A new fatal case of the rare disease melioidosis has been confirmed in Georgia, creating a medical mystery for disease detectives working to identify the source of the infection.
The Georgian died at a hospital in late July, and post-mortem testing confirmed the bacterial infection, according to a health alert from the Centers for Disease Control and Prevention. Another person died of the disease in Kansas back in March, and two other people, in Texas and Minnesota, with confirmed cases of the bacterial infection became seriously ill.
That has created a puzzle for the CDC in trying to identify the source of the bacteria, which is usually found in tropical climates such as in Southeast Asia or northern Australia.
CDC analysis of the bacterial strains of the four cases showed that they closely match one another, suggesting a common source. But none of the four patients had traveled out of the country. The geographic spread of the four known cases and the differences in time when the four fell ill also make identifying the potential source of infection difficult, the agency said.
Adding to the complexity is that the incubation period for the disease can be up to 21 days, said Dr. William Bower, a subject matter expert with the CDC’s Bacterial Special Pathogens Branch. “So we are going back and asking people who have been very ill or their family members to tell us what these people may have come in contact with over the past three weeks,” Bower said.
“We have a team talking with the family of the Georgia case,” he said. “We hope that we have gotten some information on what the patient did or where they were or what they may have had contact with over the last two to three weeks.”
So far, tests of products, soil and water at patients’ homes did not find the bacteria, and CDC now believes an imported product could be the source. But each of the four patients could have been exposed to hundreds of products before becoming ill, making pinpointing the source more complex.
“CDC is diligently working on trying to find out what this product is so we can remove it so it is not a danger to anyone else,” Bower said.
However, he said, “People should not be panicking over any product they may have...because the chances of coming into contact with this area are probably rare.”
As the investigation continues, CDC has asked clinicians to watch for any acute bacterial infection that doesn’t respond to normal antibiotics. Because the U.S. only sees a handful of such cases a year, typically from people who traveled to regions where the bacteria is endemic, physicians may not think about melioidosis for patients with severe bacterial infections, Bower said. So the alert is intended to bring the disease to their attention and to learn if there are other cases that had not been identified.
Dr. Bower also noted that the majority of those who become infected with the bacteria do not suffer a serious illness.
The four confirmed cases involve children and adults, CDC said. But it provided no other information about the patients’ ages, gender or specific locations. Those with underlying infections such as diabetes, chronic lung disease or cancer are at heightened risk from the disease. But two of the four patients with confirmed cases had no known risk factors.
CDC also said that the risk of infected people spreading the diseases is extremely low, and Bower said that while animals can be infected by the bacteria, the infection is not thought to be transmissible from animals to people.
About melioidosis, also known as Whitmore’s disease
The bacterial infection, which can affect both humans and animals, is usually found in parts of Southeast Asia and northern Australia. People usually are infected by inhaling contaminated dust or coming in contact with soil or products contaminated with the bacteria. The infection can be mistaken for other diseases, such as tuberculosis or pneumonia, according to the Centers for Disease Control and Prevention. Each type of the disease also has its own set of symptoms.
Localized infection: Localized pain or swelling, fever, ulceration, abscess
Pulmonary infection: cough, chest pain, high fever, headache, unexplained weight loss
Bloodstream infection: Fever, headache, respiratory distress, abdominal discomfort, joint pain, disorientation
Disseminated infection: Fever, weight loss, stomach or chest pain, muscle or joint pain, headache, central nervous system/brain infection, seizures
Source: The Centers for Disease Control and Prevention
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