The U.S. Centers for Disease Control and Prevention (CDC) has confirmed four cases of melioidosis, which is also known as Whitmore’s disease, among both adults and children in four states: Kansas, Georgia, Texas and Minnesota.
Two of the patients have no underlying health conditions. Diabetes, liver disease, renal disease, thalassemia, cancer, and chronic lung diseases can make people more susceptible to melioidosis.
Melioidosis symptoms are wide-ranging and can vary depending on the type of infection.
This means that the disease can be easily mistaken for other, more common illnesses, such as pneumonia, bronchitis, or tuberculosis.
Symptoms of a localized melioidosis infection include localized pain and swellings, fever, ulcers, and abscesses.
A pulmonary melioidosis infection, meanwhile, can cause completely different symptoms, such as a cough, chest pain, high fever, headache, and anorexia.
A melioidosis bloodstream infection can manifest itself as disorientation, a headache, fever, joint pain, respiratory discomfort, or abdominal pain.
Symptoms of a disseminated melioidosis infection include a fever, headache, weight loss, pains in the stomach, chest, muscles or joints, seizures, or an infection of the brain or central nervous system.
The bacteria that causes melioidosis, Burkholderia pseudomallei, can take weeks to make an infected person sick.
Melioidosis cases are rare in the U.S., with the disease more common in Australia and Southeast Asia. Most cases of melioidosis in the U.S. tend to involve people who have recently visited these areas, but none of the four people who have been infected have traveled internationally.
Despite their geographical spread, genome sequencing suggests that the cases may be linked by a common source, the CDC has said.
Burkholderia pseudomallei is normally found in water or moist soil, but the CDC says it’s possible that the bacteria could have contaminated food, drinks, medication, personal care or cleaning products.
However, of more than 100 samples extracted from products, soil and water and from around the four patients’ homes, none have yet tested positive for the bacteria.
People can become infected by inhaling it in the form of dust or water droplets, ingesting it, or absorbing it through cuts on the skin.
The CDC says that it is “very rare” for people to get the disease from another person.
Melioidosis treatment commonly begins with between two and eight weeks of intravenous antimicrobial therapy, using either ceftazidime or meropenem.
This is usually followed by up to six months of oral antimicrobial therapy, using either trimethoprim-sulfamethoxazole or co-amoxiclav.