BACKGROUND: Meliodosis is caused by infection with Burkholderia pseudomallei, a federal select agent and soil saprophyte typically found in the tropics and subtropics and particularly in Southeast Asia and northern Australia. Infections are caused by contact with contaminated water and soil. Disease, which can be severe, occurs in humans and many animal species. Cases in the United States, which are very rare, are typically associated with travel or immigration. Importations of canine melioidosis to the U.S. have not been reported since the Vietnam War era. We report the public health response to a case of imported canine melioidosis.
METHODS: In April 2016, the Wadsworth Center Laboratories confirmed the presence of B. pseudomallei in the urine of a dog that had recently been imported from Thailand. A coordinated investigation was initiated by two county health departments, a veterinary hospital, the New York State Department of Health, and the CDC. All persons and animals that had contacted the dog, its urine, or urine cultures were assessed for exposure risk and variably recommended for and offered chemoprophylaxis, serologic monitoring, and fever/symptom monitoring, depending on level of exposure and personal medical history.
RESULTS: The dog had been adopted between animal rescue organizations in Thailand and New York. The dog had visited a veterinary hospital twice for evaluation of a pre-existing spinal injury; no other signs of illness were apparent. Nineteen persons had variable exposure to B. pseudomallei, including two who had high-risk exposures based on underlying medical conditions. None of the exposed persons became ill or seroconverted. The rescue organization in New York held >130 animals including cats, dogs, and livestock; because the dog had been held in isolation and cared for using adequate biosecurity precautions, no animals were considered exposed. Given the lack of effective treatment regimens and the potential for ongoing risk to humans and animals, the dog was euthanized. Because B. pseudomallei is a select agent, the dog’s remains were disposed by alkaline hydrolysis.
CONCLUSIONS: As a select agent, B. pseudomallei has the potential to pose a severe threat to both human and animal health. Fortunately, this introduction did not cause further spread to animals or people, and soil contamination was avoided. The medical, veterinary medical, and public health communities should be aware that rare diseases may be imported into the U.S. in companion animals.