Melioidosis in Patients with COVID-19 Exposed to Contaminated Tap Water, Thailand, 2021
Abstract
M elioidosis is an infectious disease caused by the gram-negative bacillus Burkholderia pseudomallei, which is commonly present in soil and water in tropical countries (1,2).Naturally acquired infections result from skin inoculation, inhalation, or ingestion of B. pseudomallei (1).In 2020 and 2021, multiple COVID-19 field hospitals were set up in Thailand for cases of mild and moderate COVID-19 infection.We report 25 cases of acute melioidosis among patients diagnosed with COVID-19 who were being managed at a COVID-19 field hospital in Saraburi Province, central Thailand.Our study received ethical approval from the Committee of the Faculty of Tropical Medicine, Mahidol University (TMEC 24-006).The Study On September 8, 2021, the Department of Disease Control, Ministry of Public Health, Thailand, was alerted to a cluster of 20 patients with culture-confirmed melioidosis (case nos.1-20; Table, https://wwwnc.cdc.gov/EID/article/30/4/23-1476-T1.htm).The 20 patients had been admitted to a single field hospital in Saraburi Province, which had been designated a treatment facility for COVID-19, and were transferred to Kaeng Khoi Hospital, Saraburi Province, because they developed fever or pneumonia.Previously, Saraburi Province had diagnosed ≈8-12 culture-confirmed melioidosis cases per year (2).The outbreak investigation team suspected that nonpotable tap water (NPTW) was the source of infection because there were no other apparent sources (Appendix, https:// wwwnc.cdc.gov/eid/article/30/4/23-1476-App1.pdf).The initial response included the immediate transfer of patients with diabetes and those who had received steroid therapy for COVID-19 to other hospitals, followed by re-emphasizing to staff the recommended prevention strategies for melioidosis (3).The recommendations included avoiding direct exposure to soil and environmental water and drinking only boiled or bottled water.Health officials immediately planned and conducted an environmental investigation.During September 10-16, 2021, the outbreak investigation team collected samples from the field hospital, including Melioidosis in Patients with COVID-19 Exposed to ContaminatedTap Water, Thailand, 2021
Authors: Panupong Tantirat, Yotsathon Chantarawichian, Pantila Taweewigyakarn, Somkid Kripattanapong, Charuttaporn Jitpeera, Pawinee Doungngern, Chadaporn Phiancharoen, Ratanaporn Tangwangvivat, Soawapak Hinjoy, Anupong Sujariyakul, Premjit Amornchai, Gumphol Wongsuvan, Viriya Hantakun, Vanaporn Wuthiekanun, Janjira Thaipadungpanit, Nicholas Robert Thomson, David A. B. Dance, Claire Chewapreecha, Elizabeth M. Batty, Direk Limmathurotsakul
Published in: Emerging infectious diseases (2024)