Abstract
Since 2005, the range of Burkholderia pseudomallei sequence type 562 (ST562) has expanded in northern Australia. During 2005–2019, ST562 caused melioidosis in 61 humans and 3 animals. Cases initially occurred in suburbs surrounding a creek before spreading across urban Darwin, Australia and a nearby island community. In urban Darwin, ST562 caused 12% (53/440) of melioidosis cases, a proportion that increased during the study period. We analyzed 2 clusters of cases with epidemiologic links and used genomic analysis to identify previously unassociated cases. We found that ST562 isolates from Hainan Province, China, and Pingtung County, Taiwan, were distantly related to ST562 strains from Australia. Temporal genomic analysis suggested a single ST562 introduction into the Darwin region in ≈1988. The origin and transmission mode of ST562 into Australia remain uncertain.
Highlights
Since 2005, the range of Burkholderia pseudomallei sequence type 562 (ST562) has expanded in northern Australia
Australia B. pseudomallei ST562 Epidemiology During 1989–2019, a total of 61 (5.5%) of 1,108 melioidosis cases were caused by B. pseudomallei ST562
B. pseudomallei ST562, Northern Australia evacuated from a remote community in East Arnhem Land, Northern Territory, Australia, 6 days after returning from a visit in Darwin; 1 patient lived in a rural community 37 km from Darwin; and 1 patient with an unknown travel history sought treatment at Katherine District Hospital (Katherine, Northern Territory, Australia), 317 km south of Darwin
Summary
Since 2005, the range of Burkholderia pseudomallei sequence type 562 (ST562) has expanded in northern Australia. The extent to which transmission mode, host risk factors, access to diagnostic testing, appropriate antimicrobial drugs, and intensive care treatment account for differences in manifestations and outcomes remains uncertain. Phylogeographic analyses suggest that B. pseudomallei emerged in ancient Australia and subsequently disseminated throughout Asia [2,5,6]. Because of their ecologic niche, sensitivity to ultraviolet light, and rare transmission among humans, strains of B. pseudomallei in Australia have remained phylogenetically distinct from strains in Asia, Africa, and the Americas [2,6]. In Northern Australia, researchers have identified only 2 instances of long-range B. pseudomallei disper-
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