● Current melioidosis situation
Past outbreaks suggest cases of melioidosis are likely to occur three weeks after a typhoon has passed.Outbreaks of melioidosis occurred after Typhoon Haitang and Typhoon Talim passed through Taiwan in 2005 and after Typhoon Morakot passed through Taiwan in 2008.According to the data collected by the communicable disease case reporting system, during September 19 and October 14, 2010, a total of 8 cases of melioidosis, including one death, have been confirmed. Of the cases, five reside in Zuoying District, Kaohsiung City.

● Description of melioidosis
Melioidosis is caused by a bacterium called Burkholderia pseudomallei.The bacteria are found in contaminated water and soil and can cause disease in sheep, goats, pigs, horses, and other animals, as well as in humans.

● Route of transmission of melioidosis
The bacteria spread to humans and animals through direct contact with the contaminated source.The organism enters the body through skin abrasions, burns, or wounds infected by contaminated soil or water; inhalation of contaminated dust or vapor; or by consuming contaminated food or water. Clinically, less than 20% of melioidosis cases have skin wounds.The primary route of transmission is through inhalation or ingestion of pathogen.Person-to-person transmission is unusual.The incubation period varies from two days to months or years.

● Clinical presentation of melioidosis
1.The clinical presentation of melioidosis varies from person to person.Some may be symptom-free.Some may develop pneumonia, chronic pus-filled abscesses in the skin, lungs, or other organs.More severe cases may develop septic shock, which may lead to death.
2. The acute form of melioidosis can produce sepsis and pneumonia.

● At-risk groups
According to past surveillance data, over 80% of the cases are elderly with chronic diseases such as diabetes, high blood pressure, poor renal function, malignant tumor and heart disease.

● Treatment
1. Melioidosis can be deadly without prompt treatment.If suspected symptoms develop, please seek immediate medical attention.
2. Physicians are urged to consider the possibility of melioidosis when diagnosing residents from flooded areas with fever of unknown origin, especially elderly people or patients with history of chronic diseases in order to prescribe the appropriate treatment.When a suspected case is identified, the physician needs to report the case to the local health authority as soon as possible and submit specimens from the case to Taiwan CDC for laboratory testing and confirmation.

● Preventive measures
1. Avoid exposing to contaminated water or damp soil and walking barefoot across suspicious ponds or still water. Wear waterproof gloves, rubber boots and masks when in contact with soil or contaminated water and when cleaning the environment.After cleanup activities, wash up immediately and thoroughly with soap.
2.At-risk groups such as elderly and patients with chronic diseases should constantly wear masks to reduce the chance of infection.

For any questions or further information on melioidosis, please call the toll-free Communicable Disease Reporting and Consultation Hotline 1922, or visit the Taiwan CDC’s website at http://www.cdc.gov.tw.