Melioidosis in the Americas

Abstract

Melioidosis is a potentially severe bacterial infection caused by Burkholderia pseudomallei. There has been growing awareness of the disease in the Americas, particularly since the Vietnam conflict when it was diagnosed in returning service personnel. Accidental laboratory exposure indicates the difficulty making a culture-based diagnosis when melioidosis has not been considered in the differential diagnosis. Melioidosis is most likely underdiagnosed in tropical Central and South America where conditions are more suited to persistence of B. pseudomallei in the environment. Recent melioidosis case clusters in northeastern Brazil highlight the threat posed to rural populations located far from specialist services. Increased clinical awareness of the disease and improvements in laboratory diagnostic methods are likely to bring wider recognition of melioidosis in the Americas.

Severe coinfection of melioidosis and dengue fever in northeastern Brazil: first case report

“…Melioidosis was first diagnosed in Ceará in 2003 1,2 , and so far, 17 cases have been confirmed. Recent studies indicate that the disease is endemic in northeastern Brazil 3,4 .…”

Burkholderia pseudomallei Antibodies in Individuals Living in Endemic Regions in Northeastern Brazil

“…A seroepidemiological study was conducted from February to August, 2006, in the municipalities of Tejuçuoca and Banabuiu, 6 Ceará, where case clusters of melioidosis occurred previously. A questionnaire was administered to the participants of the study ( N = 321), who resided in one of those localities.…”

The public health implications of melioidosis

“…A clue to the wider distribution of infection comes from occasional reports of international travelers who return to developed countries with melioidosis acquired in other parts of the world [8][9][10]. The increasing trend towards adventure travel to exotic locations is expected to result in a steady increase in travelrelated melioidosis.…”

“…Possibly, the most unpredictable melioidosis risks are those to which people engaged in adventure travel may be exposed. This group includes overland trekkers, explorers of the remote tropics, field workers, exploratory mining engineers, eco-tourists, their guides, and military personnel engaged in training expeditions [8][9][10]. As their specific exposure to previously unidentified B. pseudomallei contaminated environments is difficult to anticipate, quantify or locate after the event, only general preventive personal advice can be given prior to departure.…”