What Is Melioidosis, the Deadly Bacterial Infection the CDC Is Warning About?
The CDC is warning about the detection of bacteria that causes melioidosis, a rare and deadly disease that has never been spotted in the U.S.
There have been four cases of the tropical illness in adults and children in the U.S. over the past few years. Two people had no known risk factors for the disease and two died.
Infectious disease experts explain why you shouldn't panic.
The Centers for Disease Control and Prevention (CDC) has issued an alert that a deadly bacteria has been spotted for the first time in the U.S. The bacteria, Burkholderia pseudomallei or B. pseudomallei, was detected through sampling of soil and water in the Gulf Coast region of Mississippi, the CDC says in a press release.
This bacteria can cause a rare and serious disease called melioidosis, aka Whitmore’s disease, the CDC explains. It’s not clear how long the bacteria has been in the area and where else it may be in the U.S. the agency says. However, the CDC notes, the environmental conditions found in the Gulf Coast states are helpful for this particular bacteria to thrive. “CDC is alerting clinicians throughout the country of this discovery through a national health advisory, reminding them to be aware of the signs and symptoms of melioidosis and to consider melioidosis in patients that present with symptoms of the disease,” the alert says.
The CDC points out that two people living in the Gulf Coast region of the U.S. became sick with melioidosis two years apart—in 2020 and 2022—which caused officials to test their household products, soil, and water in and around both patients’ homes (with their permission). Three of the samples taken from soil and puddle water in 2022 tested positive at CDC for B. pseudomallei, suggesting the bacteria from the environment caused the infections—and has been around since at least 2020.
Last year, the CDC released a statement warning of melioidosis after detecting four cases of the tropical illness in adults and children in four different states: Georgia, Kansas, Texas, and Minnesota. Two people had no known risk factors for the disease and two have died.
A CDC analysis found that the bacterial strains behind the illnesses closely match each other, which suggested there was a common source for the infections. They seem to be most closely related to strains found in South Asia, but none of the patients had traveled internationally.
Still, the disease is considered very rare in the U.S., so how concerned about it should you be? Here’s what you need to know, according to experts.
How does melioidosis spread?
Melioidosis (Whitmore’s disease) is mostly a disease of tropical climates, particularly in Southeast Asia and northern Australia where it’s widespread. The bacteria that causes melioidosis is found in contaminated water and soil, and it’s spread to humans and animals through direct contact with the contaminated source.
People are thought to get infected by inhaling contaminated dust or water droplets, drinking contaminated water, eating food that has contaminated soil on it, or having other contact with contaminated soil, like through cuts on the skin, the CDC says.
“The vast majority of cases in United States are in individuals who travel to areas where this infection is common,” says infectious disease expert Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security.
Treatment for melioidosis is intense, and it usually begins with an IV antimicrobial therapy for a minimum of two weeks—possibly up to eight weeks if someone has a severe form of the condition. That’s followed by three to six months of oral antimicrobial therapy.
What are the symptoms of melioidosis?
There is actually a wide range of symptoms of melioidosis, and they can be categorized by whether someone has a localized infection, a lung infection, a bloodstream infection, or a widespread infection.
For instance, a localized infection can cause pain or swelling in a specific part of your body, a lung infection could lead to chest pain or coughing, a bloodstream infection could lead to a headache, joint point, or abdominal pain, and a widespread infection is associated with weight loss, fever, muscle pain, and headaches. (You can find an in-depth list on the CDC’s site.)
While the pulmonary symptoms of melioidosis can overlap with COVID-19, it’s highly unlikely that you have melioidosis if you develop a cough and fever in our current climate, says William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine. “At the moment, we’re thinking about a number of other respiratory infections, including RSV and COVID,” he says.
How is melioidosis treated?
Treatment for melioidosis usually starts with an IV antimicrobial therapy for a minimum of two weeks, the CDC says, followed by three to six months of an oral antimicrobial therapy.
And, if someone has an infected wound, they may need to have part of the infected and surrounding tissue removed, Dr. Schaffner says.
How concerned should you be about melioidosis cases in the U.S.?
This is a “significant finding,” Dr. Adalja says, noting that it “widens the range of melioidosis risk” to people in the U.S. Before last year’s cases, Dr. Schaffner said it was “unheard of” for people who live in the U.S. to develop melioidosis without traveling. Now, “it’s not just something to consider in patients who have traveled to traditional endemic areas,” Dr. Adalja says.
Dr. Schaffner stresses that this is “not a bacteria that spreads from person to person,” so you don’t need to stress about “catching” melioidosis from someone else. But, if you live in the Gulf Coast region or visit the area and develop symptoms of melioidosis, he says the condition should at least be on your radar.
The bacteria that causes melioidosis tends to thrive in tropical and sub-tropical areas, Dr. Schaffner points out, which makes it unlikely to show up in other areas of the country, like the Northeast or Midwest. “But, now that we’re on the alert and looking for more cases, more will likely turn up,” he says.
In general, though, “this is not something that poses a major threat to the general public,” Dr. Adalja says. He adds, “it may be the case that the bacteria has been present for a prolonged period of time and just never discovered.”
You Might Also Like
