from the don't-let-it-happen-to-you dept.
A deadly soil bacterium common in tropical and subtropical climates has mysteriously infected three people in three different US states, killing at least one, according to a health alert from the Centers for Disease Control and Prevention.
While US cases of the infection periodically pop up in travelers, none of the three infected people have recent travel history that could easily explain how they picked up the dangerous germ. The bacteria, Burkholderia pseudomallei, usually infects by direct contact with an environmental source, i.e. contaminated soil or water. It most often attacks through breaks in the skin and it very rarely jumps from human to human. Yet genetic analyses of the bacterial strains in the latest US cases indicate that the three, geographically-separated infections are related.
The curious cluster of cases suggests there was a common source of the bacteria. Investigators speculate that a yet-unidentified imported product or animal could be a common source. For instance, iguanas and monkeys imported with infections have been linked to cases in the past. But the cluster also resurfaces concern that B. pseudomallei is no longer a mere interloper in the US, rather it may have become a permanent, low-key resident.
The distinction is not only critical for infection prevention efforts but also clinical care. Infections with B. pseudomallei cause melioidosis, which can be fatal in 10 percent to 50 percent of cases. People with diabetes, kidney disease, chronic lung disease, and alcoholism are most at risk. But the symptoms can be vague and widely variable. They include everything from localized pain, swelling, fever, ulceration, and abscesses, to coughing, chest pain, headaches, anorexia, respiratory distress, abdominal discomfort, joint pain, disorientation, weight loss, stomach or chest pain, muscle pain, joint pain, and seizures.
The symptoms are so nebulous, melioidosis is sometimes called the "Great Mimicker" because it's often mistaken for other serious conditions, such as tuberculosis. Without a travel history that may hint at an exposure to B. pseudomallei, doctors may misdiagnose it—and that can quickly turn deadly. B. pseudomallei is resistant to many antibiotic treatments. Delayed diagnosis and improper treatment can allow the infection to go systemic, which can be fatal in 90 percent of cases.
In the three new cases occurring in two adults and one child, the symptoms ranged from cough and shortness of breath, to weakness, fatigue, nausea, vomiting, intermittent fever, and rash on the trunk, abdomen, and face, the CDC said.