Melioidosis in India

Overview of Melioidosis

• Cause
  • Bacterial infection caused by Burkholderia pseudomallei, primarily acquired through inoculation, inhalation, or ingestion of contaminated soil and water.
• Global Burden
  • Annually, 165,000 cases worldwide, with South Asia (including India) accounting for 44% of cases (The Lancet, 2016).
• Medical Complexity
  • Can present as mild skin infection to severe sepsis (fatality rate up to 50% in septicemia).
  • Difficult to diagnose due to prolonged bacterial incubation and similarity with Pseudomonas aeruginosa.
  • Treatment requires extended antibiotic therapy: Intravenous phase followed by a 12-20 week eradication phase.

Odisha-Based Study on Environmental Impact

• Conducted by AIIMS Bhubaneswar (Microbiology Dept.) and IIT Bhubaneswar (Climate Sciences).
• Objective: To investigate how climate and environmental factors influence melioidosis transmission in Odisha.
• Methodology
  • Nine-year study (2015-2023) tracking 144 cases.
  • Analysed 3,024 days of meteorological data: rainfall, temperature, humidity, solar radiation.
  • Created a state-wide risk map using 10 km grid sizes.

Key Findings

• Seasonal Pattern
  • Peak infections during and after monsoon.
  • Strong correlation with temperature, rainfall, cloud cover, and solar radiation.
• High-Risk Districts: Cuttack, Balasore, Khordha, and Jajpur—coinciding with densely populated regions.
• Other Contributing Factors
  • Land-use changes and soil composition (not fully explored due to data limitations).
  • Rapid urbanization and poor sanitation increasing human exposure to the bacteria.
  • Climate change altering rainfall patterns, potentially expanding or shifting disease prevalence.

Implications for Public Health and Policy

• Need for Climate-Integrated Disease Surveillance
  • Use weather and climate analytics in disease prediction models.
  • Enhance public health planning and outbreak preparedness.
• Potential Beyond Melioidosis
  • Study serves as a model for other climate-sensitive infectious diseases.
  • Odisha’s research approach could be replicated in other vulnerable regions.