ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2015
Contact investigation of melioidosis cases reveals regional endemicity in Puerto Rico.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
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35 citing papers in PubMed, 50 citations in OpenAlex.
- Virulence of Burkholderia pseudomallei Strains from Western Hemisphere and Africa in Mice.Emerging infectious diseases · 2026Article
- Concurrent resistance and virulence traits in extremely drug-resistant Burkholderia pseudomallei from bovine milk samples: potential for zoonotic transmission.Veterinary research communications · 2026Article
- Layered and integrated medical countermeasures againstFrontiers in microbiology · 2022Article
- Human Melioidosis Caused by Novel Transmission of Burkholderia pseudomallei from Freshwater Home Aquarium, United StatesEmerging infectious diseases · 2021Article
- Enhanced melioidosis surveillance in patients attending four tertiary hospitals in Yangon, Myanmar.Epidemiology and infection · 2021Article
- Burkholderia pseudomallei in Soil, US Virgin Islands, 2019.Emerging infectious diseases · 2020Article
- Melioidosis and the Heart: A Systematic Review.Tropical medicine and infectious disease · 2020Review
- Human Melioidosis.Clinical microbiology reviews · 2020Review
- Melioidosis after Hurricanes Irma and Maria, St. Thomas/St. John District, US Virgin Islands, October 2017.Emerging infectious diseases · 2019Article
- Burkholderia pseudomallei, the causative agent of melioidosis, is rare but ecologically established and widely dispersed in the environment in Puerto Rico.PLoS neglected tropical diseases · 2019Article
- Differentiating New from Newly Detected: Melioidosis in Yap, Federated States of Micronesia.The American journal of tropical medicine and hygiene · 2019Article
- Melioidosis is in the Americas: A Call to Action for Diagnosing and Treating the Disease.The American journal of tropical medicine and hygiene · 2018Article
- Public health response to an imported case of canine melioidosis.Zoonoses and public health · 2018Article
- Melioidosis in Mexico, Central America, and the Caribbean.Tropical medicine and infectious disease · 2018Article
- Transmission Modes of Melioidosis in Taiwan.Tropical medicine and infectious disease · 2018Review
- Burkholderia pseudomallei distribution in Australasia is linked to paleogeographic and anthropogenic history.PloS one · 2018Article
- Article
- Phylogeography of Burkholderia pseudomallei Isolates, Western Hemisphere.Emerging infectious diseases · 2017Article
- Genome-scale analysis of the genes that contribute to Burkholderia pseudomallei biofilm formation identifies a crucial exopolysaccharide biosynthesis gene cluster.PLoS neglected tropical diseases · 2017Article
- Melioidosis: Clinical impact and public health threat in the tropics.PLoS neglected tropical diseases · 2017Review
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Authors and funding
20 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMelioidosis results from infection with Burkholderia pseudomallei and is associated with case-fatality rates up to 40%. Early diagnosis and treatment with appropriate antimicrobials can improve survival rates. Fatal and nonfatal melioidosis cases were identified in Puerto Rico in 2010 and 2012, respectively, which prompted contact investigations to identify risk factors for infection and evaluate endemicity.
methodsQuestionnaires were administered and serum specimens were collected from coworkers, neighborhood contacts within 250 m of both patients' residences, and injection drug user (IDU) contacts of the 2012 patient. Serum specimens were tested for evidence of prior exposure to B. pseudomallei by indirect hemagglutination assay. Neighborhood seropositivity results guided soil sampling to isolate B. pseudomallei.
resultsSerum specimens were collected from contacts of the 2010 (n = 51) and 2012 (n = 60) patients, respectively. No coworkers had detectable anti-B. pseudomallei antibody, whereas seropositive results among neighborhood contacts was 5% (n = 2) for the 2010 patient and 23% (n = 12) for the 2012 patient, as well as 2 of 3 IDU contacts for the 2012 case. Factors significantly associated with seropositivity were having skin wounds, sores, or ulcers (odds ratio [OR], 4.6; 95% confidence interval [CI], 1.2-17.8) and IDU (OR, 18.0; 95% CI, 1.6-194.0). Burkholderia pseudomallei was isolated from soil collected in the neighborhood of the 2012 patient.
conclusionsTaken together, isolation of B. pseudomallei from a soil sample and high seropositivity among patient contacts suggest at least regional endemicity of melioidosis in Puerto Rico. Increased awareness of melioidosis is needed to enable early case identification and early initiation of appropriate antimicrobial therapy.
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