Melioidosis, Northeastern Brazil

Rolim, Dionne Bezerra; Vilar, Dina Cortez Feitosa Lima; Sousa, Anastácio Q.; Miralles, Iracema Sampaio; Oliveira, Diana Carmen Almeida de; Harnett, Gerald B.; O'Reilly, Lyn C.; Howard, Kay; Sampson, Ian A.; Inglis, Timothy J. J.

doi:10.3201/eid1209.050493

Cited by 18 publications

(23 citation statements)

References 7 publications

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“…It should also be remembered that these methods need prior development and rehearsal by a regional public health reference laboratory in concert with environmental health officers, biologists and public health physicians. Best results will be obtained when all the public health stakeholders are able to prepare, plan, rehearse and deploy as a team effort, as was evidenced by investigations in Western Australia in 1997 and 1998 [23,27], and in Ceará, Brazil in 2004 and 2005 [25]. In both cases, a high degree of interagency cooperation was achieved by exemplary public health leadership and advocacy at an executive level.…”

Section: Environmental Health Investigationsmentioning

confidence: 99%

“…Only three clear-cut human outbreaks have been attributed to a single source, and the common feature was confirmed or likely contamination of a water source: in the two Australian events, it was the drinking water supply of affected communities [23,24]. In the Brazilian event, the source was an irrigation dam reservoir into which the infected subjects had dived shortly after the dam filled with early rains [25]. Porcine outbreaks occurred in Queensland after heavy rain and river flooding [26].…”

Section: Outbreaks and Case-clustersmentioning

confidence: 99%

“…It is likely that similar events go unnoticed and uninvestigated in parts of the recognized endemic zone where field investigation tools are lacking. The Brazil outbreak was particularly notable, because it affected a small group of previously healthy children [25]. The explanation for this observation is lacking; it could be due to a particularly high infective dose, an unusually virulent strain of B. pseudomallei or a genetic susceptibility.…”

Section: Outbreaks and Case-clustersmentioning

confidence: 99%

“…The porcine melioidosis case cluster in Queensland may thus have acted as an awareness raiser among veterinary and human health authorities, anticipating a whole-health approach to melioidosis control efforts in more recent years [26]. It is possible that a livestock die-off in the Tejuçuoca municipality of Ceará prior to the small melioidosis case cluster of 2004 might have been a melioidosis epizootic [25], but the absence of veterinary analysis of this livestock problem means that this interpretation remains speculative. Sporadic animal cases of melioidosis are well recognised and may have occurred elsewhere in Brazil, from recent anecdotal accounts.…”

Section: Community Measuresmentioning

confidence: 99%

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The public health implications of melioidosis

Inglis¹,

Sousa²

2009

Braz J Infect Dis

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Melioidosis, which is caused by the bacterium Burkholderia pseudomallei, is a potentially fatal tropical infection, little known outside its main endemic zone of Southeast Asia and northern Australia. Though it has received more attention in recent years on account of its claimed suitability as a biological weapon agent, the principal threat from melioidosis is a result of naturally occurring events. Occasional case clusters, sporadic cases outside the known endemic zone and infections in unusual demographic groups highlight a changing epidemiology. As melioidosis is the result of an environmental encounter and not person-to-person transmission, subtle changes in its epidemiology indicate a role environmental factors, such as man-made disturbances of soil and surface water. These have implications for travel, occupational and tropical medicine and in particular for risk assessment and prevention. Practical problems with definitive laboratory diagnosis, antibiotic treatment and the current lack of a vaccine underline the need for prevention through exposure avoidance and other environmental health measures. It is likely that the increasing population burden of the tropical zone and extraction of resources from the humid tropics will increase the prevalence of melioidosis. Climate change-driven extreme weather events will both increase the prevalence of infection and gradually extend its main endemic zone.

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Section: Environmental Health Investigationsmentioning

confidence: 99%

Section: Outbreaks and Case-clustersmentioning

confidence: 99%

Section: Outbreaks and Case-clustersmentioning

confidence: 99%

Section: Community Measuresmentioning

confidence: 99%

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The public health implications of melioidosis

Inglis¹,

Sousa²

2009

Braz J Infect Dis

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“…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 .…”

Section: Introductionmentioning

confidence: 99%

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

Macedo

Rocha

Rolim³

et al. 2012

Rev. Soc. Bras. Med. Trop.

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This report focuses on a fatality involving severe dengue fever and melioidosis in a 28-year-old truck driver residing in Pacoti in northeastern Brazil. He exhibited long-term respiratory symptoms (48 days) and went through a wide-ranging clinical investigation at three hospitals, after initial clinical diagnoses of pneumonia, visceral leishmaniasis, tuberculosis, and fungal sepsis. After death, Burkholderia pseudomallei was isolated in a culture of ascitic fluid. Dengue virus type 1 was detected by polymerase chain reaction in cerebrospinal fluid (CSF); this infection was the cause of death. This description reinforces the need to consider melioidosis among the reported differential diagnoses of community-acquired infections where both melioidosis and dengue fever are endemic.

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An allelic exchange system for compliant genetic manipulation of the select agents Burkholderia pseudomallei and Burkholderia mallei

Hamad

Zajdowicz

Holmes

et al. 2009

Gene

136

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Burkholderia pseudomallei and B. mallei are Gram-negative bacterial pathogens that cause melioidosis in humans and glanders in horses, respectively. Both bacteria are classified as category B select agents in the United States. Due to strict select-agent regulations, the number of antibiotic selection markers approved for use in these bacteria is greatly limited. Approved markers for B. pseudomallei include genes encoding resistance to kanamycin (Km), gentamicin (Gm), and zeocin (Zeo); however, wild type B. pseudomallei is intrinsically resistant to these antibiotics. Selection markers for B. mallei are limited to Km and Zeo resistance genes. Additionally, there are few well developed counter-selection markers for use in Burkholderia. The use of SacB as a counter-selection method has been of limited success due to the presence of endogenous sacBC genes in the genomes of B. pseudomallei and B. mallei. These impediments have greatly hampered the genetic manipulation of B. pseudomallei and B. mallei and currently few reliable tools for the genetic manipulation of Burkholderia exist. To expand the repertoire of genetic tools for use in Burkholderia, we developed the suicide plasmid pMo130, which allows for the compliant genetic manipulation of the select agents B. pseudomallei and B. mallei using allelic exchange. pMo130 harbors an aphA gene which allows for Km selection, the reporter gene xylE, which allows for reliable visual detection of Burkholderia transformants, and carries a modified sacB gene that allows for the resolution of co-integrants. We employed this system to generate multiple unmarked and in-frame mutants in B. pseudomallei, and one mutant in B. mallei. This vector significantly expands the number of available tools that are select-agent compliant for the genetic manipulation of B. pseudomallei and B. mallei.

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Melioidosis, Northeastern Brazil

Cited by 18 publications

References 7 publications

The public health implications of melioidosis

The public health implications of melioidosis

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

An allelic exchange system for compliant genetic manipulation of the select agents Burkholderia pseudomallei and Burkholderia mallei

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