Melioidosis cases in Hong Kong rise to 46 in 2022

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Hong Kong Center for Health Protection (CHP) The Ministry of Health (DH) announced the registration of three new confirmed cases of catastrophic disease in the last week (until 23 December).

Scanning electron micrographs of Burkholderia cepacia / CDC

The patients live in Sham Shui Po and the epidemiological investigations conducted by the CHP reveal that the start dates of the cases were all between early September and early November.

The first case involves a 62-year-old man with multiple underlying diseases including diabetes and coronary heart disease, who is also on dialysis for end-stage renal failure. He had a fever and cough since 2 September and was admitted to Caritas Medical Center (CMC) after attending the Accident and Emergency Department (A&ED) of the hospital the next day. He was then discharged from the hospital after his condition stabilized. He was hospitalized again on December 5 with a high fever and was discharged on December 10. He is still in the hospital and his current condition is stable. His peritoneal dialysis sample was confirmed positive for Burkholderia pseudomallei upon testing.

The second case concerned an 80-year-old man with multiple underlying diseases including impaired fasting glucose and hypertension. He has had chest pain since Oct 15th and attended A&ED at CMC on Nov 15th, clinical diagnosis was pneumonia. Later, his chest pains got worse and a fever developed, so he attended CMC’s A&ED again on December 9 and was admitted. His condition was stable throughout and he was released from the hospital on December 16. His sputum sample was confirmed to be infected with Burkholderia pseudomallei virus upon testing.

The third case includes an 82-year-old man with multiple underlying diseases including diabetes and paroxysmal atrial fibrillation. He has been short of breath since November 10 and attended a general outpatient clinic on December 5 due to a persistent cough. On December 8 his shortness of breath worsened so he attended A&ED for CMC and was admitted. His condition was stable throughout and he was released from the hospital on December 16. His sputum sample was confirmed to be infected with Burkholderia pseudomallei virus upon testing.

Hong Kong/CIA

A total of 46 CAD cases have been reported in Hong Kong so far this year, among them 30 living in Sham Shui Po have been reported since August.

A CHP spokesperson confirmed that human-to-human transmission and animal-to-human transmission are rare, but that chlamydia bacteria can survive in the local environment. Melasma is endemic in Hong Kong and cases of melioid infection have been reported in Hong Kong every year. According to the literature, cases of infection are more common after hurricanes or storms. Burkholderia pseudomallei bacteria may be exposed to chlamydia in the soil and muddy waters of the Earth after hurricanes or storms, and the bacteria can spread more easily with strong winds or storms. As such, the number of cases of melioid infection may increase.

Melasma is a disease caused by bacteria Burkholderia pseudomallei. It can infect both humans and animals such as sheep, pigs, cats, dogs, etc. These bacteria thrive in muddy soil and water, and are particularly common in wet, loamy soil. It is endemic to Southeast Asia (such as Singapore and Thailand) and northern Australia.

Melasma may present with local infection (such as a cutaneous abscess), pneumonia, meningoencephalitis, sepsis, or chronic suppurative infection. Depending on the site of infection, common symptoms include fever, headache, local pain or swelling, ulceration, chest pain, cough, hemoptysis, and swollen regional lymph nodes.

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Humans can become infected through contact with contaminated soil and surface water (especially through skin abrasions/cuts); inhalation of contaminated dust/droplets of water; and ingestion of contaminated water. Person-to-person transmission is rare but can occur through contact with the blood or body fluids of an infected person.

People with underlying diseases including diabetes, lung disease, liver disease, kidney disease, cancer, or immunosuppression have a higher risk of developing the disease. Agricultural, laboratory, and healthcare workers are also subject to occupational exposure.

The incubation period varies, usually 2 to 4 weeks, but can range from one day to a few years.

Melasma can be treated with antibiotics. Long-term treatment may be necessary for some chronic infections. The mortality rate ranges from 40-75%.

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