Melioidosis (Burkholderia pseudomallei)

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Melioidosis (Burkholderia pseudomallei)

Melioidosis, also known as Whitmore’s disease, is an infectious disease found in soil and water. Humans and animals can become infected through direct contact with a contaminated source. It is predominately found in Southeast Asia and northern Australia, but infections have occurred around the world. People who become ill in the United States usually become infected while traveling to a country where Melioidosis is endemic.


Transmission

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Transmission

Melioidosis is transmitted to humans through: 

  • Inhalation of contaminated dust or water droplets
  • Ingesting contaminated water
  • Ingesting soil-contaminated food
  • Contaminated soil getting into skin abrasions
  • Person-to-person can occur, but is rare

Symptoms

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Symptoms

Symptoms can begin one to 21 days following exposure, but incubation can last years. Melioidosis has a wide range of symptoms and can be mistaken for other diseases, such as tuberculosis. Infections of Melioidosis can manifest in four ways 

Localized 

  • Localized pain or swelling
  • Fever
  • Ulceration
  • Abscess

Pulmonary 

  • Cough
  • Chest pain
  • High fever
  • Headache
  • Anorexia 

Bloodstream 

  • Fever
  • Headache
  • Respiratory distress
  • Abdominal pain
  • Joint pain
  • Disorientation 

Disseminated 

  • Fever
  • Weight loss
  • Stomach or chest pain
  • Muscle or joint pain
  • Headache
  • Central nervous system/brain infection
  • Seizures

Diagnosis

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Diagnosis

Melioidosis is diagnosed by laboratory test of a blood, urine, sputum, skin lesion, or abscess sample from an infected individual or detecting antibodies to the bacteria.


Treatment

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Treatment

The type of infection can determine what medication is necessary and if a patient has any comorbidities. In general, treatment starts with intravenous (within a vein) antibiotics for two to 8 weeks, followed by oral antibiotics for several months.


Treatment

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Treatment

To minimize risk in areas where the disease is widespread or endemic: 

  • Those with comorbidities, such as diabetes or chronic renal disease, should avoid contact with soil and standing water.
  • Agricultural workers should wear boots and gloves to prevent infection.
  • Health care workers can use standard precautions when treating patients with melioidosis

Exclusion Guidance

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Exclusion Guidance

General exclusions apply for other workers and those in schools. 

For additional information about melioidosis,
contact North Dakota Health and Human Services’ Public Health Division at 800.472.2180.

Resources

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Resources

1.Centers for Disease Control and Prevention. (2021, April 28). CDC Chickenpox (varicella). Centers for Disease Control and Prevention. Retrieved June 21, 2023, from https://www.cdc.gov/chickenpox/index.html.

2.Kimberlin, D. W., Barnett, E. D., Lynfield, R., Sawyer, M. H. (2021) Red Book: 2021-2024 Report of the Committee on Infectious Diseases. 32nd ed. American Academy of Pediatrics. [Management and Prevention of Infectious Diseases; Chickenpox] [pages 831-843]

08/23/24