Where Melioidosis Occurs, From Southeast Asia to the U.S. Gulf Coast

Melioidosis is caused by the bacterium Burkholderia pseudomallei. Infections have occurred all over the world, but the disease is found mostly in Southeast Asia and northern Australia.

Where it is common

Most cases are reported in Thailand, northern Australia, Singapore and Malaysia.

Cases are also frequent in Bangladesh, Cambodia, India and Sri Lanka, Indonesia, Hong Kong, Laos, Myanmar (Burma), southern China, Taiwan, Vietnam and the Philippines.

Outside Asia and Australia, cases have been reported in parts of Africa and the Middle East, Brazil, the British Virgin Islands, Ecuador, El Salvador, Guadeloupe, Guyana, Martinique, Mexico, Panama, Peru, Puerto Rico, the U.S. Virgin Islands, the Gulf Coast of the United States and New Caledonia in the South Pacific.

In the United States

The bacterium has been found in soil in Mississippi, Puerto Rico and the U.S. Virgin Islands. Around a dozen cases are identified in the United States each year, mostly in travelers from places where the disease is widespread. When someone gets melioidosis without such travel, CDC often works with local health departments to find out how.

• Mississippi, 2022. State partners and CDC found B. pseudomallei in the environment on Mississippi's Gulf Coast — the first time it had been found in the continental United States. How long it has been there, and where else it may be, is still being studied.
• An imported room spray, 2021. From March to July 2021, CDC confirmed four linked cases, two of them fatal, in Georgia, Kansas, Minnesota and Texas, in people who had not traveled abroad. Whole genome sequencing showed the bacteria closely matched one another — pointing to a common source — and resembled strains most common in South Asia, suggesting an imported product. After testing patients' blood and soil, water and household products, CDC confirmed the source as a product found in one patient's home: Better Homes & Gardens Lavender & Chamomile Essential Oil Infused Aromatherapy Room Spray with Gemstones, which was recalled.
• Georgia, 1983–2024. CDC and Georgia health officials identified four cases in the same county. Two unrelated workers at the same worksite fell ill after exposure to mud, rain, flooding and wind when Hurricane Helene hit Georgia in September 2024; both were hospitalized, treated and discharged. The investigation turned up two earlier patients from the same county who died of melioidosis in the 1980s — one who worked at a military base near the 2024 worksite, and one who fell ill after Hurricane Hugo in 1989. How they were infected is unclear.

Sources

• Centers for Disease Control and Prevention: "Melioidosis and Cases Around the World," with the Consumer Product Safety Commission's recall notice and Emerging Infectious Diseases 31(9), "Related Melioidosis Cases with Unknown Exposure Source, Georgia, USA, 1983–2024."