What Is Melioidosis?

Melioidosis, also known as Whitmore's disease, is an infectious disease that can infect humans or animals, according to the CDC. While melioidosis is more common in tropical climates, it's found most often in Southeast Asia and northern Australia.

Melioidosis isn't an infection most people in the US are familiar with, and with good reason. "It is very rare in the US," said Richard Watkins, MD, an infectious disease physician and professor of internal medicine at the Northeast Ohio Medical University.

According to the CDC, about a dozen or so cases of melioidosis occur annually in the US. Typically, the people who develop melioidosis have been traveling in countries where the disease is more prevalent. However, there have been a few reported cases from people who have not traveled to countries where the disease is widespread. Also, in 2022 the CDC discovered the B. psuedomallei bacteria in the soil along the Gulf Coast Region of Mississippi.

Here's what you need to know about this serious infection.

Causes

Melioidosis is caused by the bacteria Burkholderia pseudomallei. According to the CDC, the bacterium spreads to people and animals when they make contact with contaminated water and soil.

According to the CDC, it's thought that people and animals can get the infection by:

• Inhaling contaminated dust or water droplets
• Consuming contaminated water/food
• Coming into direct contact with contaminated soil (especially through cuts or scrapes)

"The vast majority of cases in the United States are in individuals who travel to areas where this infection is common," said infectious disease expert Amesh A. Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security.

Symptoms

There are different types of melioidosis infections, and each has its own symptoms. The CDC breaks it down this way:

Localized Infection

• Localized pain or swelling
• Fever
• Ulceration
• Abscess

Lung Infection

• Cough
• Chest pain
• High fever
• Headache
• Anorexia

Bloodstream Infection

• Fever
• Headache
• Respiratory distress
• Abdominal discomfort
• Joint pain
• Disorientation

Widespread Infection

• Fever
• Weight loss
• Stomach or chest pain
• Muscle or joint pain
• Headache
• Central nervous system/brain infection
• Seizures

Treatment

Melioidosis treatment usually starts with an IV antimicrobial infusion that lasts for a minimum of two weeks, according to the CDC. And if the infection is severe, IV medication may be needed for up to eight weeks. After that, patients will be given three to six months of oral antimicrobial medication to help them recover.

Risk Factors

Technically, anyone can get the infection. According to the CDC, there are a few factors that increase your risk, including having one of the following underlying conditions:

• Diabetes
• Liver disease
• Kidney disease
• Thalassemia (a blood disorder)
• Cancer or another immune-suppressing condition not related to HIV
• Chronic lung disease

How Concerned Should You Be?

Dr. Adalja said the general public shouldn't worry about this. "It is important [for health officials] to understand what their ultimate source is." Why? "Melioidosis is also an important agent in biological warfare/bioterrorism, so all cases outside of endemic region require thorough investigation," Dr. Adalja said. According to the CDC, bioterrorism is when germs are released on purpose to make people sick or kill them.

"It's also important to understand if any of the involved persons were connected to any lab working with the bacteria where a biosafety lapse may have occurred."

Prevention

In areas where melioidosis is common (aka not the US), it's recommended that people wear protective clothes like shoes and gloves when they're exposed to soil or water, like when they're gardening, according to the CDC.

"Also, it can be inhaled during monsoon season, so it is important to take precautions if outside during the rain where bacteria may be kicked up in endemic areas," Dr. Adalja said.

The CDC also recommends that healthcare workers use standard precautions—such as proper hand hygiene and personal protective equipment—when treating people with melioidosis to help prevent infection to protect themselves.

Summary

Melioidosis is rare in the US, but it does happen. "If you develop symptoms of melioidosis, especially after contact with water or soil, you should seek medical care right away," Dr. Watkins said.