07/01/2020: Lab Alert: Burkholderia pseudomallei in Southwestern United States

Updated January 26, 2023

CDC's Laboratory Outreach Communication System (LOCS)

Audience: Clinical Laboratory Professionals

Level: Laboratory Alert

Burkholderia pseudomallei in Southwestern United States

A recently published case of melioidosis in a Texas resident has increased concerns that Burkholderia pseudomallei, the bacteria that causes this rare disease, may be present in soil and water in some southwestern areas of the United States. The gram-negative bacteria that causes melioidosis, B. pseudomallei, is classified as a Tier 1 Select Agent. Laboratorians in these states should be aware of the bacteria and the potential risk for unintentional exposure of laboratory staff if B. pseudomallei is not handled using appropriate biosafety methods in the laboratory. Most melioidosis cases reported in the United States are among returning international travelers who were exposed in tropical areas such as Southeast Asia, South and Central America, and northern Australia. However, the recently published case in Texas had no travel history outside the United States.

This case led to seven laboratory exposures among staff who were unaware of the need to take additional precautions while performing diagnostic testing. Laboratory staff who may have been exposed to B. pseudomallei should refer to existing CDC guidance. For information about working with suspected B. pseudomallei, refer to your state Laboratory Response Network (LRN).

In cases where the patient’s illness is compatible with melioidosis or where melioidosis is suspected, laboratory professionals should:

  • Perform all work in a biosafety cabinet (BSC), specifically any potential aerosol-generating procedures. Visit the Biosafety in Microbiological and Biomedical Laboratories (BMBL) 5th Edition for more information.
  • Wear appropriate PPE (which may minimally include gloves, gown, and eye protection).
  • Staff who are high-risk (e.g., diabetic or immune-compromised), should use caution when handling material suspected to contain pseudomallei.
  • Contact your state LRN for assistance with rule-out of pseudomallei.

For more information, visit CDC’s melioidosis website or read the article in Emerging Infectious Diseases.

Online resources:

Laboratory Outreach Communication System | Division of Laboratory Systems (DLS)

Center for Surveillance, Epidemiology, and Laboratory Services (CSELS)

Centers for Disease Control and Prevention (CDC)