Melioidosis in Singapore: Clinical, Veterinary, and Environmental Perspectives

Abstract

Melioidosis is a notifiable infectious disease registered with the Ministry of Health (MOH) and Agri-Food & Veterinary Authority (AVA), Singapore. From a clinical perspective, increased awareness of the disease has led to early detection and treatment initiation, thus resulting in decreasing mortality rates in recent years. However, the disease still poses a threat to local pet, zoo and farm animals, where early diagnosis is a challenge. The lack of routine environmental surveillance studies also makes prevention of the disease in animals difficult. To date, there have been no reports that provide a complete picture of how the disease impacts the local human and animal populations in Singapore. Information on the distribution of Burkholderia pseudomallei in the environment is also lacking. The aim of this review is to provide a comprehensive overview of both published and unpublished clinical, veterinary and environmental studies on melioidosis in Singapore to achieve better awareness and management of the disease.

Tuberculosis and Melioidosis at Distinct Sites Occurring Simultaneously

“…e overall annual incidence rate of melioidosis in Singapore was reported to be at 1.1 per 100,000 population. Diabetes mellitus is a key comorbidity in this study [9]. e patient's occupation also put him at risk of being infected with melioidosis.…”

Humoral Immune Responses to Burkholderia pseudomallei Antigens in Captive and Wild Macaques in the Western Part of Java, Indonesia

“…In general, nonhuman primates are susceptible to melioidosis. Gorillas and orangutans are predicted to have a higher susceptibility among other NHP species, based on the high occurrence and severity of spontaneous melioidosis cases in those animals [ 2 , 15 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. However, to the best of our knowledge, there have been no reports on susceptibility comparison between M. fascicularis and M. nemestrina.…”

Melioidosis fatalities in captive slender-tailed meerkats (Suricata suricatta): combining epidemiology, pathology and whole-genome sequencing supports variable mechanisms of transmission with one health implications

“…Lung lesions in all cases were either random multifocal and/or centred on pulmonary vessels. This is suggestive of bacteraemic embolic spread from the systemic circulation [44] rather than bronchopneumonia from inhalation, which is a common pathogenesis in other species [3, 13, 14, 45, 46]. The occurrence of most of the cases in the drier months (between April and October) rather than the monsoon season also fits with inhalation not being a major source of infection, since inhalational melioidosis has been shown to occur more frequently during severe-weather related events and heavy monsoonal rains [3, 9].…”

“…Although zoonotic transmission of B. pseudomallei and direct transmission between animals is considered rare, outbreaks related to exposure of a contaminated environmental source have been reported in both endemic and non-endemic settings, including piggeries in Queensland, Australia [19], non-human primates in European and Asian zoos [13, 20], and previous incidents in captive slender-tailed meerkats on display in eastern Thailand [21]. Regular outbreaks observed in intensive livestock farms [19] and in zoos [14] suggest that stressful conditions may initiate the onset of disease, particularly in exotic non-native species.…”