Fatal Burkholderia pseudomallei Infection Initially Reported as a Bacillus Species, Ohio, 2013

Thomas J. Doker Epidemic Intelligence Service, and Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia; Ohio Department of Health, Columbus, Ohio; Pike County General Health District, Waverly, Ohio

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Celia L. Quinn Epidemic Intelligence Service, and Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia; Ohio Department of Health, Columbus, Ohio; Pike County General Health District, Waverly, Ohio

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Ellen D. Salehi Epidemic Intelligence Service, and Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia; Ohio Department of Health, Columbus, Ohio; Pike County General Health District, Waverly, Ohio

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Joshua J. Sherwood Epidemic Intelligence Service, and Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia; Ohio Department of Health, Columbus, Ohio; Pike County General Health District, Waverly, Ohio

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Tina J. Benoit Epidemic Intelligence Service, and Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia; Ohio Department of Health, Columbus, Ohio; Pike County General Health District, Waverly, Ohio

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Mindy Glass Elrod Epidemic Intelligence Service, and Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia; Ohio Department of Health, Columbus, Ohio; Pike County General Health District, Waverly, Ohio

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Jay E. Gee Epidemic Intelligence Service, and Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia; Ohio Department of Health, Columbus, Ohio; Pike County General Health District, Waverly, Ohio

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Sean V. Shadomy Epidemic Intelligence Service, and Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia; Ohio Department of Health, Columbus, Ohio; Pike County General Health District, Waverly, Ohio

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William A. Bower Epidemic Intelligence Service, and Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia; Ohio Department of Health, Columbus, Ohio; Pike County General Health District, Waverly, Ohio

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Alex R. Hoffmaster Epidemic Intelligence Service, and Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia; Ohio Department of Health, Columbus, Ohio; Pike County General Health District, Waverly, Ohio

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Henry T. Walke Epidemic Intelligence Service, and Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia; Ohio Department of Health, Columbus, Ohio; Pike County General Health District, Waverly, Ohio

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David D. Blaney Epidemic Intelligence Service, and Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia; Ohio Department of Health, Columbus, Ohio; Pike County General Health District, Waverly, Ohio

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Mary S. DiOrio Epidemic Intelligence Service, and Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia; Ohio Department of Health, Columbus, Ohio; Pike County General Health District, Waverly, Ohio

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the Melioidosis Investigation Team Epidemic Intelligence Service, and Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia; Ohio Department of Health, Columbus, Ohio; Pike County General Health District, Waverly, Ohio

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A fatal case of melioidosis was diagnosed in Ohio one month after culture results were initially reported as a Bacillus species. To identify a source of infection and assess risk in patient contacts, we abstracted patient charts; interviewed physicians and contacts; genetically characterized the isolate; performed a Burkholderia pseudomallei antibody indirect hemagglutination assay on household contacts and pets to assess seropositivity; and collected household plant, soil, liquid, and insect samples for culturing and real-time polymerase chain reaction testing. Family members and pets tested were seronegative for B. pseudomallei. Environmental samples were negative by real-time polymerase chain reaction and culture. Although the patient never traveled internationally, the isolate genotype was consistent with an isolate that originated in Southeast Asia. This investigation identified the fifth reported locally acquired non-laboratory melioidosis case in the contiguous United States. Physicians and laboratories should be aware of this potentially emerging disease and refer positive cultures to a Laboratory Response Network laboratory.

Author Notes

* Address correspondence to Thomas J. Doker, Epidemic Intelligence Service, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333. E-mail: thomas.doker@gmail.com

Authors' addresses: Thomas J. Doker and Celia L. Quinn, Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: thomas.doker@gmail.com and fyq6@cdc.gov. Ellen D. Salehi and Mary S. DiOrio, Ohio Department of Health, Columbus, OH, E-mails: ellen.salehi@odh.ohio.gov and mary.diorio@odh.ohio.gov. Joshua J. Sherwood, Pike County General Health District, Waverly, OH, E-mail: jsherwood@pike-health.org. Tina J. Benoit, Mindy Glass Elrod, Jay E. Gee, Sean V. Shadomy, William A. Bower, Alex R. Hoffmaster, Henry T. Walke, and David D. Blaney, Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: tbenoit@cdc.gov, welrod@cdc.gov, xzg4@cdc.gov, sshadomy@cdc.gov, wbower@cdc.gov, ahoffmaster@cdc.gov, hwalke@cdc.gov, and dblaney@cdc.gov.

  • 1.

    Wiersinga WJ, Currie BJ, Peacock SJ, 2012. Melioidosis. N Engl J Med 367: 10351044.

  • 2.

    Inglis TJJ, Rolim DB, Sousa AD, 2006. Melioidosis in the Americas. Am J Trop Med Hyg 75: 947954.

  • 3.

    Currie BJ, 2003. Melioidosis: an important cause of pneumonia in residents of and travelers returned from endemic regions. Eur Respir J 22: 542550.

  • 4.

    Inglis TJ, Rolim DB, Rodriguez JI, 2006. Clinical guideline for diagnosis and management of melioidosis. Rev Inst Med Trop Sao Paulo 48: 14.

  • 5.

