Melioidosis in Mexico, Central America, and the Caribbean

Abstract

Burkholderia pseudomallei is the causative agent of melioidosis, an endemic disease in tropical areas around the world. Cumulative human cases have demonstrated that melioidosis is prevalent and increasingly recognized in the American continent. Even though the first reports of melioidosis in Mexico, Central America, and the Caribbean Islands date back to the late 1940s, the potential of the disease as a public health concern in the region has not been fully appreciated. Unfortunately, recent studies predicting the global distribution of the disease and the demonstration of melioidosis endemicity in Puerto Rico have not increased recognition of the disease by health professionals in this region. Furthermore, a lack of both diagnostic capacity and awareness of the disease has resulted in a limited number of studies that have attempted to accurately determine its prevalence and geographical distribution. In this review, a summary of reported cases in the countries of this region are presented, as well as recommendations to increase the diagnosis and awareness of the disease as an important public health problem in Mexico, Central America, and the Caribbean islands.

Three New Cases of Melioidosis, Guadeloupe, French West Indies

“…M elioidosis, caused by the telluric gram-negative rod Burkholderia pseudomallei, is endemic in Southeast Asia and northern Australia (1) but may be underdiagnosed in other tropical regions (2). Increasing occurrences have been reported in the Caribbean during the past few decades among persons with no exposure to known endemic areas (3)(4)(5). Tropical environmental conditions and the presence of this bacterium in soil samples in the Caribbean support the plausibility of endemicity (3).…”

“…(3). The skin test became commercially available again in 2014 after more than a decade; it is approved for adults 18-64 of age who have a history of pulmonary coccidioidomycosis (3,4). However, little is known about its use…”

Melioidosis: A Neglected Cause of Community-Acquired Pneumonia

“…20 From the published literature alone, a review recently reported 63 cases of melioidosis from Mexico, central America, and the Caribbean, establishing its endemicity within the region. 21 An excellent example of uncovering the hidden burden using increased surveillance, awareness, and WHO's laboratory capacity building program is that from Sri Lanka. 22 The first case was isolated in 1927 23 and up until 2000, a handful of isolated cases had been reported from Sri Lanka and on occasion even considered nonendemic for melioidosis.…”

Misidentification of Burkholderia pseudomallei and Other Burkholderia Species From Pediatric Infections in Mexico

“…Diabetes mellitus is a major risk factor, and individuals suffering from this disease are at higher risk for developing melioidosis than the rest of the population [3]. Bps is primarily found in tropical areas, mainly in northern Australia and the south of Asia, but it is being found more frequently in other tropical countries as well [4]. In Mexico, there have been 15 documented cases of melioidosis, between 1958 and 2018 [4], with the most recent resulting in the fatality of 2 teenaged siblings (aged 12 and 16) [5].…”