The Global Distribution and Burden of Melioidosis, an Overlooked Emerging Infectious Disease
Melioidosis
-
Upload
sariu-ali -
Category
Health & Medicine
-
view
4.032 -
download
0
Transcript of Melioidosis
![Page 1: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/1.jpg)
Melioidosis
![Page 2: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/2.jpg)
Center for Food Security and Public Health Iowa State University 2005
OverviewOverview
• Organism• History• Epidemiology• Transmission• Disease in Humans• Disease in Animals• Prevention and Control
![Page 3: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/3.jpg)
The Organism
![Page 4: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/4.jpg)
Center for Food Security and Public Health Iowa State University 2005
OrganismOrganism
• Burkholderia pseudomallei−Aerobic, gram-negative
motile bacillus−Found in water and moist soil−Opportunistic pathogen−Produces exotoxins−Can survive in phagocytic cells
Latent infections common
![Page 5: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/5.jpg)
History
![Page 6: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/6.jpg)
Center for Food Security and Public Health Iowa State University 2005
HistoryHistory
• 1912, Alfred Whitmore• Burma• Organism isolated
in humans− Glanders-like disease− No equine exposure− Colony growth differed
from glanders− “Whitmore” disease
Alfred Whitmore 1876-1941
![Page 7: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/7.jpg)
Center for Food Security and Public Health Iowa State University 2005
HistoryHistory
• 1913, Malaysia• Stanton and Fletcher• “Distemper-like”
outbreak in animals• Pioneered serological
tests
AmbroseThomasStanton
William Fletcher
![Page 8: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/8.jpg)
Center for Food Security and Public Health Iowa State University 2005
HistoryHistory
• 1948-1954, Indo-China−Over 100 French soldiers
• 1973, Vietnam−Over 300 American soldiers−“Vietnamese time bomb”
Infections reoccurred after latent period
−Military dogs in Vietnam also affected Fever, myalgia, dermal abscesses
![Page 9: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/9.jpg)
Center for Food Security and Public Health Iowa State University 2005
HistoryHistory
• 1970’s, France−Numerous horses and zoo
animals affected−Melioidosis in temperate climates
• 1989−Effective antibiotic treatment
![Page 10: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/10.jpg)
Transmission
![Page 11: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/11.jpg)
Center for Food Security and Public Health Iowa State University 2005
TransmissionTransmission
• Wound infection−Contact with contaminated soil or water
• Ingestion−Contaminated water
• Inhalation−Dust from contaminated soil
• Rarely−Person-to-person−Animal-to-person
![Page 12: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/12.jpg)
Epidemiology
![Page 13: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/13.jpg)
Center for Food Security and Public Health Iowa State University 2005
EpidemiologyEpidemiology
• Disease of rice farmers • Endemic in tropics and subtropics
−Southeast Asia, Australia, The Middle East, India, China, Caribbean
• U.S. cases linked with travel abroad
![Page 14: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/14.jpg)
Center for Food Security and Public Health Iowa State University 2005
Distribution of MelioidosisDistribution of Melioidosis
![Page 15: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/15.jpg)
Center for Food Security and Public Health Iowa State University 2005
EpidemiologyEpidemiology
• Clinical disease uncommon• In endemic areas
− Antibodies in 5-20% of agricultural workers
− No history of disease
• Wet season− Heavy rainfall− High humidity or
temperature
![Page 16: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/16.jpg)
Disease in Humans
![Page 17: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/17.jpg)
Center for Food Security and Public Health Iowa State University 2005
Human DiseaseHuman Disease
• Incubation period: 2 days to years• Latent infection • Most infections asymptomatic• Clinical forms
−Acute pulmonary infection Most common
−Focal infection−Septicemia−Neurological (rare)
![Page 18: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/18.jpg)
