BANGKOK—
Melioidosis, a deadly bacterial disease most frequently
found in Asia, is more widespread than previously believed and resists a wide
range of antibiotic treatments, a just-issued study reports.
The new journal Nature Microbiology on Monday published findings
that the little-known disease likely is present in 79 countries, including 34
that have never reported it. Research was conducted at the Mahidol Oxford
Tropical Medicine Research Unit (MORU) here and the University of Washington in
the northwestern U.S. city of Seattle, among other institutions.
The study estimates the disease kills nearly as many people
as measles, which the World Health Organization cited as responsible
for almost 115,000 fatalities in 2014. Melioidosis causes more deaths annually
than dengue or leptospirosis, both of which are health priorities for numerous
international health organizations.
It’s caused by Burkholderia pseudomallei, a highly
pathogenic bacterium commonly found in soil and water. It is contracted through
the skin, lungs or by drinking infected water.
Symptoms can include fever, weight loss, body
aches, coughing and headaches, among other signs, according to the U.S. Centers
for Disease Control and Prevention. Patients are frequently misdiagnosed as
having pneumonia or suffering from sepsis, a potentially life-threatening
complication of an infection.
"Doctors will try to rule out whether [patients] have
malaria or dengue infection by rapid diagnostic tests," MORU’s Dr. Direk
Limmathurotsakul told VOA. If neither is confirmed, "doctors will suspect
that any bacterial infection is the cause of the pneumonia and sepsis" and
will prescribe antibiotics, he said. Disease resists many drugs
But this particular bacterium is resistant to a wide range
of antimicrobials, including penicillin. Treatment with ineffective
antimicrobials can result in fatality rates exceeding 70 percent, according to
specialists.
"If they die, they die. If they survive, they
survive" without the actual ailment being known, said Direk, one of the
world's most prominent specialists on melioidosis.
The bacterium is especially common in Asia. The study
predicts high infections rates throughout Southeast Asia, notably in Vietnam
and India, where there is especially low awareness about it among medical
practitioners. The tropical zones of Australia are also considered at high risk
for melioidosis, as are East Asia and the Pacific, sub-Saharan Africa and South
America.
Some areas in Central America, southern Africa and the
Middle East are also at risk, according to researchers.
Diabetes, kidney disease raise risks
The number of cases is expected to rise amid an increase in
diabetes in the tropics, especially among the poor. Those with chronic kidney
disease also are considered at higher risk to contract melioidosis.
Melioidosis "can survive well within your white blood
cells or macrophage. This bacteria will spread much faster and kill you easier
if you have those kinds of diseases," said Direk, who is also an assistant
professor on Mahidol University’s tropical medicine faculty.
People who excessively drink alcohol are at higher risk for
the same reason. International travelers, too, could have higher rates of the
disease; mobility increases the risk of the pathogen being introduced to new
areas.
The study recommends health workers, international
organizations and policy makers give melioidosis a higher priority.
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