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Petras JK, Elrod MG, Ty MC, Dawson P, O'Laughlin K, Gee JE, Hanson J, Boutwell C, Ainsworth G, Beesley CA, Saile E, Tiller R, Gulvik CA, Ware D, Sokol T, Balsamo G, Taylor K, Salzer JS, Bower WA, Weiner ZP, Negrón ME, Hoffmaster AR, Byers P. Locally Acquired Melioidosis Linked to Environment - Mississippi, 2020-2023. N Engl J Med 2023; 389:2355-2362. [PMID: 38118023 PMCID: PMC10773590 DOI: 10.1056/nejmoa2306448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Melioidosis, caused by Burkholderia pseudomallei, is a rare but potentially fatal bacterial disease endemic to tropical and subtropical regions worldwide. It is typically acquired through contact with contaminated soil or fresh water. Before this investigation, B. pseudomallei was not known to have been isolated from the environment in the continental United States. Here, we report on three patients living in the same Mississippi Gulf Coast county who presented with melioidosis within a 3-year period. They were infected by the same Western Hemisphere B. pseudomallei strain that was discovered in three environmental samples collected from the property of one of the patients. These findings indicate local acquisition of melioidosis from the environment in the Mississippi Gulf Coast region.
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Affiliation(s)
- Julia K Petras
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Mindy G Elrod
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Maureen C Ty
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Patrick Dawson
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Kevin O'Laughlin
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Jay E Gee
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Jennifer Hanson
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Carla Boutwell
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Gail Ainsworth
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Cari A Beesley
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Elke Saile
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Rebekah Tiller
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Christopher A Gulvik
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Daphne Ware
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Theresa Sokol
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Gary Balsamo
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Kathryn Taylor
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Johanna S Salzer
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - William A Bower
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Zachary P Weiner
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - María E Negrón
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Alex R Hoffmaster
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Paul Byers
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
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