The person, who died at the end of July, was the second fatality out of four total cases of melioidosis (also called Burkholderia pseudomallei infection) to have been identified in United States this year. The first case, which proved to be fatal, was found in Kansas in March. The two other patients were hospitalized in May in Minnesota and Texas for extended periods of time before being discharged to transitional care facilities. While the bacteria can cause gravely serious outcomes, the CDC notes that symptoms of melioidosis are varied and nonspecific, and may include pneumonia, abscess formation, and blood infections. The four infected individuals exhibited a range of symptoms, including cough and shortness of breath, weakness, fatigue, nausea, vomiting, intermittent fever, and a rash on the trunk, abdomen, and face. William Schaffner, MD, an infectious disease specialist and professor of preventive medicine and health policy at the Vanderbilt University School of Medicine in Nashville, Tennessee, underscores that the infection is “virtually unheard of in the United States,” so its rareness may make it hard to recognize. “If doctors see a really puzzling case of pneumonia, they might want to work extra hard to get a good specimen from the lungs and send it to the laboratory,” he says, adding that the disease is highly treatable with appropriate medication if caught early on. Dr. Schaffner also stresses that melioidosis is “not a conventionally communicable disease,” so the risk of it becoming a widespread public health crisis like COVID-19 is “quite unlikely.”
Source of Illness Baffles Investigators
The CDC has labeled the four cases, which include both children and adults, as especially unusual because none of the individuals had recently left the United States. “Since none of the four traveled, it is most likely that they were exposed to either contaminated food or beverage products imported from that area,” said Teresa Murray Amato, MD, chair of emergency medicine at Long Island Jewish Forest Hills in Queens, New York. The CDC suggested that other imported items or an animal could be the source. Federal health authorities suspect that all of the patients most likely shared a common source of exposure because the latest case in Georgia closely matched the three cases previously detected in 2021. “We have the technology now so we can identify these very small clusters of infection and initiate these very elaborate investigations,” says Schaffner. “It’s a testimony to our increasing capacity to do public health investigations.”