    Limmathurotsakul D, Kanoksil M, Wuthiekanun V, Kitphati R, deStavola B, Day NP, Peacock SJ, 2013. Activities of daily living associated with acquisition of melioidosis in northeast Thailand: a matched case-control study. PLoS Negl Trop Dis 7: 16.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Cheng AC, Currie BJ, 2005. Melioidosis: epidemiology, pathophysiology, and management. Clin Microbiol Rev 18: 383416.

  • 7.

    Currie BJ, Fisher DA, Howard DM, Burrow JN, Selvanayagam S, Snelling PL, Anstey NM, Mayo MJ, 2000. The epidemiology of melioidosis in Australia and Papua New Guinea. Acta Trop 74: 121127.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Njauy V, Lemeshev Y, Sadkowski L, Crawford G, 2005. Cutaneous melioidosis in a man who was taken as a prisoner of war by the Japanese during World War II. J Clin Microbiol 43: 970972.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Currie BJ, Ward L, Cheng AC, 2010. The epidemiology and clinical spectrum of melioidosis: 540 cases from the 20 year Darwin prospective study. PLoS Negl Trop Dis 4: 111.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Alexander AD, Huxsoll DL, Warner ARJ, Shepler V, Dorsey A, 1970. Serological diagnosis of human melioidosis with indirect hemagglutination and complement fixation tests. J Appl Microbiol 20: 825833.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Novak RT, Glass MB, Gee JE, Gal D, Mayo MJ, Currie BJ, Wilkins PP, 2006. Development and evaluation of a real-time PCR assay targeting the type III secretion system of Burkholderia pseudomallei. J Clin Microbiol 44: 8590.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Godoy D, Randle G, Simpson AJ, Aanensen DM, Pitt TL, Kinoshita R, Spratt BG, 2003. Multilocus sequence typing and evolutionary relationships among the causative agents of melioidosis and glanders, Burkholderia pseudomallei and Burkholderia mallei. J Clin Microbiol 41: 20682079.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Liguori AP, Warrington SD, Ginther JL, Pearson T, Bowers J, Glass MB, Mayo M, Wuthiekanun V, Engelthaler D, Peacock SJ, Currie BJ, Wagner DM, Keim P, Tuanyok A, 2011. Diversity of 16S-23S rDNA internal transcribed spacer (ITS) reveals phylogenetic relationships in Burkholderia pseudomallei and its near-neighbors. PLoS ONE 6: e29323.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Harris PNA, Ketheesan N, Owens L, Norton RE, 2009. Clinical features that affect indirect-hemagglutination-assay responses to Burkholderia pseudomallei. Clin Vaccine Immunol 16: 924930.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Brook MD, Currie B, Desmarcheller PM, 1997. Isolation and identification of Burkholderia pseudomallei from soil using selective culture techniques and the polymerase chain reaction. J Appl Microbiol 82: 589596.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Kaestli M, Mayo M, Harrington G, Watt F, Hill J, Gal D, Currie BJ, 2007. Sensitive and specific molecular detection of Burkholderia pseudomallei, the causative agent of melioidosis, in the soil of tropical northern Australia. Appl Environ Microbiol 73: 68916897.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Garry MW, Koch ML, 1951. Chronic melioidosis: bacteriologic and clinical correlation in diagnosis. J Lab Clin Med 38: 374383.

  • 18.

    Osteraas GR, Hardman JM, Bass JW, Wilson C, 1971. Neonatal melioidosis. Am J Dis Child 122: 446448.

  • 19.

    Currie BJ, Fisher DA, Howard DM, Burrow JN, Lo D, Selva-nayagam S, Anstey NM, Huffam SE, Snelling PL, Marks PJ, Stephens DP, Lum GD, Jacups SP, Krause VL, 2000. Endemic melioidosis in tropical northern Australia: a 10-year prospective study and review of the literature. Clin Infect Dis 31: 981986.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    McCormick JB, Sexton DJ, McMurray JG, Carey E, Hayes P, Feldman RA, 1975. Human-to-human transmission of Pseudomonas pseudomallei. Ann Intern Med 83: 512513.

  • 21.

    Zehnder AM, Hawkins MG, Koshi MA, Lifland B, Byrne BA, Swanson AA, Rood MP, Gee JE, Elrod MG, Beesley CA, Blaney DD, Ventura J, Hoffmaster AR, Beeler ES, 2014. Burkholderia pseudomallei in 2 pet iguanas, California, USA. Emerg Infect Dis 20: 304306.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Stewart T, Engelthaler DM, Blaney DD, Tuanyok A, Wangsness E, Smith TL, Pearson T, Komatsu KK, Keim P, Currie BJ, Levy C, Sunenshine R, 2011. Epidemiology and investigation of melioidosis, southern Arizona. Emerg Infect Dis 17: 12861288.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Centers for Disease Control and Prevention, 2013. The Laboratory Response Network: Partners in Preparedness. Available at: http://www.bt.cdc.gov/lrn/. Accessed January 2, 2014.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    American Society of Microbiology, 2014. Sentinel Level Clinical Laboratory Guidelines for Suspected Agent of Bioterrorism and Emerging Infectious Diseases: Glanders (Burkholderia mallei) and Melioidosis (Burkholderia pseudomallei). Available at: http://www.asm.org/images/PSAB/Burkholderia. Accessed January 2, 2014.

    • PubMed
    • Search Google Scholar
    • Export Citation
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