John Ross

Bizarre footnote to the recent US outbreak of meloidosis (Burkholderia pseudomallei): the Texas case, in a critically ill 4-year-old girl, was apparently caused by the family's pet raccoon (!), which knocked over and broke an aromatherapy bottle. The raccoon died two weeks later. Autopsy samples from the raccoon were PCR+ve for Burkholderia.

Samples from the four patients were identical to the strain of Burkholderia pseudomallei found in the spray, which was recalled. https://www.cdc.gov/mmwr/volumes/71/wr/mm7150a5.htm

Notes from the Field: Burkholderia pseudomallei Detected...

This report describes environmental testing on soil and a racoon carcass following a multistate outbreak of melioidosis linked to an aromatherapy room spray.

Centers for Disease Control and Prevention
Dec 15, 2022 at 6:24pmWeb
Show threadJohn RossDec 15, 2022
Most cases of meloidosis are acquired in Southeast Asia and northern Australia. In the United States, the bacteria that causes melioidosis has been identified in environmental samples from Mississippi, Puerto Rico, and the U.S. Virgin Islands. Contamination of the aromatherapy spray with Burkholderia pseudomallei in the recent outbreak may have occurred during manufacturing in India.
Show threadBlanding S TurtleDec 15, 2022
@johnrossmd
WTF: "The time between exposure and development of signs and symptoms varies. Usually, symptoms appear 2–4 weeks after exposure, but can range from one day to MANY YEARS AFTER EXPOSURE."
https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/melioidosis/
Melioidosis - Epidemiology

What is melioidosis? Melioidosis, also known as Whitmore’s disease, is an uncommon bacterial infection caused by Burkholderia pseudomallei. The disease affects humans and animals. Individuals acquire the bacteria through direct contact with contaminated soil and surface waters. Who gets melioidosis? Melioidosis is a rare disease in the United States, but it is more common in […]

Epidemiology
Show threadJohn RossDec 16, 2022
@peatbog The old-timers at the VA used to call it Vietnamese time bomb, because vets could become ill with it many years after their tours of duty
Show threadBlanding S TurtleDec 16, 2022
@johnrossmd I still have nightmares from my parasitology class back in the '80s but meloidosis never made it to my LTM.
Show threadNick Mark, MD Dec 15, 2022
@johnrossmd that is a bizarre case!
Show threadmem_somervilleDec 15, 2022
@johnrossmd That is bonkers on so many levels....Wow.
Show threadGabriele PollaraDec 15, 2022
@johnrossmd sad but impressive piece of infectious disease investigative epidemiology!
Show threadmistershinsDec 15, 2022
@johnrossmd this raccoon should be venerated as a hero of epidemiology.
Show threadLiza BringsDec 15, 2022
@johnrossmd
In the Truly Bizarre Adventures of the CDC, agents descend on the back yard of a Texas homeowner, dig up his dead pet raccoon, and test it and the surrounding soil and water samples to ascertain the presence (yes) of a disease causing bacterium, contracted by the late Mr Rocky as a result of strolling through a puddle of imported air freshener, (bottle having been broken by same). The disease was fatal for Mr Rocky, & sickened a young girl.
Show threadJohn RossDec 15, 2022
@LizaBrings Truly bizarre. The young girl survived, but sadly seems to be quite disabled as a result of her illness. https://www.nejm.org/doi/full/10.1056/NEJMoa2116130
Multistate Outbreak of Melioidosis Associated with Imported Aromatherapy Spray | NEJM

Original Article from The New England Journal of Medicine — Multistate Outbreak of Melioidosis Associated with Imported Aromatherapy Spray

New England Journal of Medicine
Show threadLiza BringsDec 15, 2022
@johnrossmd holy cow Dr Racaniello needs to do this one on TWiV!
Show threadcarolDec 16, 2022
@LizaBrings @johnrossmd Not to make a joke, but I swear I saw that plot on House, only with a cat.
Show threadcarolDec 16, 2022
@johnrossmd I have to say, as soon as you mentioned the raccoon, I thought the story was going to go in another direction.
Show threadspinsterDec 16, 2022
@carols @johnrossmd Rabies!