Melioidosis is in the Americas: A Call to Action for Diagnosing and Treating the Disease

Abstract

Melioidosis, a disease caused by the pathogen , is a significant underreported endemic disease found in tropical countries worldwide. Recent studies have demonstrated that human melioidosis cases have been increasingly recognized in the Americas. Therefore, the first Scientific Reunion of Melioidosis in the Americas was organized in Colombia, with the participation of health authorities of 11 Latin American countries and the United States. This report summarizes the topics reviewed during the meeting, including how to identify human infections and properly diagnose them, with the goal of increasing recognition of the disease in the Americas.

Three New Cases of Melioidosis, Guadeloupe, French West Indies

“…Increasing occurrences have been reported in the Caribbean during the past few decades among persons with no exposure to known endemic areas (3)(4)(5). Tropical environmental conditions and the presence of this bacterium in soil samples in the Caribbean support the plausibility of endemicity (3). We describe 3 new cases detected in Guadeloupe during 2016-2017.…”

“…M elioidosis, caused by the telluric gram-negative rod Burkholderia pseudomallei, is endemic in Southeast Asia and northern Australia (1) but may be underdiagnosed in other tropical regions (2). Increasing occurrences have been reported in the Caribbean during the past few decades among persons with no exposure to known endemic areas (3)(4)(5). Tropical environmental conditions and the presence of this bacterium in soil samples in the Caribbean support the plausibility of endemicity (3).…”

“…Therefore, investigation of soil samples should be undertaken to identify the most likely sources of human infection in this area. (3). The skin test became commercially available again in 2014 after more than a decade; it is approved for adults 18-64 of age who have a history of pulmonary coccidioidomycosis (3,4).…”

Novel multi-component vaccine approaches for Burkholderia pseudomallei

“…This genomic global analysis confirmed that the Australian continent represents an early reservoir for B. pseudomallei , with the bacteria being first transmitted to southeast Asia with subsequent dissemination to South and East Asia [17]. Recent efforts to educate health professionals in countries where melioidosis has been reported [18] is expected to result in a steady increase in the awareness and better diagnosis and identification of the pathogen. Although this and other studies have provided a better understanding of the prevalence of melioidosis cases worldwide, and in many cases have demonstrated endemicity in countries where the pathogen was only sporadically detected, the full extent of the disease is still not known.…”

“…Although this and other studies have provided a better understanding of the prevalence of melioidosis cases worldwide, and in many cases have demonstrated endemicity in countries where the pathogen was only sporadically detected, the full extent of the disease is still not known. Recent efforts to educate health professionals in countries where melioidosis has been reported [18] is expected to result in a steady increase in the awareness and better diagnosis and identification of the pathogen. However, major roadblocks exist that prevent the effective determination of the burden of melioidosis, and those include diversity in the clinical manifestations, lack of basic microbiological facilities in several endemic areas, the lack of conventional bacterial identification methods and awareness and knowledge among health-care professionals and poor disease surveillance systems [2,16].…”