Center for Food Security and Public Health Iowa State University 2005
Acute Pulmonary InfectionAcute Pulmonary Infection
• Most common form• High fever, headache• Dull aching chest pain• Cough, tachypnea, rales• Chest X-rays
−Upper lobe consolidation−Nodular lesions−Pleural effusion
![Page 19: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/19.jpg)
Center for Food Security and Public Health Iowa State University 2005
Focal InfectionFocal Infection
• Abscess or granuloma formation−Skin−Bone and/or muscle− Joints− Internal organs−Genitourinary−Nervous system (infrequent)
![Page 20: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/20.jpg)
Center for Food Security and Public Health Iowa State University 2005
Septicemic MelioidosisSepticemic Melioidosis
• Acute onset−High fever, tachypnea, dyspnea,
myalgia, hepatosplenomegaly, septic shock
• Concurrent disease• Mortality
−90% without treatment−50% with treatment
![Page 21: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/21.jpg)
Center for Food Security and Public Health Iowa State University 2005
Diagnosis and TreatmentDiagnosis and Treatment
• Diagnosis− Isolation of organism−Various serological tests
• Treatment−Systemic antibiotics
Trimethoprim sulfa Ceftazidime
−Surgical drainage of skin wounds• No vaccine available
![Page 22: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/22.jpg)
Animals and Melioidosis
![Page 23: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/23.jpg)
Center for Food Security and Public Health Iowa State University 2005
Animals Affected by MelioidosisAnimals Affected by Melioidosis
• Severe disease−Sheep, goats, pigs
• Occasionally−Cattle, horses, dogs, cats−Monkeys, rodents, −Birds
• Incubation period−Variable, days to years
![Page 24: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/24.jpg)
Center for Food Security and Public Health Iowa State University 2005
Sheep, Goats and PigsSheep, Goats and Pigs
• Caseous lung abscesses• Pneumonia • High fever, cough• Ocular and nasal discharge• Lameness and arthritis• Encephalitis• Goats: Mastitis• Pigs: Abscesses in spleen
![Page 25: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/25.jpg)
Center for Food Security and Public Health Iowa State University 2005
Other speciesOther species
• Horses and cattle−Neurologic signs−Respiratory disease
• Dogs (rare)−Dermal abscesses,
epididymitis, lameness, leg swelling
• Rodents−Very susceptible
![Page 26: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/26.jpg)
Prevention and Control
![Page 27: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/27.jpg)
Center for Food Security and Public Health Iowa State University 2005
Control and PreventionControl and Prevention
• Avoid contact with soil and water in endemic areas
• Use care during necropsy of infected animals
• Thorough cleaning of wounds• Chlorination of water effective
against organism
![Page 28: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/28.jpg)
Center for Food Security and Public Health Iowa State University 2005
Melioidosis as a BioweaponMelioidosis as a Bioweapon
• CDC Category B Agent−Moderately easy to disseminate−Moderate morbidity−Low mortality−Specific diagnostics required
• Very stable in the environment• Killed very easily by heat
![Page 29: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/29.jpg)
Center for Food Security and Public Health Iowa State University 2005
Additional ResourcesAdditional Resources
• CDC – Division of Bacterial and Mycotic Diseases−http://www.cdc.gov/ncidod/dbmd/
diseaseinfo/melioidosis_g.htm
![Page 30: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/30.jpg)
Center for Food Security and Public Health Iowa State University 2005
AcknowledgmentsAcknowledgments
Development of this presentation was funded by a grant from the Centers for Disease Control and Prevention to the Center for Food Security and Public Health at Iowa State University.
![Page 31: Melioidosis](https://reader035.fdocuments.us/reader035/viewer/2022062513/556b9e87d8b42ada358b5523/html5/thumbnails/31.jpg)
Center for Food Security and Public Health Iowa State University 2005
AcknowledgmentsAcknowledgments
Author:
Co-author:
Reviewers:
Glenda Dvorak, DVM, MS, MPH
Radford Davis, DVM, MPH
Gayle Brown, DVM, PhDBindy Sornsin, BA