Global dissemination and public health impact of melioidosis

Jo Su-kyoung, Shin Yong-woo, Kang Byung-hak, Rhie Gi-eun
Division of High-risk Pathogens, Center for Laboratory Control of Infectious Diseases, KCDC

Melioidosis is an infectious disease caused by Burkholderia pseudomallei, which is a highly pathogenic bacterium in human and animals and is commonly present in the soil in tropical countries, such as Southeast Asian countries and Northern Australia.
Since this bacterium has intrinsic resistance to a wide range of antimicrobials, treatment with improper antimicrobials may result in high fatality rates (up to 70%). B. pseudomallei has been listed on Tier 1 of select agent lists in the US and designated as one of the high-risk pathogens in Korea in 2010. Despite the high pathogenicity and high fatality rate, the neglected tropical disease lists of the World Health Organization do not include melioidosis. Melioidosis is an importance disease of public health not only in Southeast Asia and Australia, but also in non-endemic regions. The global dissemination of melioidosis remains poorly understood. In particular, when the organism is released in a non-endemic country, it may be difficult to estimate the level of risk of melioidosis establishment. In the coming decades, the disease will affect travelers worldwide. In addition, there are concerns that B. pseudomallei may be used as a bioterrorism agent.
Advanced diagnostic methods and efficient antibiotic therapy will improve the disease outcomes in endemic areas. Furthermore, continuous attention to melioidosis may aid in improving the detection of B. pseudomallei and and in developing the appropriate treatment strategies.

Keywords: Melioidosis, Burkholderia pseudomallei, Global Distribution, Public Health, Neglected Tropical Disease