Melioidosis Outbreak after Typhoon, Southern Taiwan

Abstract

From July through September 2005, shortly after a typhoon, 40 cases of Burkholderia pseudomallei infection (melioidosis) were identified in southern Taiwan. Two genotypes that had been present in 2000 were identified by pulsed-field gel electrophoresis. Such a case cluster confirms that melioidosis is endemic to Taiwan.

Sporadic and Outbreak Cases of Melioidosis in Southern Taiwan: Clinical Features and Antimicrobial Susceptibility

“…Overall 118 melioidosis cases were reported to Taiwan [8]; eighteen cases, including two reported cases in literatures [11,12] were sporadically found from January 2000 to June 2005 (the sporadic group). The last case included in the clustered group was 14 September 2005.…”

“…pseudomallei were identified by the typical colony morphology in Ashdown's medium and biochemical tests, and the presence of flagellin genes was detected by polymerase chain reaction, as described earlier [8]. In vitro susceptibility was determined by the E-test strips (AB BIODISK, Sweden).…”

“…Since 2000, melioidosis was designated as a notifiable disease by Taiwan Centers for Disease Control (CDC). Some sporadic cases were noted annually thereafter; however, between July and September in 2005, an outbreak with at least 40 melioidotic cases was identified in southern Taiwan after a heavy rainfall accompanying the Haitang Typhoon in July 2005 [8]. To Their medical charts were reviewed for demographic data and clinical information, including initial presentations, underlying diseases, possible portal of entry, antimicrobial therapy, and clinical outcome for further analysis.…”

Fatal Co-Infection–Melioidosis and Leptospirosis

“…Together with strong wind that was present during the period of the rescue operation, infected aerosolized particles could have been spread as it happened in the outbreak of melioidosis following a typhoon in Taiwan. 8 Furthermore, these four patients did not swim, bathe in the river, walk bare-footed, or come into contact with the soil but they did use water from the river to wash their hands and faces. This predisposed them to leptospirosis, as the portal of entry of leptospira is by the conjunctiva, in addition to abraded skin and mucous membrane.…”

Animal Models forFrancisella tularensisandBurkholderiaSpecies

“…Indeed, increased rates of melioidosis, characterized by severe pneumonia and higher mortality, follow the monsoon and typhoon seasons in Southeast Asia and Australia. 18,46 This seasonal increase has been linked to prolonged inhalation of storm-generated aerosols of contaminated particles. 118 Clinical manifestations of melioidosis range from acute sepsis to chronic disease or a latent infection that can reactivate years after initial exposure.…”