What is melioidosis? The silent killer of the tropics

While tropical diseases such as dengue and malaria often make headlines, there is another silent but deadly disease that goes largely unnoticed: melioidosis. This dangerous bacterial infection, caused by Burkholderia pseudomallei, thrives in soil and water, especially in tropical and subtropical regions such as Southeast Asia and Northern Australia.

Despite its severity, melioidosis remains relatively unknown, often leading to misdiagnosis and delayed treatment.

This silent but deadly disease is a growing problem in tropical regions, and it is essential to raise awareness to prevent further loss of life.

Indiatoday spoke to Dr. Chiranjay Mukhopadhyay, Professor, Department of Microbiology, Kasturba Medical College, Manipal, MAHE to gain more insights.

WHAT IS MELIIOIDOSIS?

Melioidosis is a bacterial infection transmitted mainly through contact with contaminated soil or water, especially during the rainy or monsoon season, when these environments are wet and submerged.

The bacterium, Burkholderia pseudomallei, thrives under these conditions, especially in regions prone to heavy rainfall and flooding.

Individuals become infected when they come into direct contact with contaminated water or soil, especially if they have open cuts or wounds.

The bacteria can also enter the body by inhaling contaminated dust or droplets, making anyone exposed to flood water – especially farmers, gardeners or people in close contact with the soil – more susceptible.

The rainy season poses an increased risk because flood waters transport the bacteria to larger areas, making it easier for people to come into contact with the bacteria.

Farmers and agricultural workers are particularly vulnerable, but even incidental exposure to contaminated water can lead to infection.

THE SILENT KILLER

One of the most concerning aspects of melioidosis is its ability to mimic other diseases. The symptoms of the infection are varied, ranging from fever, chest pain, coughing and breathing difficulties, resembling pneumonia or tuberculosis.

In some cases it can cause local infections, with abscesses in the skin, liver, spleen or lungs. The infection can also lead to sepsis, with symptoms such as high fever, confusion and shock.

It can lead to serious health problems, especially for people with existing health problems such as diabetes, chronic kidney disease, or a weakened immune system.

What makes melioidosis even more dangerous is its ability to lie dormant in the body for years, only to emerge when a person’s immune system weakens.

This characteristic makes it a ‘silent killer’ that can strike without warning. The disease can go unnoticed for a long time, making it a persistent and hidden threat.

UN DIAGNOSIS CHALLENGES

One of the main reasons why melioidosis goes under the radar is that it is often misdiagnosed. Healthcare providers, especially in regions where the disease is less known, may not immediately recognize the disease.

The symptoms overlap with those of other common diseases, leading to incorrect diagnoses.

This delay in identifying melioidosis can be life-threatening, as the infection requires specific antibiotic treatment.

Compounding the problem is the bacteria’s resistance to many commonly used antibiotics.

This means that even if an infection is suspected, finding the right medication can be a challenge.

Not all antibiotics will work against Burkholderia pseudomallei, making the treatment process longer and more complicated.

TREATMENT AND RECOVERY

Melioidosis is treatable if caught early. Standard treatment includes an initial phase of intravenous (IV) antibiotics for 10 to 14 days, followed by a course of oral antibiotics for three to six months.

The long-term use of oral antibiotics is necessary to ensure that the bacteria are completely eradicated from the body and to prevent a recurrence of the infection.

However, for those who are diagnosed late or whose disease has progressed to a more severe stage, recovery may be more difficult and the risk of long-term complications increases.

The key to successful treatment is early detection, which highlights the importance of raising awareness about the disease among healthcare providers and the general public.

PREVENTION IS KEY

Preventing melioidosis mainly involves reducing exposure to contaminated water and soil. Here are some important steps to minimize the risk of infection:

• When working in soil, water or flooded areas it is important to wear gloves, boots and other protective clothing. This helps prevent the bacteria from entering the body through open wounds or abrasions.
• During the rainy season, it is crucial that you avoid walking in water, especially if you have cuts or wounds. Flood water is likely to contain high levels of bacteria, increasing the risk of infection.
• Increasing awareness about melioidosis is crucial for preventing infection. Public health campaigns that focus on educating people can play a key role in reducing the spread of the disease. Communities should be informed about the risks and symptoms of melioidosis to ensure early diagnosis and treatment.

Melioidosis may not be recognized in the same way as other tropical diseases, but it is no less dangerous. This silent killer can cause serious illness and even death if not diagnosed and treated in time.

Increasing awareness among healthcare providers and local communities is essential for improving diagnosis and treatment outcomes. By taking preventative measures and educating the public, we can protect vulnerable populations from this hidden threat.

With more research and global awareness, we can create a safer future where melioidosis is no longer a disease that operates in the shadows.

Melioidosis may be under the radar for now, but it doesn’t have to stay that way. By taking action now to raise awareness and improve treatment, we can prevent this silent killer from claiming more lives.