Melioidosis: An emerging yet neglected bacterial zoonosis

Abstract

Melioidosis (Whitmore’s disease) is an emerging disease caused by the Gram-negative saprophyte bacterium Burkholderia pseudomallei. It is a common but sometimes neglected zoonotic disease with a wide range of hosts, including humans. It has emerged as the leading cause of morbidity and mortality in tropical countries, such as Thailand, northern Australia, etc., and is continually emerging on a wider geographical scale. Recent epidemiological studies have suggested that most parts of Africa and the Middle East countries are environmentally suitable for B. Pseudomallei. Bacteria can easily travel from Asia to the Americas via Africa, as shown by phylogenetic analyzes of sporadic cases recently reported in America. Although melioidosis is included in the category 2 bioterrorism agents, there is ignorance in general people and even among clinicians regarding the infection. The disease requires long-term treatment regimens with no assurance of bacterial clearance. Several vaccine candidates are being tested, but none have reached clinical trials in humans. Diagnostic tests are still in the development stage and have compromised specificity and sensitivity in endemic areas. Understanding the adaptations of this organism to environmental factors and basic awareness is of the utmost importance today. Therefore, this review aims to provide an overview of melioidosis, including risk factors, epidemiology, clinical presentation, diagnosis, and preventive measures, as well as recommendations to increase awareness of the disease as a major public health problem.