Abstract
Melioidosis is a severe tropical infectious disease caused by the soil-dwelling bacterium Burkholderia pseudomallei, predominantly endemic to Southeast Asia and northern Australia. Between the 1970s and the 1990s, the presence of B. pseudomallei causing melioidosis in humans and other animals was demonstrated in four coastal provinces in southern China: Hainan, Guangdong, Guangxi, and Fujian, although indigenous cases were rare and the disease failed to raise concern amongst local and national health authorities. In recent years, there has been a rise in the number of melioidosis cases witnessed in the region, particularly in Hainan. Meanwhile, although China has established and maintained an effective communicable disease surveillance system, it has not yet been utilized for melioidosis. Thus, the overall incidence, social burden and epidemiological features of the disease in China remain unclear. In this context, we present a comprehensive overview of both historical and current information on melioidosis in Southern China, highlighting the re-emergence of the disease in Hainan. Surveillance and management strategies for melioidosis should be promoted in mainland China, and more research should be conducted to provide further insights into the present situation.
Highlights
Melioidosis is a fatal infectious disease caused by Burkholderia pseudomallei, a saprophytic environmental bacterium that is endemic in many tropical regions of the world and affects both humans and animals [1,2]
We identified 196 articles to the end of August 2018, which we reviewed for relevance based on whether they described melioidosis cases or B. pseudomallei isolates from mainland China
With the recognition of melioidosis as an emerging threat to both endemic and non-endemic areas, since 2017 B. pseudomallei has been included in PulseNet China, a national monitoring platform for major bacterial pathogens led by ICDC
Summary
Melioidosis is a fatal infectious disease caused by Burkholderia pseudomallei, a saprophytic environmental bacterium that is endemic in many tropical regions of the world and affects both humans and animals [1,2]. With the rapid economic development and social transition over the past two decades, the situation has changed and there has been a substantial increase in the number of cases diagnosed in Hainan, with the occurrence of sporadic locally-acquired or imported cases in other areas throughout China. This shift requires a reconsideration of the current status and epidemiology of the disease within China. We hope that this review will help to inform clinicians and policy makers about the disease in southern China and lead to the formulation of plans to prevent and control it in the future
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