevalent.

Despite this, Lucey said there is no need to introduce restrictions on any products coming into the United States.

"At this time, given the rarity of this unexplained infection, there is no scientific basis for restricting use in the U.S. of any specific products whether food or drink, personal care or cleaning products or medicine," he said.

While the average American doesn't need to be overly concerned about melioidosis, associate professor Direk Limmathurotsakul, with the Mahidol-Oxford Tropical Medicine Research Unit and Faculty of Tropical Medicine, Mahidol University, Thailand, said people should stay aware of the disease, adopt "recommended preventive behaviors" and follow the information from the CDC as it becomes available.

As recommended by the CDC, "people should use protective gear such as rubber gloves and boots when in direct contact with soil, consume clean water for drinking as recommended during the COVID-19, and avoid using or consuming uncertified imported products," Limmathurotsakul said.

"If you are uncertain about your imported products, it is better to wait, follow the CDC for updated information, and decide later."

According to West, melioidosis is probably under-recognized in much of the world but over 160,000 cases are estimated to occur each year globally.

"To the best of my knowledge, B. pseudomallei has never been found in the environment in the continental U.S. However, B. pseudomallei has been isolated from the environment in Puerto Rico and several cases of melioidosis have been reported there.

"Even in areas where the disease is not known to be endemic, it is important for clinicians to consider melioidosis as a diagnostic possibility when circumstances suggest it because optimal treatment of the infection requires prompt administration of specific antibiotics, usually for several months duration," he said.

The CDC is asking clinicians to consider melioidosis as a possible diagnosis even in people who have not traveled outside of the United States.

An illustration of bacteria
Stock image showing an artist's illustration of several bacterium. Melioidosis is an infectious disease caused by the bacteria, Burkholderia pseudomallei. iStock