Detailed Information on Melioidosis

Melioidosis is an infectious disease caused by the bacterium Burkholderia pseudomallei. Melioidosis is common in parts of the world of south East Asia (including Thailand, Singapore, Malaysia, Burma and Vietnam) and northern Australia.  It was rare in the United States prior to recent immigration from Southeast Asia. Melioidosis is presently a public health concern because it is most common in AIDS patients and intravenous drug users. The bacteria causing melioidosis are found in contaminated water and soil and are spread to humans and animals through direct contact with the contaminated source.

Glanders is contracted by humans from infected domestic animals. People acquire the disease by inhaling dust contaminated by the bacteria and when the contaminated soil comes in contact with abraded (scraped) area of the skin. Infection most commonly occurs during the rainy season. Melioidosis can be spread from person to person as well. Melioidosis infection commonly involves the lungs. Male-to-female sexual transmission involved males with chronic prostatic infection due to melioidosis. Melioidosis symptoms most commonly stem from lung disease where the infection can form a cavity of pus (abscess).

The result can range from meek bronchitis to severe pneumonia. As a result, patients also may experience fever, headache, and loss of appetite, cough, chest pain, and general muscle soreness. The effects can also be localized to infection on the skin (cellulitis) with associated fever and muscle aches. It can spread from the skin through the blood to become a chronic form of melioidosis affecting the heart, brain, liver, kidneys, joints, and eyes. The treatment of melioidosis involves antibiotics and depends on the location of the disease. Patients with mild or moderate infections are given a course of trimethoprim-sulfamethoxazole and ceftazidime.

Prevention requires prompt cleansing of scrapes, burns, or other open wounds in areas where the disease is common and avoidance of needle sharing among drug addicts. Persons with diabetes and skin lesions should avoid contact with soil and standing water in these areas. Wearing boots during agricultural work can prevent infection through the feet and lower legs. In health care settings, using common blood and body fluid precautions can prevent transmission.