Melioidosis and glanders found in Siquijor fatalities, DOH confirms

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Questions remain about how two uncommon bacterial diseases managed to surface in the same province, affecting the same patients, with fatal consequences

NEGROS OCCIDENTAL, Philippines – It began with a report on glanders, but nearly a week after two Siquijor men died in a Dumaguete City, Negros Oriental hospital on Wednesday, May 28, health officials revealed another deadly detail.

The two men were inflicted with glanders and melioidosis, and both had comorbidities, Health Undersecretary Mary Ann Palermo-Maestral told Rappler on Monday, June 2, citing laboratory tests.

At least four others from Siquijor were also confirmed earlier to have contracted glanders.

The health department placed a second rare deadly disease at the center of the case: melioidosis. Known as Whitmore’s disease, melioidosis is caused by the environmental bacterium Burkholderia pseudomallei, which thrives in soil and water. Glanders, on the other hand, is caused by Burkholderia mallei, a pathogen typically found in sick horses and other animals.

The two diseases share a number of symptoms including high fever, pneumonia, abscesses, and septic shock. Both can infect humans, and are rare.

While the Department of Health (DOH) has moved to contain the infections, questions remain about how two uncommon bacterial diseases managed to surface in the same area, affecting the same patients, with fatal consequences.

Glanders and melioidosis are present in Siquijor right now, said Albert Barrogo, acting regional director of the Department of Agriculture (DA) for the Negros Island Region.

He said the bacterium that causes melioidosis thrives in wallows or mud holes used by carabaos or cattle.

Barrogo said the DA is working closely with the DOH to contain the diseases and prevent their spread. 

He flew to Manila to follow up on laboratory results of blood samples taken from nearly 100 goats, carabaos, and cattle in the towns of Larena, Siquijor, and San Juan between May 20 and 25.

He said they have been waiting for the results so the Bureau of Animal Industry (BAI) could make recommendations. He said the decision on whether or not to start culling animals would depend on BAI’s assessment.

The samples were taken from animals suspected to be infected in the towns of Larena, Siquijor, and San Juan from May 20 to 25.

Barrogo said a surveillance team is monitoring the situation to prevent the spread of the diseases to other towns in Siquijor such as Lazi, Maria, and Enrique Villanueva.

The DOH, meanwhile, said it remained on top of the situation to prevent the spread of the bacterial diseases to NIR.

Melioidosis is a potentially fatal disease that can infect humans and animals through contact with contaminated soil, water, or air, according to the US Centers for Disease Control and Prevention (CDC). It said infection typically occurs through skin abrasions, inhalation, or ingestion, particularly following extreme weather events that disturb soil.

On its website, the CDC said symptoms may mimic other infections and could include fever, chest pain, cough, muscle aches, and confusion. Severe cases may lead to bloodstream infection and multi-organ failure.

It said people with diabetes, chronic illnesses, or weakened immune systems are at higher risk of severe illness. 

The CDC said human-to-human transmission of melioidosis is rare, but a wide range of animals can be infected, including sheep, goats, pigs, boars, horses, cats, dogs, and cattle.

It has recommended avoiding exposure to soil and standing water in affected areas and using protective gear during high-risk activities. Treatment requires a prolonged course of antibiotics – initially intravenous, followed by oral antibiotics for several months – to prevent relapse. – Rappler.com