sábado, 20 de diciembre de 2014

Association of Melioidosis Incidence with Rainfall and Humidity, Singapore, 2003–2012 - Volume 21, Number 1—January 2015 - Emerging Infectious Disease journal - CDC

full-text ►

Association of Melioidosis Incidence with Rainfall and Humidity, Singapore, 2003–2012 - Volume 21, Number 1—January 2015 - Emerging Infectious Disease journal - CDC


Volume 21, Number 1—January 2015


Association of Melioidosis Incidence with Rainfall and Humidity, Singapore, 2003–2012

Xiang Liu1, Long Pang1, Siew Hoon Sim, Kee Tai Goh, Sharada Ravikumar, Mar Soe Win, Gladys Tan, Alex Richard Cook, Dale Fisher, and Louis Yi Ann ChaiComments to Author 
Author affiliations: National University Health System University Medicine Cluster, Singapore (X. Liu, S. Ravikumar, M.S. Win, D. Fisher, L.Y.A. Chai)National University of Singapore and National University Health System Saw Swee Hock School of Public Health, Singapore (L. Pang, K.T. Goh, A.R. Cook)Defence Medical and Environmental Research Institute, Singapore (S.H. Sim, G. Tan)Ministry of Health, Singapore (K.T. Goh)National University of Singapore Yale-NUS College, Singapore (A.R. Cook)National University of Singapore Yong Loo Lin School of Medicine, Singapore (D. Fisher)


Soil has been considered the natural reservoir for the bacterium Burkholderia pseudomallei, which causes melioidosis. We examined 550 melioidosis cases that occurred during a 10-year period in the highly urbanized city of Singapore, where soil exposure is rare, and found that rainfall and humidity levels were associated with disease incidence.
The gram-negative, saprophytic bacillus Burkholderia pseudomallei, which causes melioidosis, is endemic in northern Australia and Southeast Asia countries such as Thailand, Malaysia, and Singapore (1). Soil has traditionally been described as the natural reservoir of B. pseudomallei (hence the synonym “soil bacteria”) (2,3). Symptoms and signs of melioidosis can be mild, but severe manifestations such as bacteremia, organ abscesses, and severe pneumonia can lead to high death rates (4).
Two reports from northern Australia and northeastern Thailand, both conducted in predominantly rural areas, found an increase in melioidosis cases after heavy rainfall or extreme weather events such as tropical storms or monsoons (5,6). In Singapore, however, the occurrence of melioidosis in association with climatic variations has not been extensively studied. Geographically, Singapore has an urbanization rate of 100%, in contrast to northeastern Thailand (34%) and northern Australia (55%) (7,8). Because soil is the presumptive reservoir for B. pseudomallei, exposure may be less common in an extensively developed, urban setting such as Singapore, but other environmental factors, such as humidity and temperature, might also influence the pathogenicity of B. pseudomallei. We investigated 550 cases of melioidosis that occurred during a 10-year period in Singapore to determine if climatic factors might be related to the epidemiology of this disease in an urban setting.

Ms. Liu is a medical student at Duke-NUS Medical School. Her research interests are infectious diseases and immunology.


  1. Currie BJDance DACheng ACThe global distribution of Burkholderia pseudomallei and melioidosis: an update. Trans R Soc Trop Med Hyg.2008;102:S14DOIPubMed
  2. Limmathurotsakul DWuthiekanun VChantratita NWongsuvan GAmornchai PDay NPBurkholderia pseudomallei is spatially distributed in soil in northeast Thailand. PLoS Negl Trop Dis2010;4:e694DOIPubMed
  3. Heng BHGoh KTYap EHLoh HYeo MEpidemiological surveillance of melioidosis in Singapore. Ann Acad Med Singapore1998;27:47884.PubMed
  4. Currie BJWard LCheng ACThe epidemiology and clinical spectrum of melioidosis: 540 cases from the 20 year Darwin prospective study. PLoS Negl Trop Dis2010;4:e900DOIPubMed
  5. Currie BJJacups SPIntensity of rainfall and severity of melioidosis, Australia. Emerg Infect Dis2003;9:153842 and. DOIPubMed
  6. Suputtamongkol YHall AJDance DAChaowagul WRajchanuvong ASmith MDThe epidemiology of melioidosis in Ubon Ratchatani, northeast Thailand. Int J Epidemiol1994;23:108290DOIPubMed
  7. Australia Social Trends, cat no. 4102. Canberra (ACT, Australia): Australia Bureau of Statistics; 2008.
  8. United Nations, Department of Economic and Social Affairs, Population Division. World urbanization prospects, the 2011 revision. Final report with annex tables. New York: United Nations; 2012.
  9. Ministry of Health Singapore. Melioidosis. A guide on infectious diseases of public health importance in Singapore. 7th ed. Singapore; 2011.
  10. Ministry of Health Singapore. Communicable diseases surveillance in Singapore 2013 [cited 2014 Nov 17].https://www.moh.gov.sg/content/moh_web/home/Publications/Reports/2014/communicable-diseases-surveillance-in-singapore-2013.html
  11. Koh GCMaude RRSchreiber MFLimmathurotsakul DWiersinga WJWuthiekanun VGlyburide is anti-inflammatory and associated with reduced mortality in melioidosis. Clin Infect Dis2011;52:71725DOIPubMed
  12. Lo TJAng LWJames LGoh KTMelioidosis in a tropical city state, Singapore. Emerg Infect Dis2009;15:16457 . DOIPubMed
  13. Nandi TTan PLess is more: Burkholderia pseudomallei and chronic melioidosis. MBio2013;4:e709DOIPubMed
  14. Limmathurotsakul DKanoksil MWuthiekanun VKitphati RdeStavola BDay NPActivities of daily living associated with acquisition of melioidosis in northeast Thailand: a matched case–control study. PLoS Negl Trop Dis2013;7:e2072 . DOIPubMed



Suggested citation for this article: Liu X, Pang L, Sim SH, Goh KT, Ravikumar S, Win MS, et al. Association of melioidosis incidence with rainfall and humidity, Singapore, 2003–2012. Emerg Infect Dis. 2015 Jan [date cited]. http://dx.doi.org/10.3201/eid2101.140042
DOI: 10.3201/eid2101.140042
1These authors contributed equally to this article.

No hay comentarios:

Publicar un comentario