Melioidosis in the Western Indian Ocean and the Importance of Improving Diagnosis, Surveillance, and Molecular Typing

Rakotondrasoa, Andriniaina; Issack, Mohammad Iqbal; Garin, Benoît; Biot, Fabrice; Valade, Eric; Wattiau, Pierre; Allou, Nicolas; Belmonte, Olivier; Bibi, Jastin; Price, Erin P.; Collard, Jean-Marc

doi:10.3390/tropicalmed3010030

Cited by 8 publications

(7 citation statements)

References 21 publications

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“…Although Nigeria is speculated to have the greatest environmental suitability and hence burden of infection, only 1 case has been reported to date (156). Four Indian Ocean islands, Madagascar, Mauritius, Reunion Island, and Seychelles, have had confirmed human cases since 2004 (157). Genetic analysis of three African isolates revealed both genetic diversity and an ancestral relationship to an Asian clade, furthermore supporting the evidence of both anthropogenic dissemination and endemicity in Africa (158).…”

Section: Africamentioning

confidence: 79%

Human Melioidosis

2020

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SUMMARY The causative agent of melioidosis, Burkholderia pseudomallei, a tier 1 select agent, is endemic in Southeast Asia and northern Australia, with increased incidence associated with high levels of rainfall. Increasing reports of this condition have occurred worldwide, with estimates of up to 165,000 cases and 89,000 deaths per year. The ecological niche of the organism has yet to be clearly defined, although the organism is associated with soil and water. The culture of appropriate clinical material remains the mainstay of laboratory diagnosis. Identification is best done by phenotypic methods, although mass spectrometric methods have been described. Serology has a limited diagnostic role. Direct molecular and antigen detection methods have limited availability and sensitivity. Clinical presentations of melioidosis range from acute bacteremic pneumonia to disseminated visceral abscesses and localized infections. Transmission is by direct inoculation, inhalation, or ingestion. Risk factors for melioidosis include male sex, diabetes mellitus, alcohol abuse, and immunosuppression. The organism is well adapted to intracellular survival, with numerous virulence mechanisms. Immunity likely requires innate and adaptive responses. The principles of management of this condition are drainage and debridement of infected material and appropriate antimicrobial therapy. Global mortality rates vary between 9% and 70%. Research into vaccine development is ongoing.

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Section: Africamentioning

confidence: 79%

Human Melioidosis

2020

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“…The first seven cases of community-acquired melioidosis that we reported for the Indian Ocean region had occurred over a period of 14 years. 3,4 Six of these cases had come from the Mahajanga region of Madagascar, 4 where B. pseudomallei was recently identified in soil samples. 4 The last case of melioidosis had occurred in Reunion Island and was indigenous.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 Six of these cases had come from the Mahajanga region of Madagascar, 4 where B. pseudomallei was recently identified in soil samples. 4 The last case of melioidosis had occurred in Reunion Island and was indigenous. 5 In the present series, two cases of melioidosis in Mayotte were likely indigenous because the patients did not report any travel.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Six New Cases of Melioidosis in the Indian Ocean Region: Comoros, Madagascar, Reunion Island

Renou

Miltgen

Blondé

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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Melioidosis is an emerging disease caused by the environmental Gram-negative bacillus Burkholderia pseudomallei. Melioidosis has been reported to be endemic mainly in northern Australia and Southeast Asia. Here, we report the first two cases of melioidosis on the Comorian island of Mayotte. We also describe four cases that occurred over a short period of time in patients who had traveled between Mayotte, Madagascar, and Reunion Island.

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“…In contrast to the situation in eastern continental Africa, Madagascar, the second largest island state in the western Indian Ocean, was already recognized as an endemic area in the 1930s [ 30 ]. Since there is a comprehensive summary of recent cases of melioidosis in the western Indian Ocean [ 31 ], in particular in Madagascar, we will only briefly summarize the current situation. First reports on melioidosis in pigs were published by French scientists in 1936 and a further report on the isolation of B. pseudomallei from soil [ 16 ] confirmed the presence of this pathogen on the island.…”

Section: Melioidosis and Environmental B Pseudomallei mentioning

confidence: 99%

Melioidosis in Africa: Time to Uncover the True Disease Load

et al. 2018

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Melioidosis is an often fatal infectious disease with a protean clinical spectrum, caused by the environmental bacterial pathogen Burkholderia pseudomallei. Although the disease has been reported from some African countries in the past, the present epidemiology of melioidosis in Africa is almost entirely unknown. Therefore, the common view that melioidosis is rare in Africa is not evidence-based. A recent study concludes that large parts of Africa are environmentally suitable for B. pseudomallei. Twenty-four African countries and three countries in the Middle East were predicted to be endemic, but no cases of melioidosis have been reported yet. In this study, we summarize the present fragmentary knowledge on human and animal melioidosis and environmental B. pseudomallei in Africa and the Middle East. We propose that systematic serological studies in man and animals together with environmental investigations on potential B. pseudomallei habitats are needed to identify risk areas for melioidosis. This information can subsequently be used to target raising clinical awareness and the implementation of simple laboratory algorithms for the isolation of B. pseudomallei from clinical specimens. B. pseudomallei was most likely transferred from Asia to the Americas via Africa, which is shown by phylogenetic analyses. More data on the virulence and genomic characteristics of African B. pseudomallei isolates will contribute to a better understanding of the global evolution of the pathogen and will also help to assess potential differences in disease prevalence and outcome.

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Melioidosis in the Western Indian Ocean and the Importance of Improving Diagnosis, Surveillance, and Molecular Typing

Cited by 8 publications

References 21 publications

Human Melioidosis

Human Melioidosis

Case Report: Six New Cases of Melioidosis in the Indian Ocean Region: Comoros, Madagascar, Reunion Island

Melioidosis in Africa: Time to Uncover the True Disease Load

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