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Melioidosis is caused by Burkholderia pseudomallei bacteria found in soil and water. A person becomes ill by inhaling contaminated soil or water droplets, ingesting contaminated water, and through skin lesions. It is rarely transmitted by coming into contact with an infected person’s blood and body fluids. Depending on how it was acquired, Melioidosis can affect the lungs (showing as Tuberculosis symptoms), cause blood poisoning, or create skin ulcers surrounding the lesion which came into contact with the bacteria.
Risk
Melioidosis is endemic in Southeast Asia and northern Australia. Sporadic cases have been reported from countries in Central America, South America, Africa, South Asia and the Pacific Islands.
Ecotourists, adventure travellers, and persons working in agriculture, mining, and construction are at risk. Travellers with a weakened immune system or a pre-existing health condition such as diabetes, kidney disease, lung disease, or cancer are also at risk due to the inability to fight off infection. Outbreaks typically occur during rainy seasons when the bacteria are more active.
Symptoms
Usually symptoms appear 1 to 21 days after being infected, but in some patients symptoms can appear months or even years after exposure to the bacteria. The acute form of the infection typically presents as pneumonia with symptoms of fever, cough, chest pain, difficulty breathing, and lack of appetite. If the infection reaches the bloodstream, symptoms include fever, headache, muscle and joint pain, disorientation, and shock. Localized skin infection symptoms include fever, skin ulcers, and abscesses in organs such as the spleen and prostate. Melioidosis can be fatal if not treated promptly. Treatment includes supportive care of symptoms and antibiotic therapy for at least three months to prevent relapse.
Prevention
Avoid swimming in fresh water and coming into contact with soil or mud during the rainy season in endemic areas.
If you have a skin cut or burn, thoroughly clean it with soap and water immediately. Rinse with an antiseptic cleanser to prevent wound infection.
Healthcare and agricultural workers should wear protective gear to help prevent infection.
If you suspect that you have Melioidosis, seek medical attention immediately.
There is no preventive medication or vaccine against Melioidosis.
Wertheim, Heiman; Horby, Peter; Woodall, John, eds. Atlas of Human Infectious Diseases. Oxford: Wiley-Blackwell; 2012. 273 p.
White, N. Melioidosis and Glanders. In: McGill, A; Ryan, E; Hill, D; Solomon, T, eds. Hunter's Tropical Medicine and Emerging Infectious Diseases. 9th ed. New York: Saunders Elsevier; 2013: 580-583.
Centers for Disease Control and Prevention: Melioidosis