The Centers for Disease Control and Prevention (CDC) has declared Burkholderia pseudomallei, a highly dangerous bacteria with a global fatality rate of approximately 50 percent, as endemic on the U.S. Gulf Coast.
Three cases of infection caused by these bacteria, which can lead to the potentially fatal melioidosis if left untreated, have been confirmed by the CDC.
"It is an environmental organism that lives naturally in the soil, and typically freshwater in certain areas around the world. Mostly in subtropical and tropical climates," Julia Petras, an epidemic intelligence service officer with CDC's National Center for Emerging and Zoonotic Infectious Diseases, HealthDay News reported.
In January, the most recent case of Burkholderia pseudomallei infection was reported in Mississippi. Two additional cases were confirmed in the same Mississippi county in July 2020 and May 2020.
However, it is important to note that many individuals infected with the bacteria may not show symptoms and instead develop antibodies against it, indicating a likely higher number of infections, New York Post reported.
In all three cases in Mississippi, the patients successfully recovered.
"This is one of those diseases that is also called the great mimicker because it can look like a lot of different things," Petras told the outlet.
"It's greatly under-reported and under-diagnosed and under-recognized — we often like to say that it's been the neglected, neglected tropical disease."
The bacteria typically infect individuals through open wounds or by inhaling the germs, especially during intense storms. People with diabetes or kidney and liver issues are particularly vulnerable to the infection.
"Excessive alcohol use is also a known risk factor, and binge drinking has actually been associated with cases as well from endemic areas," Petras said. The CDC defines an endemic as "a constant amount of that specific disease present in a geographic location, like a state or country."
To date, there have been only two documented instances globally of person-to-person transmission of the bacteria.
According to Petras, once the bacteria enter the body, it targets organs such as the lungs and brain, as well as any organ that develops an abscess.
"A lot of patients will have pneumonia with sepsis, and or sepsis, which is associated with higher mortality and worse outcomes," she said.
"We have antibiotics that work," she said. "What I'm talking about is IV antibiotics for at least two weeks, followed by three to six months of oral antibiotics."
There are approximately 160,000 reported cases of melioidosis worldwide each year, resulting in 80,000 deaths. Early diagnosis of melioidosis is crucial to ensure proper treatment, Petras emphasized.
"It's extensive treatment, but if you've finished the full course and you're diagnosed early, which is the really key thing, your outcome is probably going to be quite good," she added.
Meropenem and ceftazidime (Fortaz) are administered intravenously to patients as the initial form of treatment. During the second phase, amoxicillin is then administered as tablets, according to Petras.
Although it is unclear how or when B. mallei reached the Gulf Coast, experts think that climate change is probably a contributing factor.
According to Petras, B. mallei was initially discovered in Australia and Thailand and thrives in warm, humid environments.
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