Melioidosis and Bioterrorism

The Threat

Melioidosis is a disease caused by bacteria (germs) called Burkholderia pseudomallei that occur naturally in certain parts of the world, including Southeast Asia and northern Australia. In the United States, the bacteria that causes melioidosis has been identified in soil and water in Mississippi, Puerto Rico, and the U.S. Virgin Islands.

One reason public health authorities study the disease is because it is possible that the germs that cause melioidosis might be used as a weapon in a biological attack. A biological attack is the intentional release of germs that can sicken or kill people, livestock, or crops.

A biological attack that releases bacteria that cause melioidosis into the air, water, food, or other products might put many people at risk for getting sick. For example, if the bacteria were released into the air in a crowded place, many people might inhale them. Or if the bacteria were put into food, people who eat the contaminated food would be exposed.

Why might the bacteria that cause melioidosis be used as a weapon?

• It can be hard to diagnose melioidosis quickly as people may have symptoms similar to what you'd see with the flu or tuberculosis.
• While melioidosis is found around the world, there are very few cases in the United States, and most doctors are unfamiliar with the disease.
• Melioidosis can make people very sick, and without quick treatment with specific antibiotics, people can die.
• Previous bioweapons during war in other countries have used similar kinds of bacteria.

You cannot see, smell, or taste the bacteria, so an attack might not be noticed until doctors begin to see many people sick with unusual fevers and respiratory illnesses.

Once doctors diagnose patients with melioidosis, they will work with public health authorities to find out how people got the disease.

What CDC is Doing

In an emergency, CDC would work with state and local public health authorities wherever people are sick with melioidosis. CDC would also work with law enforcement agencies as they investigate how people came into contact with the germs that cause melioidosis. Some of the ways CDC would respond to an emergency caused by a biological attack include:

• Alerting healthcare providers that their patients might have melioidosis.
• Consulting with doctors about how to diagnose and treat patients with melioidosis.
• Sending out disease detectives (epidemiologists) to learn how people came into contact with the germs that cause melioidosis, and identifying others who might have been exposed.
• Working with the Laboratory Response Network to coordinate lab testing to diagnose patients with melioidosis quickly and accurately.
• Coordinating activities within CDC and with other partners through the Emergency Operations Center.
• Communicating with the public about the situation, how to protect themselves, symptoms to watch for, or when to seek treatment.
• Providing medication and other supplies from the Strategic National Stockpile to state, local, tribal, and territorial partners as needed.

CDC prepares for a melioidosis emergency so that if one ever happens, public health authorities can respond quickly. Some of CDC's ongoing work includes:

• Researching ways to improve laboratory tests and developing better ways to diagnose the disease.
• Working with doctors and scientists from countries where melioidosis is widespread to learn how to best treat the disease.
• Providing support to laboratories in the United States so they have the knowledge and equipment to diagnose melioidosis quickly and accurately.
• Improving how we collect health data to help us get better insight about the disease to protect and promote health.
• Stockpiling antibiotics for distribution and use as needed.
• Writing guidance to educate healthcare providers about melioidosis treatment and prevention.
• Providing funds and guidance to help public health departments respond to all types of public health emergencies and build more resilient communities.
• Regulating the possession, use, and transfer of the germs that cause melioidosis through the Federal Select Agent Program.