Melioidosis in Singapore: Clinical, Veterinary, and Environmental Perspectives

Abstract

Melioidosis is a notifiable infectious disease registered with the Ministry of Health (MOH) and Agri-Food & Veterinary Authority (AVA), Singapore. From a clinical perspective, increased awareness of the disease has led to early detection and treatment initiation, thus resulting in decreasing mortality rates in recent years. However, the disease still poses a threat to local pet, zoo and farm animals, where early diagnosis is a challenge. The lack of routine environmental surveillance studies also makes prevention of the disease in animals difficult. To date, there have been no reports that provide a complete picture of how the disease impacts the local human and animal populations in Singapore. Information on the distribution of Burkholderia pseudomallei in the environment is also lacking. The aim of this review is to provide a comprehensive overview of both published and unpublished clinical, veterinary and environmental studies on melioidosis in Singapore to achieve better awareness and management of the disease.

Keywords: B. pseudomallei; Singapore; clinical; environmental; melioidosis; veterinary.

Figure 1

Annual number of human melioidosis cases from 2003 to 2016 in Singapore.

Figure 2

Multifocal abscess (black arrows) in the liver of a Douc langur with melioidosis.

Figure 3

Large abscess in the left caudal lung lobe (black arrow) of a Douc langur with melioidosis.

Figure 4

Whole genome phylogeny tree of clinical and environmental isolates from same locale in Singapore. Phylogenetic tree generated using Phylogenetic Tree Building Service by PATRIC v3.5.7 (https://www.patricbrc.org/app/PhylogeneticTree), depicting the relationships of the clinical isolate Bp22 and environmental isolates obtained from an island off Singapore. Bp K96243 was included as a reference isolate.