07/29/2022: Lab Advisory: Melioidosis Locally Endemic in Areas of the Mississippi Gulf Coast

CDC's Laboratory Outreach Communication System (LOCS)

Audience: Clinical Laboratory Professionals

Level: Lab Advisory

On July 27, 2022, the U.S. Centers for Disease Control and Prevention (CDC) issued a Health Alert Network (HAN) Health Advisory to alert clinicians and laboratory professionals in the United States to consider melioidosis in patients whose clinical presentation is compatible with signs and symptoms of the disease, regardless of travel history to international disease-endemic regions, as melioidosis is now considered to be locally endemic in areas of the Gulf Coast region of Mississippi. The HAN includes the following recommendations for laboratory professionals:

  • Laboratory automated identification algorithms (e.g., MALDI-TOF, 16s, VITEK-2) may misidentify B. pseudomallei as another bacterium. Consider re-evaluating patients with isolates identified on automated systems as Burkholderia spp. (specifically B. cepacia and B. thailandensis), Chromobacterium violaceum, Ochrobactrum anthropic, and, possibly, Pseudomonas spp., Acinetobacter spp., and Aeromonas spp.
  • Contact your state or local public health department immediately if you identify B. pseudomallei or if you suspect an organism for B. pseudomallei. The health department should forward the isolate to the closest state laboratory or to a Laboratory Response Network (LRN) laboratory for confirmation. State and LRN laboratories can send presumptive positives to CDC for confirmation as needed.
  • If an isolate is confirmed as B. pseudomallei, the state or LRN laboratory should forward the isolate to CDC for whole genome sequencing. Once isolates have been confirmed as B. pseudomallei, select agent regulations will apply.
  • Follow good laboratory practices to reduce your risk of exposure. Refer to CDC guidance if you think you may have been exposed to B. pseudomallei.
  • Contact your state health department if you have any questions or if you suspect a patient may be infected with B. pseudomallei.

We encourage you to review the HAN in detail and share this message widely with your networks.

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Thank you,

The Laboratory Outreach Communication System

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

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

Centers for Disease Control and Prevention (CDC)