What Is Melioidosis?

Melioidosis, also known as Whitmore's disease, is a bacterial infection that can affect both people and animals. It's caused by bacteria called B. pseudomallei. These bacteria can contaminate water or soil. People can get the disease when they:

Breathe in affected water or dust
Drink or eat things that have come into contact with these sources
Have skin contact with contaminated dirt or water

Melioidosis is mainly found in tropical climates. It most often occurs in Thailand, Malaysia, Singapore, and northern Australia. Cases are also reported frequently in:

India and Sri Lanka
Southern China
Hong Kong
Taiwan
Vietnam
Indonesia
Cambodia
Laos
Myanmar (Burma)

Less often, it's found in other parts of the world, including a few cases in the United States and Europe.

What Are the Symptoms of Melioidosis?

Melioidosis infections can range from mild to very serious. You might not have any symptoms. You could have a localized infection in a particular area of your body. Or the disease could affect your lungs, your bloodstream, or many parts of your body at once. If not treated, it can be fatal.

Because it can involve almost any organ, it may be mistaken for other diseases, such as tuberculosis or pneumonia.

Infections with no symptoms are common in animals. But melioidosis can also cause a range of symptoms in animals based on the type of infection. It can infect many types of animals, including dogs, cats, sheep, goats, pigs, cattle, and horses.

A localized melioidosis infection usually affects a particular area of your skin. It may cause:

Fever
Pain and swelling in that area
Abscesses (pus-filled areas)
Sores

Lung (pulmonary) infections can lead to:

Signs of a bloodstream infection can include:

A widespread infection may cause:

Symptoms usually appear 2 to 4 weeks after you encounter the bacteria. But experts haven't clearly defined the period between exposure and the first signs.

Who's at Risk for Melioidosis?

Even healthy people can become infected. But those with health conditions have a higher risk of getting a serious infection. Conditions that increase your risk include:

How Does Melioidosis Spread?

Human-to-human transmission of melioidosis is unlikely. But experts have found a few possible cases of sexual transmission. The infection may also spread to infants through human milk or while a baby is still in the womb, but this is very rare.

It's also rare from the disease to spread from animals to humans, though researchers have identified tropical freshwater fish as a possible risk.

Studies show that B. pseudomallei can live for months or years in soil or water. The bacteria can survive in water with high salt concentrations, as well as acidic environments.

But some disinfectants, like 1% sodium, 70% ethanol, glutaraldehyde, and formaldehyde, may partially eliminate B. pseudomallei. Sunlight and heat, especially moist heat of 121 degrees for at least 15 minutes or dry heat at 170 degrees for at least an hour, may also kill it.

How Is Melioidosis Treated?

Your doctor can diagnose a melioidosis infection through a:

Treatment usually starts with IV antimicrobial drugs for at least 2 weeks, or up to 8 weeks for a severe infection. Your doctor will then give you 3 to 6 months of oral antimicrobials.

Your IV therapy might include ceftazidime (Fortaz) every 6 to 8 hours, or meropenem (Merrem) every 8 hours.

Your oral therapy may consist of either:

How Can You Prevent Melioidosis?

To lower your risk of infection in areas where disease is widespread:

Avoid contact with soil and standing water, especially if you have open wounds or other risk factors.
Wear boots and gloves to protect yourself during outdoor activities.
Wash your hands after handling soil.
Keep cuts and scrapes covered with waterproof bandages.

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