Melioidosis in a Tropical City State, Singapore

Melioidosis is an infectious disease of humans and animals caused by gram-negative bacillus found in soil and water. The causative agent for Melioidosis is Pseudomonas pseudomallei. This disease is endemic in Southeast Asia and parts of Africa. It was rare in the United States prior to recent immigration from Southeast Asia. Melioidosis is a huge public health issue because it is most common in AIDS patients and intravenous drug users.

The organism enters the body through skin abrasions, burns or wounds which are contaminated by the soil, inhalation of dust or eating food that is contaminated with P.pseudomallei. Person-to-person transmission is unusual. The incubation period is two to three days. Diagnosis should be confirmed through laboratory tests. P.pseudomallei can be cultured from patient’s blood, sputum or tissue from abscesses. There is no form of vaccine for melioidosis. Prevention requires prompt cleansing of scrapes, burns, or other areas where the disease is common and avoidance of needle sharing among drug addicts.

Melioidosis can mimic many other diseases because it can affect almost any organ. A misdiagnosis could be fatal. P.pseudomallei is susceptible to a certain amount of antibiotics. There are endemic areas where melioidosis is an important cause of illness and death in humans and animals. In 1975, a Panda introduced melioidosis to the Paris Zoo. This caused a severe outbreak. The epidemic spread to other zoos in Paris. It wiped out zoo populations and caused two human deaths. Due to this, there are fears that P.pseudomallei could be used as a biological weapon.

Melioidosis is rising as a serious public health problem in many countries. In Singapore the case-fatality rate of melioidosis has decreased. However, it has the potential to come back with adverse climate events such as heavy rainfall and flash floods.

Works Cited:
Lo TJ, Ang LW, James L, Goh KT. Melioidosis in a tropical city state, Singapore. Emerg Infect Dis [serial on the Internet] 2009 Oct [date cited] Available from http://www.cdc.gov/EID/content/15/10/1645.htm
Barnes JL, Ketheesan N. Route of infection in melioidosis. Emerg Infect Dis [serial on the Internet]. 2005 Apr [date cited]. Available from http://www.cdc.gov/ncidod/EID/vol11no04/04-1051.htm