It is particularly important to be on the alert after storms and floods.
Melioidosis, also known as Whitmore’s disease, is an infectious disease that is commonplace in tropical climates. Although it is most common in Southeast Asia and northern Australia, cases have been identified in Puerto Rico. This infectious disease is caused by the bacterium Burkholderia pseudomallei, which can be found in contaminated water and soil.
How Is It Transmitted?
It is believed that both humans and animals become infected if they inhale contaminated dust or water droplets, ingest contaminated water or food, or through other contact with contaminated soil, especially through skin wounds. Person-to-person transmission is very rare.
IT RESEMBLES LEPTOSPIROSIS
By Cerevisae – Adapted from journal source.[1], CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=85592785
What Are Its Symptoms?
Symptoms usually appear two to four weeks after exposure and may be confused with other diseases, such as tuberculosis or pneumonia. The following symptoms may be experienced depending on where the infection is localized:
Localized
- Localized pain or swelling
- Fever
- Ulceration
- Abscess
Pulmonary
- Coughing
- Chest pain
- High fever
- Headaches
- Anorexia
Central nervous system (brain)
- Seizures
In the bloodstream
- Fever
- Headaches
- Difficulty breathing
- Abdominal discomfort
- Joint pain
- Disorientation
Generalized
- Fever
- Weight loss
- Stomachache or chest pain
- Muscle or joint pain
- Headaches
How Is It Diagnosed?
Melioidosis can affect almost any organ and can mimic many other diseases. That is why it is sometimes called “the great mimicker.” A misdiagnosis can be fatal. A culture of B. pseudomallei bacteria is considered to be the standard diagnostic test. To do this, doctors obtain small samples of blood, sputum, pus, urine, synovial fluid (found between joints), peritoneal fluid (found in the abdominal cavity), or pericardial fluid (found around the heart) and place it in a culture medium to see if the bacteria will grow.
How Is It Treated?
Treatment may vary depending on the type of melioidosis. The first stage is intravenous, while the second stage is oral.
First Stage: Course of at least 10 to 14 days of one of these antibiotics, given intravenously (IV) for up to eight weeks.
- Ceftazidime – administered every six to eight hours.
- Meropenem – administered every eight hours
Second Stage: Course of three to six months of one of these oral antibiotics:
- Sulfamethoxazole trimethoprim – taken every 12 hours
- Doxycycline – taken every 12 hours
Relapses occur mainly in people who do not complete the course of antibiotics.
Be careful!
Underlying medical conditions like diabetes, liver disease, kidney disease, anemia, cancer, immunosuppressive disease (not related to HIV), cystic fibrosis, COPD, and bronchiectasis may increase your risk.
There is currently no vaccine for humans.
How Can You Prevent It?
If you have an open skin wound, diabetes, or chronic kidney disease, avoid contact with soil and stagnant water.
This is especially important after storms and the heavy rainfall they bring.
Sources:
https://www.cdc.gov/melioidosis/health-care-workers/index.html
https://www.cdc.gov › melioidosis
https://www.nejm.org/doi/full/10.1056/NEJMra1204699
