2 deaths in Siquijor due to melioidosis, not glanders, DOH clarifies

Metro Manila, Philippines - A different bacterial infection — and not the zoonotic glanders disease — caused the deaths of two people in Siquijor, the Department of Health clarified on Friday, May 30.

Health Secretary Ted Herbosa told reporters that DNA analyses from the patients confirmed they acquired the bacteria Burkholderia pseudomallei, which causes melioidosis.

“In initial testing, ang na-identify nila [what was identified] through the microscope is another bacteria, ‘yung Burkholderia mallei,” Herbosa said, referring to the bacteria that causes glanders.

He described Burkholderia mallei as “in the same family” with Burkholderia pseudomallei, but with different modes of transmission.

Siquijor earlier confirmed six people caught the rare glanders disease. Herbosa corrected that four of the cases were also suspected melioidosis, and they also died.

According to the United States Centers for Disease Control and Prevention (US CDC), melioidosis spreads to people and animals through direct contact with soil, air, or water contaminated by the Burkholderia pseudomallei.

The US CDC said the bacteria is mostly found in tropical climates, especially in Southeast Asia and northern Australia.

“It's very rare for people to get the disease from another person,” the US CDC said.

It said animals such as sheep, goats, pigs, horses, cats, and dogs can get melioidosis.

Herbosa said people got infected with glanders through contact with infected horses and other hoofed animals.

The health secretary said those vulnerable to melioidosis could be farmers who wade in mud.

“Ang advice ngayon is really prevention sa wearing of boots sa mga putik at saka mga surface water… Huwag kakain ng mga hayop na namatay sa sakit,” he said.

[Translation: The advice is really prevention through wearing boots in mud and surface water. Don’t eat meat from animals that died from the disease.]

More information on melioidosis

The US CDC said those infected with melioidosis can have symptoms within one to four weeks after exposure.

“The disease can affect one body system or affect the entire body. Because of these factors, melioidosis is hard to diagnose and may be mistaken for other diseases,” it said.

The US CDC said melioidosis may look like an ulcer or skin sore; may cause fever, swelling, and muscle aches; but most often manifests as a lung infection.

The disease can affect different organ systems throughout the body and can cause problems with the liver, spleen, prostate, joints, bones, lymph nodes, skin, or brain. It can also lead to a dangerous bloodstream infection or sepsis.

The US CDC advised people to avoid contact with soil and standing water if a person has open skin wounds or has chronic conditions like diabetes or kidney disease.

Agricultural workers and other at-risk individuals must wear boots to lower risk of exposure from contaminated soil and water. Health care workers and laboratory personnel must observe standard precautions.

The US CDC said treatment could include intravenous antibiotics from two to eight weeks, then pill medication for three to six months.