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Travel-associated melioidosis: a narrative review.
Norman, Francesca F; Chen, Lin H.
  • Norman FF; National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid, Spain.
  • Chen LH; Division of Infectious Diseases and Travel Medicine, Mount Auburn Hospital, Cambridge, MA, USA.
J Travel Med ; 30(3)2023 05 18.
Article in English | MEDLINE | ID: covidwho-2274411
ABSTRACT

BACKGROUND:

Melioidosis, caused by Burkholderia pseudomallei, may be considered a neglected tropical disease that remains underdiagnosed in many geographical areas. Travellers can act as the sentinels of disease activity, and data from imported cases may help complete the global map of melioidosis.

METHODS:

A literature search for imported melioidosis for the period 2016-22 was performed in PubMed and Google Scholar.

RESULTS:

In total, 137 reports of melioidosis associated with travel were identified. The majority were males (71%) and associated with exposure in Asia (77%) (mainly Thailand, 41%, and India, 9%). A minority acquired the infection in the Americas-Caribbean area (6%), Africa (5%) and Oceania (2%). The most frequent comorbidity was diabetes mellitus (25%) followed by underlying pulmonary, liver or renal disease (8, 5 and 3%, respectively). Alcohol/tobacco use were noted for seven and six patients, respectively (5%). Five patients (4%) had associated non-human immunodeficiency virus (HIV)-related immunosuppression, and three patients (2%) had HIV infection. One patient (0.8%) had concomitant coronavirus disease 19. A proportion (27%) had no underlying diseases. The most frequent clinical presentations included pneumonia (35%), sepsis (30%) and skin/soft tissue infections (14%). Most developed symptoms <1 week after return (55%), and 29% developed symptoms >12 weeks after. Ceftazidime and meropenem were the main treatments used during the intensive intravenous phase (52 and 41% of patients, respectively) and the majority (82%) received co-trimoxazole alone/combination, for the eradication phase. Most patients had a favourable outcome/survived (87%). The search also retrieved cases in imported animals or cases secondary to imported commercial products.

CONCLUSIONS:

As post-pandemic travel soars, health professionals should be aware of the possibility of imported melioidosis with its diverse presentations. Currently, no licensed vaccine is available, so prevention in travellers should focus on protective measures (avoiding contact with soil/stagnant water in endemic areas). Biological samples from suspected cases require processing in biosafety level 3 facilities.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / Burkholderia pseudomallei / COVID-19 / Melioidosis Type of study: Diagnostic study / Observational study / Prognostic study / Reviews Topics: Long Covid / Vaccines Limits: Animals / Female / Humans / Male Country/Region as subject: Asia Language: English Journal subject: Communicable Diseases / Public Health Year: 2023 Document Type: Article Affiliation country: Jtm

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Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / Burkholderia pseudomallei / COVID-19 / Melioidosis Type of study: Diagnostic study / Observational study / Prognostic study / Reviews Topics: Long Covid / Vaccines Limits: Animals / Female / Humans / Male Country/Region as subject: Asia Language: English Journal subject: Communicable Diseases / Public Health Year: 2023 Document Type: Article Affiliation country: Jtm