CDC Warns Doctors to Watch out for Melioidosis, Rare Tropical Disease Now Found in 4 States

The Centers for Disease Control and Prevention (CDC) said Monday it is warning doctors to watch out for symptoms of a rare and serious bacterial infection known as melioidosis, after a fourth case of the disease was recently confirmed in the U.S.

So far, the CDC said four cases of the illness have been confirmed among adults and children in Georgia, Kansas, Minnesota and Texas, and two of the patients have died.

But what's puzzling health officials is that the disease—which is endemic to tropical and subtropical climates in Southeast Asia and northern Australia—is typically contracted via travel. However, none of the four individuals who have recently been infected have traveled internationally.

On Monday, the CDC said the most likely cause of infection is through an imported product, such as a food or drink, personal care or cleaning products or medicine, or an ingredient in one of those types of products. The agency said the bacterial strains that sickened each of the four patients closely match each other, suggesting there is a common source for the cases.

Now, the CDC is asking clinicians to watch for any acute bacterial infections that do not respond to normal antibiotics, and to consider melioidosis as a diagnosis, regardless of whether a patient has traveled outside of the U.S.

"CDC also urges clinicians not to rule out melioidosis as a possible diagnosis in children and those who were previously healthy and without known risk factors for melioidosis," the agency said in a statement.

Symptoms of melioidosis vary depending on the type of infection and it can at first be mistaken for other diseases. An image of Burkholderia pseudomallei, the bacteria that causes the infectious illness, melioidosis. Smith Collection/Gado/Getty Images

Melioidosis is an infectious disease caused by the bacteria Burkholderia pseudomallei which is found in contaminated water and soil. The main routes of infection are through inhalation of contaminated dust or water droplets, ingestion of contaminated water or soil-contaminated food, and contact with contaminated soil, particularly when the individual has skin abrasions.

Symptoms of melioidosis vary depending on the type of infection, and it can at first be mistaken for other diseases, such as tuberculosis. Among the four recently sickened patients, symptoms included cough, shortness of breath, weakness, vomiting, fever, and rash on the abdomen and face.

The CDC has warned that while healthy people can contract the disease, underlying health issues, such as kidney disease, diabetes and excessive alcohol use, can increase risk of serious illness.

The first victim was identified in March in Kansas and died of the disease, while the most recent victim was identified after dying in a hospital last month in Georgia. Two of the patients, including one who died, had risk factors such as chronic obstructive pulmonary disease and cirrhosis, while the two other patients had no risk factors.

The CDC said it has collected and tested over 100 samples from products, soil, and water in and around the four patients' homes. So far, no samples have come back positive for the bacteria.

"Unlike the germs that cause most foodborne outbreaks, the bacteria responsible for melioidosis can take two to three weeks to make someone sick. This expands the window of time that investigators need to explore and means people may be less likely to remember everything they were exposed to before becoming ill," the CDC said Monday.