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Melioidosis: What to Know

Medically Reviewed by Neha Pathak, MD on March 03, 2022

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 Burkholderia 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
  • Exposure to some aromatherapy sprays or essential oils

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
  • 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.

According to the CDC, the infection from the rare bacteria can be deadly and cause you to become seriously ill. It has investigated and confirmed a handful of cases in the U.S. where some people have become sick or died after encountering the bacteria.  

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:

Melioidosis Transmission

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.

Melioidosis Diagnosis

Your doctor can diagnose a melioidosis infection by separating Burkholderia pseudomallei bacteria from:

  • Blood test
  • Urine sample
  • Throat swab
  • Skin lesion test
  • Abscesses

Doctors may also diagnose it by looking for an antibody response to the bacteria.

They may identify the diagnosis as:

  • Localized infection -- it’s limited to one part of the body. 
  • Lung infection
  • Bloodstream infection
  • Disseminated infection -- the bacteria may have spread to different organs in the body.

How Is Melioidosis Treated?

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.

Show Sources

SOURCES:

CDC: “Melioidosis,” “Melioidosis, For Healthcare Workers,” “Aromatherapy spray tests positive for deadly bacteria.”Iowa State University Center for Food Security and Public Health: “Melioidosis.”

Virginia Department of Health: “Melioidosis.”

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