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Clinical Manifestations and Genomic Evaluation of Melioidosis Outbreak among Children after Sporting Event, Australia

Simon Smith, Tonia Marquardt, Amy V Jennison

    Emerging Infectious Diseases
    |October 25, 2023
    PubMed

    Insights

    An outbreak of melioidosis (Burkholderia pseudomallei) occurred in immunocompetent Australian children after a sporting event. Adverse reactions to trimethoprim/sulfamethoxazole highlighted treatment challenges.

    Area of Science:

    • Infectious Diseases
    • Microbiology
    • Epidemiology

    Background:

    • Melioidosis, caused by Burkholderia pseudomallei, typically affects adults with predisposing conditions.
    • In Australia, melioidosis commonly occurs during the wet season.

    Purpose of the Study:

    • To investigate an unusual outbreak of melioidosis in immunocompetent children.
    • To describe the clinical features, environmental factors, and genomic epidemiology of the outbreak.
    • To outline the public health response and inform future management strategies.

    Main Methods:

    • Case identification and clinical data collection.
    • Environmental sampling for Burkholderia pseudomallei.
    • Genomic sequencing for epidemiologic investigation.
    • Analysis of treatment responses.

    Main Results:

    • Seven immunocompetent children contracted melioidosis following a single-day sporting event in tropical Australia during the dry season.
    • All cases presented with limited cutaneous disease.
    • All patients experienced adverse reactions to trimethoprim/sulfamethoxazole, requiring treatment cessation.

    Conclusions:

    • This outbreak highlights the potential for melioidosis transmission in immunocompetent individuals, even during the dry season.
    • Adverse drug reactions to trimethoprim/sulfamethoxazole pose a significant challenge in managing pediatric melioidosis.
    • Making melioidosis a notifiable disease and utilizing genomic epidemiology are crucial for effective outbreak response and prevention.
    Keywords:
    AustraliaBurkholderia pseudomalleibacteriamelioidosispediatricspublic healthtropical medicine

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