Deadly Bacteria Burkholderia Pseudomallei in U.S.: Melioidosis Symptoms

The uncommon bacteria Burkholderia pseudomallei have been found in the U.S. environment for the first time, according to health officials. The bacteria can cause a potentially deadly illness known as melioidosis—a disease that mostly occurs in tropical climates, especially in Southeast Asia and northern Australia. On Thursday, the Mississippi State Department of Health (MSDH) announced the bacteria had been found in soil samples from the Gulf Coast of Mississippi as part of a joint investigation with the Centers for Disease Control and Prevention (CDC).

The investigation was launched after two people fell ill with melioidosis on the Gulf Coast two years apart. Soil samples collected from around both patients' homes then tested positive for the bacteria. MSDH said the finding indicates that bacteria from the environment were probably what caused the two individuals to fall ill and that the bacteria had been there since 2020. Dr. Paul Byers, a state epidemiologist, said in a press release: "Burkholderia pseudomallei normally occurs in tropical and sub-tropical areas like Southeast Asia or Central or South America. Because of the identification of this bacteria on the Mississippi Gulf Coast, persons at high risk for severe infection living on the Gulf Coast should take recommended precautions." MSDH said people at risk should avoid contact with soil or muddy water especially after heavy rain; protect open wounds with a waterproof dressing; wear waterproof boots when gardening or doing agricultural work, which it said is "critical" to preventing infection in the feet and lower legs; and wearing gloves when working with soil. Melioidosis, also known as Whitmore's disease, is a disease caused by direct contact with Burkholderia pseudomallei in soil or water. This includes inhaling particles or droplets, drinking contaminated water, eating soil-contaminated food, or other contact with contaminated soil especially through skin abrasions, according to the CDC.

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Most healthy people who come into contact with the bacteria do not develop melioidosis, though people with chronic illnesses like diabetes, kidney disease and lung disease, or those who drink too much alcohol may be at risk of severe illness from infection, according to MSDH and need to take steps to protect themselves. Melioidosis has a wide range of symptoms, which can depend on the type of infection. A localized infection might cause pain or swelling, fever, ulcerations, or abscess. Pulmonary (lung-related) infection may cause a cough, chest pain, high fever, headache and anorexia. A bloodstream infection may cause fever, headache, respiratory distress, abdominal discomfort, joint pain and disorientation, the CDC states. A disseminated infection, in which the infection spreads to other areas of the body, can lead to central nervous system or brain infection and cause fever, weight loss, stomach or chest pain, muscle or joint pain, headache and seizures. The time between exposure to the bacteria and illness varies, ranging from one day to years. Generally, symptoms start between two and four weeks after exposure. Melioidosis can be treated with medication, depending on the type of infection. Usually, treatment involves antimicrobial medication being injected for a minimum of two weeks followed by three to six months of oral medication. While the findings this week represent the first time Burkholderia pseudomallei has been identified in the environment in the U.S., cases in the country have happened before. Usually these are linked to travel. One outbreak in 2021 was caused by a contaminated aromatic spray product.