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Melioidosis in 6 tsunami survivors in southern Thailand

Wirongrong Chierakul1, Wut Winothai, Charnkij Wattanawaitunechai

  • 1Department of Clinical Tropical Medicine, Wellcome TrustMahidol UniversityOxford Tropical Medicine Research Programme, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|September 6, 2005
PubMed
Abstract

Insights

Tsunami survivors injured in environments with Burkholderia pseudomallei face an increased risk of melioidosis. This bacterial infection, often linked to aspiration and injury, can lead to severe pneumonia and increased mortality.

Area of Science:

  • Infectious Diseases
  • Environmental Microbiology
  • Disaster Medicine

Background:

  • Six cases of melioidosis were identified in tsunami survivors in Phangnga, a non-endemic region of Thailand.
  • All cases were associated with aspiration, with four also involving lacerations.

Purpose of the Study:

  • To compare the clinical characteristics and outcomes of melioidosis in tsunami survivors with those in patients from an endemic region.
  • To investigate the presence of Burkholderia pseudomallei in soil samples from both regions.

Main Methods:

  • Comparison of clinical, laboratory, and radiographic findings of 6 tsunami survivors with 22 patients with aspiration-related melioidosis from northeast Thailand.
  • Analysis of soil samples for Burkholderia pseudomallei detection in Phangnga and northeast Thailand.

Main Results:

  • Tsunami survivors developed pneumonia 3-38 days post-tsunami; one case resulted in a lung abscess and one death.
  • Patients from the endemic region had a shorter onset interval, higher rates of shock, respiratory/renal failure, and altered consciousness, with a 64% in-hospital mortality.
  • Burkholderia pseudomallei was detected in significantly fewer soil samples from Phangnga (0.8%) compared to northeast Thailand (20%).

Conclusions:

  • Tsunami survivors are at elevated risk for melioidosis, particularly if injured in environments contaminated with Burkholderia pseudomallei.
  • Factors such as water aspiration, inoculum size, and potential wound contamination may influence disease severity.

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