CDC Update On Multi-State Outbreak Of Melioidosis

Credit CDC PHIL  

#16,266

Three times over the summer (see here, here, and here) we've looked at an unusual multi-state outbreak of Melioidosis - a bacterial infection caused by Burkholderia pseudomallei - a gram negative saprophytic (feeds on dead or decaying organic matter) bacterium that is often found in soil and water in endemic regions.

It has never, as far I'm aware, been isolated in the wild in the United States. 

While naturally occuring in the tropics, and Southeast Asia, Burkholderia pseudomallei is considered a Tier-1 Select agent, because - and I quote the CDC - `. . .  these biological agents and toxins present the greatest risk of deliberate misuse with significant potential for mass casualties or devastating effect to the economy, critical infrastructure, or public confidence, and pose a severe threat to public health and safety"

While rare, about a dozen (usually imported) human infections have been reported in the United States each year.  As we saw last year in an EID Journal dispatch (see Melioidosis in a Resident of Texas with No Recent Travel History, United States), sometimes the source of infection is never determined. 

Yesterday the CDC announced a promising break in the current investigation, when Burkholderia pseudomallei was detected in a bottle of aromatherapy spray found in the home of the 4th victim (from Georgia). 

CDC labs are now attempting to determine if the genetic fingerprint of this bacteria matches that found in the 4 victims, and if any of the other 3 known cases used similar products. The Consumer Product Safety Commission has issued a recall notice (below).

Walmart Recalls Better Homes and Gardens Essential Oil Infused Aromatherapy Room Spray with Gemstones Due to Rare and Dangerous Bacteria; Two Deaths Investigated

The CDC update follows: 

CDC Identifies Rare Bacteria in Aromatherapy Product

Aromatherapy spray tests positive for deadly bacteria

Press Release

For Immediate Release: Friday, October 22, 2021
Contact: Media Relations
(404) 639-3286


Laboratory testing at the U.S. Centers for Disease Control and Prevention (CDC) has identified the bacteria Burkholderia pseudomallei in an aromatherapy spray — the same type of bacteria that sickened four people in the United States earlier this year. The spray, “Better Homes & Gardens Lavender & Chamomile Essential Oil Infused Aromatherapy Room Spray with Gemstones,” was found Oct. 6 in the home of a Georgia resident who became ill with melioidosis in late July. CDC is continuing testing to see if the genetic fingerprint of the bacteria in the bottle matches those of the bacteria identified in the four patients – one each in Georgia, Kansas, Texas, and Minnesota. Two of the four patients died.

The contaminated spray was sold at about 55 Walmart stores and on Walmart’s website between February and October 21, 2021, when Walmart pulled remaining bottles of this spray and related products from store shelves and its website. The Consumer Product Safety Commission and Walmart are issuing a recall for the lavender and chamomile room spray and five other scents in the same product line. Investigation continues into whether other related scents and brands may pose a risk.

CDC recommends that anyone who has this aromatherapy spray in their home:

1. Stop using this product immediately. Do not open the bottle. Do not throw away or dispose of the bottle in the regular trash.
2. Double bag the bottle in clean, clear zip-top bags and place in a small cardboard box. Return the bagged and boxed product to a Walmart store.
3. Wash sheets or linens that the product may have been sprayed on using normal laundry detergent and dry completely in a hot dryer; bleach can be used if desired.
4. Wipe down counters and surfaces that might have the spray on them with undiluted Pine-Sol or similar disinfectant.
5. Limit how much you handle the spray bottle and wash hands thoroughly after touching the bottle or linens. If you used gloves, wash hands afterward.
6. If you have used the product within the past 21 days and have fever or other melioidosis symptoms, seek medical care and tell your doctor you were exposed to the spray. If you do not have symptoms but were exposed to the product in the last 7 days, your doctor may recommend that you get antibiotics (post-exposure prophylaxis) to prevent infection.

CDC has been testing blood samples from the patients, as well as soil, water, and consumer products from in and around the four patients’ homes since the agency began receiving samples in May. A sample of the Better Homes & Gardens spray tested positive this week. The genetic fingerprint of the bacteria that sickened the four patients is similar to that of strains usually found in South Asia; the aromatherapy spray was made in India. CDC is coordinating with state health departments in Kansas, Minnesota, and Texas to try to determine whether the other three patients may have also used this or similar products.

“Our hearts go out to the families that have been impacted by this situation,” said Inger Damon, MD, MPH, director of CDC’s Division of High-Consequence Pathogens and Pathology, which manages melioidosis. “We at CDC have been very concerned to see these serious related illness spread across time and geography. That is why our scientists have continued to work tirelessly to try to find the potential source for the melioidosis infections in these patients. We hope this work can help protect other people who may have used this spray.”

Melioidosis is a rare but serious disease in the United States, with about 12 cases reported annually. Worldwide, most cases are in people who live in or have traveled to areas where the bacteria naturally occurs, such as parts of South and Southeast Asia and northern Australia. It is also occasionally found in the Americas (e.g., Brazil, Mexico, Puerto Rico). Melioidosis causes a wide range of symptoms that can be confused with other common illnesses, like flu or a cold. Person-to-person spread is extremely rare.

For more information about the investigation, please visit the webpage on this cluster of illnesses and the Health Alert Network notice. For information about melioidosis, please go to: https://www.cdc.gov/melioidosis/index.html.