July 28, 2022
A potentially deadly bacteria has been found in U.S. soil and water samples for the first time, according to an alert from the CDC.
The bacteria, Burkholderia pseudomallei, was found along the Gulf Coast region in southern Mississippi. Typically, the bacteria are in tropical and subtropical climates, especially in parts of Southeast Asia, northern Australia, Central America, South America, Puerto Rico, and the U.S. Virgin Islands.
The bacteria can cause melioidosis, a rare and serious infectious disease that spreads to animals and humans through contact with contaminated soil and water via cuts, wounds, mucous membranes, breathing the bacteria in, or eating or drinking it. Worldwide, the disease is fatal in 10% to 50% of those who become infected.
CDC and state officials are investigating the samples to find out how widespread the bacteria are within the U.S. So far, modeling suggests that the environmental conditions on the Gulf Coast support the growth of B. pseudomallei.
"It is unclear how long the bacteria has been in the environment and where else it might be found in the U.S.," according to the CDC statement. "CDC is alerting clinicians throughout the country of this discovery through a national health advisory, reminding them to be aware of the signs and symptoms of melioidosis and to consider melioidosis in patients that present with symptoms of the disease."
Two unrelated people who live near the Gulf Coast region of Mississippi became sick with melioidosis recently – one in July 2020 and one in May 2022. Neither had traveled outside of the U.S. The cases led the CDC and the Mississippi State Department of Health to collect environmental samples and test household products at the patients' homes in June 2022. Three of the samples taken from soil and puddle water in the 2020 case tested positive for the bacteria.
Genomic sequencing revealed that both patients were infected with the same strain of the bacteria from the Western Hemisphere. They were hospitalized with sepsis due to pneumonia and had known risk factors for melioidosis. Both patients recovered after they were treated with antibiotics.
An average of 12 melioidosis cases are diagnosed in the U.S. each year, with most in people with recent travel to a country where the bacteria is endemic, or regularly found. Cases have also been linked to contaminated products imported from endemic countries. In late 2021, four cases in four states – Georgia, Kansas, Minnesota, and Texas – were linked to a contaminated aromatherapy spray that was imported, and Walmart issued a recall in November of that year, according to a CDC announcement. Two of the four people died.
Given the small number of cases found in the U.S., the CDC believes the risk of melioidosis for the general population continues to be "very low," and the risk of person-to-person spread is considered "extremely low." But people who live on the Gulf Coast of Mississippi and who have health conditions that may put them at a higher risk, such as diabetes, chronic kidney disease, chronic lung disease, excessive alcohol use, and immunosuppressive conditions, should protect themselves.
The CDC recommends avoiding contact with soil or muddy water, particularly after heavy rains, and protecting open wounds with waterproof bandages. People should also wear waterproof boots when gardening, working in the yard, or doing agricultural work, which can prevent infection through the feet and lower legs, especially after flooding or storms. People should also wear gloves to protect their hands when working directly with soil.
Melioidosis has a wide range of symptoms, including fever, joint pain, headaches, coughing, chest pain, and belly pain. It can also cause conditions such as pneumonia, abscesses, and blood infections. The disease can infect any organ, including the brain. In most cases, symptoms appear within 1 to 21 days after exposure, with an average of 7 days after exposure.
The CDC's health advisory for health professionals and public health officials shows melioidosis is now considered to be locally endemic in areas of the Gulf Coast region in Mississippi.
"Once well-established in the soil, B. pseudomallei cannot feasibly be removed from the soil," according to the advisory. "Public health efforts should focus primarily on improving identification of cases so that appropriate treatment can be administered."
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WebMD, July 28, 2022.
CDC: "Bacteria that Causes Rare Disease Melioidosis Discovered in U.S. Environmental Samples," "CDC Identifies Rare Bacteria in Aromatherapy Product," "Melioidosis Locally Endemic in Areas of the Mississippi Gulf Coast after Burkholderia pseudomallei Isolated in Soil and Water and Linked to Two Cases – Mississippi, 2022 and 2022."