Abstract
Sporadic cases of melioidosis have been diagnosed in Myanmar since the disease was first described in Yangon in 1911. Published and unpublished cases are summarized here, along with results from environmental and serosurveys. A total of 298 cases have been reported from seven states or regions between 1911 and 2018, with the majority of these occurring before 1949. Findings from soil surveys confirm the presence of Burkholderia pseudomallei in the environment in all three regions examined. The true epidemiology of the disease in Myanmar is unknown. Important factors contributing to the current gaps in knowledge are lack of awareness among clinicians and insufficient laboratory diagnostic capacity in many parts of the country. This is likely to have led to substantial under-reporting.
Highlights
Introduction and History of Melioidosis inMyanmarAll historical accounts of melioidosis start with Myanmar, since the disease was first recognized in 1911 in Rangoon ( Yangon) General Hospital by Alfred Whitmore, a British pathologist who worked in Burma between 1906 and 1924 [1]
We found a total of 298 published and unpublished cases of melioidosis in Myanmar since 1913 (Table 1)
Several were diagnosed outside Myanmar, and the remainder came from a very small number of centres
Summary
All historical accounts of melioidosis start with Myanmar (formerly Burma), since the disease was first recognized in 1911 in Rangoon ( Yangon) General Hospital by Alfred Whitmore, a British pathologist who worked in Burma between 1906 and 1924 [1]. In the ensuing years, reported case numbers in the country dwindled, and after the end of World War II, the disease disappeared from sight for more than years. This hiatus corresponded firstly with the transition from colonial rule to independence Microbiologists working in larger centres inside Myanmar have reported sporadic cases over the last 20 years, but the true epidemiology of the disease is unknown. It is likely that melioidosis is significantly underdiagnosed in Myanmar, and the projected annual number of cases (more than 6000) and deaths (more than 3000) from a recent modelling study could well be an accurate reflection of the true situation [3]. We consulted the Myanmar medical literature and the melioidosis global database [4], and contacted consultant microbiologists in the biggest centres in the country (public sector)
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