CDC warns doctors to watch out for melioidosis, a rare tropical disease now found in 4 states

The Centers for Disease Control and Prevention (CDC) said Monday they are warning doctors to watch out for symptoms of a rare and serious bacterial infection known as melioidosis, after a fourth case of the disease recently been confirmed in the United States.

So far, the CDC has said four cases of the disease have been confirmed in adults and children in Georgia, Kansas, Minneosta and Texas, and two of the patients have died.

But what puzzles health officials is that the disease, which is endemic to tropical and subtropical climates in Southeast Asia and northern Australia, is usually contracted while traveling. However, none of the four recently infected people have traveled overseas.

On Monday, the CDC said the most likely cause of the infection was an imported product, such as a food or drink, personal care or cleaning products or medication, or an ingredient in one of these types of products. The agency said the bacterial strains that sickened each of the four patients closely resemble each other, suggesting there is a common source for the cases.

Now, the CDC is asking clinicians to watch for any acute bacterial infection that does not respond to normal antibiotics and to consider melioidosis as a diagnosis whether or not a patient has traveled outside of the United States.

“The CDC also urges clinicians not to rule out melioidosis as a possible diagnosis in children and those who were previously healthy and without known risk factors for melioidosis,” the agency said in a statement.

Melioidosis is an infectious disease caused by the bacteria Burkholderia pseudomallei that is found in contaminated water and soil. The main routes of infection are inhalation of dust or contaminated water droplets, ingestion of contaminated water or food contaminated with soil, and contact with contaminated soil, especially when the person has skin abrasions.

Symptoms of melioidosis vary depending on the type of infection and may initially be confused with other illnesses, such as tuberculosis. Among the four recently ill patients, symptoms included cough, shortness of breath, weakness, vomiting, fever, and rash on the abdomen and face.

The CDC has warned that while healthy people can contract the disease, underlying health problems, such as kidney disease, diabetes, and excessive alcohol consumption, can increase the risk of serious illness.

The first victim was identified in March in Kansas and died of the disease, while the most recent victim was identified after he died in a hospital last month in Georgia. Two of the patients, one of whom died, had risk factors such as chronic obstructive pulmonary disease and cirrhosis, while the other two patients had no risk factors.

The CDC said it collected and tested more than 100 product, soil and water samples in and around the homes of the four patients. So far, no sample has come back positive for the bacteria.

“Unlike the germs that cause most foodborne outbreaks, the bacteria responsible for melioidosis can take two to three weeks to make someone sick. This widens the window of time for investigators to explore and means people may be less likely to remember everything they’ve been exposed to before they get sick, ”the CDC said Monday.