Melioidosis in South Asia (India, Nepal, Pakistan, Bhutan and Afghanistan)
Despite the fact that South Asia is predicted to have the highest number of cases worldwide, melioidosis is a little-known entity in South Asian countries. It has never been heard of by the majority of doctors and has as yet failed to gain the attention of national Ministries of Health and country o...
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doaj-50b1d2913e154662ba7a06c5e1ba454d2020-11-24T22:13:45ZengMDPI AGTropical Medicine and Infectious Disease2414-63662018-05-01325110.3390/tropicalmed3020051tropicalmed3020051Melioidosis in South Asia (India, Nepal, Pakistan, Bhutan and Afghanistan)Chiranjay Mukhopadhyay0Tushar Shaw1George M. Varghese2David A. B. Dance3Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, IndiaDepartment of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, IndiaDepartment of Infectious Diseases, Christian Medical College, Vellore 632004, IndiaLao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, LaosDespite the fact that South Asia is predicted to have the highest number of cases worldwide, melioidosis is a little-known entity in South Asian countries. It has never been heard of by the majority of doctors and has as yet failed to gain the attention of national Ministries of Health and country offices of the World Health Organization (WHO). Although a few centers are diagnosing increasing numbers of cases, and the mortality documented from these institutions is relatively high (nearly 20%), the true burden of the disease remains unknown. In India, most cases have been reported from southwestern coastal Karnataka and northeastern Tamil Nadu, although this probably simply reflects the presence of centers of excellence and researchers with an interest in the disease. As elsewhere, the majority of cases have type 2 diabetes mellitus and occupational exposure to the environment. Most present with community-acquired pneumonia and/or bacteremia, especially during heavy rainfall. The high seropositivity rate (29%) in Karnataka and isolation of B. pseudomallei from the environment in Tamil Nadu and Kerala confirm India as melioidosis-endemic, although the full extent of the distribution of the organism across the country is unknown. There are limited molecular epidemiological data, but, thus far, the majority of Indian isolates have appeared distinct from those from South East Asia and Australia. Among other South Asian countries, Sri Lanka and Bangladesh are known to be melioidosis-endemic, but there are no cases that have conclusively proved to have been acquired in Nepal, Bhutan, Afghanistan or Pakistan. There are no surveillance systems in place for melioidosis in South Asian countries. However, over the past two years, researchers at the Center for Emerging and Tropical Diseases of Kasturba Medical College, University of Manipal, have established the Indian Melioidosis Research Forum (IMRF), held the first South Asian Melioidosis Congress, and have been working to connect researchers, microbiologists and physicians in India and elsewhere in South Asia to raise awareness through training initiatives, the media, workshops, and conferences, with the hope that more patients with melioidosis will be diagnosed and treated appropriately. However, much more work needs to be done before we will know the true burden and distribution of melioidosis across South Asia.http://www.mdpi.com/2414-6366/3/2/51Burkholderia pseudomalleiIndiamelioidosisSouth Asia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chiranjay Mukhopadhyay Tushar Shaw George M. Varghese David A. B. Dance |
spellingShingle |
Chiranjay Mukhopadhyay Tushar Shaw George M. Varghese David A. B. Dance Melioidosis in South Asia (India, Nepal, Pakistan, Bhutan and Afghanistan) Tropical Medicine and Infectious Disease Burkholderia pseudomallei India melioidosis South Asia |
author_facet |
Chiranjay Mukhopadhyay Tushar Shaw George M. Varghese David A. B. Dance |
author_sort |
Chiranjay Mukhopadhyay |
title |
Melioidosis in South Asia (India, Nepal, Pakistan, Bhutan and Afghanistan) |
title_short |
Melioidosis in South Asia (India, Nepal, Pakistan, Bhutan and Afghanistan) |
title_full |
Melioidosis in South Asia (India, Nepal, Pakistan, Bhutan and Afghanistan) |
title_fullStr |
Melioidosis in South Asia (India, Nepal, Pakistan, Bhutan and Afghanistan) |
title_full_unstemmed |
Melioidosis in South Asia (India, Nepal, Pakistan, Bhutan and Afghanistan) |
title_sort |
melioidosis in south asia (india, nepal, pakistan, bhutan and afghanistan) |
publisher |
MDPI AG |
series |
Tropical Medicine and Infectious Disease |
issn |
2414-6366 |
publishDate |
2018-05-01 |
description |
Despite the fact that South Asia is predicted to have the highest number of cases worldwide, melioidosis is a little-known entity in South Asian countries. It has never been heard of by the majority of doctors and has as yet failed to gain the attention of national Ministries of Health and country offices of the World Health Organization (WHO). Although a few centers are diagnosing increasing numbers of cases, and the mortality documented from these institutions is relatively high (nearly 20%), the true burden of the disease remains unknown. In India, most cases have been reported from southwestern coastal Karnataka and northeastern Tamil Nadu, although this probably simply reflects the presence of centers of excellence and researchers with an interest in the disease. As elsewhere, the majority of cases have type 2 diabetes mellitus and occupational exposure to the environment. Most present with community-acquired pneumonia and/or bacteremia, especially during heavy rainfall. The high seropositivity rate (29%) in Karnataka and isolation of B. pseudomallei from the environment in Tamil Nadu and Kerala confirm India as melioidosis-endemic, although the full extent of the distribution of the organism across the country is unknown. There are limited molecular epidemiological data, but, thus far, the majority of Indian isolates have appeared distinct from those from South East Asia and Australia. Among other South Asian countries, Sri Lanka and Bangladesh are known to be melioidosis-endemic, but there are no cases that have conclusively proved to have been acquired in Nepal, Bhutan, Afghanistan or Pakistan. There are no surveillance systems in place for melioidosis in South Asian countries. However, over the past two years, researchers at the Center for Emerging and Tropical Diseases of Kasturba Medical College, University of Manipal, have established the Indian Melioidosis Research Forum (IMRF), held the first South Asian Melioidosis Congress, and have been working to connect researchers, microbiologists and physicians in India and elsewhere in South Asia to raise awareness through training initiatives, the media, workshops, and conferences, with the hope that more patients with melioidosis will be diagnosed and treated appropriately. However, much more work needs to be done before we will know the true burden and distribution of melioidosis across South Asia. |
topic |
Burkholderia pseudomallei India melioidosis South Asia |
url |
http://www.mdpi.com/2414-6366/3/2/51 |
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