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

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  • 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

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.

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