This document provides an overview of melioidosis, a bacterial disease caused by Burkholderia pseudomallei. It is endemic in tropical regions like Southeast Asia and Northern Australia. The bacteria lives in soil and water and can infect humans through inhalation, ingestion, or skin contact. Symptoms range from localized infections to more severe pulmonary or bloodstream infections. Risk factors include agricultural work, diabetes, and lung/kidney disease. Treatment involves intravenous and oral antibiotics for 3-6 months. Prevention strategies focus on protective equipment when working in soil/water and promptly cleaning wounds.

1. Awareness Training on Melioidosis
Swaraj Kumar
Manager EHS, EAP&CIS
Power T & D CablesRailways CivilSolar Smart InfraRailways

2. 2
Overview
 What is Melioidosis
 Endemicity of Melioidosis
 Transmission of Melioidosis
 Symptoms
 Exposure and Risks
 Prevention
 Treatment

3. 3
What is Melioidosis
Melioidosis (also known as Whitmore’s disease) is a bacterial disease caused by
bacteria BURKHOLDERIA PSEUDOMALLEI.
This bacteria live below the soil surface but after heavy rainfall are found in surface
water and mud and may become airborne
• It affects human being and many species of animals
• Found in moist soil, rice paddies and muddy water
• Spread to humans and animals through direct contact with the contaminated
source
• It the environment it can remain dormant for years or kill within 48 hours
 Mortality ranges from 40-75% despite the proper use of antimicrobial therapy.
 Around 165000 cases per year estimated out of 90000 death.
 It Persists in Environment up to 6 years

4. 4
Endemicity of Melioidosis
Melioidosis is found in the tropical areas throughout the world and endemic in South-East Asia,
China and North Australia. It is predominately a disease of tropical and subtropical climates.
Risk of Exposure
- Thailand
- Malaysia
- Singapore
- Papua New Guinea
- Indian Subcontinent
- Indonesia
- Laos
- Myanmar
- Vietnam
- Cambodia
- Hong Kong

5. 5
Transmission of Melioidosis
How is it spread!!
Ingestion
• Contaminated Water
Inhalation
• Dust /droplets from contaminated soil
Wound
Infection
• Contact with contaminated soil through cuts
/sores in the skin
Melioidosis doesn’t usually spread from one person to another or from animals to humans

6. 6
Symptoms of Melioidosis
LOCALIZED INFECTION
 Localized pain and swelling
 Fever
 Ulcers
 Abscess , boils
PULMONARY INFECTION
 Cough
 Chest Pain
 High Fever
 Headache
BLOODSTREAM INFECTION
 Fever Headache
 Respiratory Distress (breathing disorder, difficulty to breath)
 Abdominal discomfort
 Joint pain and Disorientation
OTHER SYMPTOMS
 Difficulty passing urine
 Slow illness with weight loss, chest pain and cough
 Chest infection and shortness of breath
 Intermittent fever (Pattern of fever-elevated for several hours and drop back to normal)

7. 7
Risk and Exposures
 People exposed to such contamination like farmers, workers in plantation/excavation or who
works in the vicinity of forest / Jungle / River / Pond
 Wet season : Heavy rainfall, High humidity and temperature
 Working in muddy soil (contaminated) without hand / foot protection
 Factor increasing the risk of diseases
• Excessive Alcohol consumption
• Diabetes (at higher risk)
• Renal Disease
• Lung disease
• Liver disease
• Immune suppressing condition (steroids) or cancer
Animal affected by Melioidosis:
Severe disease – Sheep, Goats and Pigs
Occasionally - Cattle, Horses, dogs, Cats and Birds

8. 8
Prevention Strategies
There is currently no vaccine against Melioidosis. Therefore preventive measures are the key to
avoiding infection. Which can be :
 Person with open skin wounds and those with diabetes or chronic renal disease are at risk
for Melioidosis and should avoid contact with soil and standing water.
 Those who performs agriculture works, works at wet soil (at construction ) should wear boot.
 Chlorination of water and heat are effective against the bacterium.
 Protective gloves should be worn when handling soil, particularly during the wet season.
 Wound should be promptly and thoroughly washed, cleaned and covered.
 People with risk factor like diabetes, lung / kidney disease or high alcohol consumption
should stay indoors during period of heavy wind and rain because of the potential of
airborne droplet of this bacterium.
 To avoid the inhalation of Bactria people should cover their mouth and noses who using high
pressure hose around soil.

9. 9
Treatment
 All patients (or suspected ) must be admitted to Hospital initially.
 Antibiotics to be administered and to be continued for at least 3 month.
 Starts with intravenous antimicrobial therapy
 Followed by oral antimicrobial therapy (3-6 months)

10. THANK YOU
Reference:
 Center of disease control and prevention
 Melioidosis : Clinical microbiology Review : 2005, Currey BJ
 Emerging Infectious disease ; Internet
 A review of Melioidosis case in America : Internet
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