The fourth person affected by a bacterial outbreak linked to imported aromatherapy room sprays sold at Walmart last year occurred in a previously healthy 5-year-old boy in Georgia, who died of the infection. That’s according to new information presented Tuesday at the International Conference on Emerging Infectious Diseases (ICEID), hosted by the Centers for Disease Control and Prevention in Atlanta.
The tragic new details of the boy’s cases—presented by epidemiologist Jessica Pavlick of the Georgia Department of Public Health—have newfound significance for the US. In the year since the boy’s death, the tropical soil bacterium behind his deadly infection has been found in environmental samples in southern Mississippi. The bacterium—Burkholderia pseudomallei—is now considered endemic to the Gulf Coast region, creating an ever-present threat to people in the area.
For years, CDC researchers have suspected that B. pseudomallei could already be lurking in soil and water in the continental US, rather than being brought in via imported animals and products (like the room sprays), as well as travelers and migrants. In recent years, the US has averaged about 12 cases of B. pseudomallei infection, which causes a disease called melioidosis.
Most of the cases are linked to travel, but not all of them, leading CDC researchers to speculate that B. pseudomallei had become a permanent resident rather than an occasional interloper. It wasn’t until an unexplained case in southern Mississippi in 2022—which occurred just miles away from another mysterious case from 2020—that investigators finally caught B. pseudomallei in US environmental samples.
Though melioidosis cases are rare even in places where B. pseudomallei is most prevalent—namely in Southeast Asia and northern Australia—when they occur, they can be difficult to diagnose and treat, and it can easily turn deadly. Awareness of the disease and rapid diagnosis are critical. This was sadly not the case for the 5-year-old in Georgia.
The boy fell ill in July 2021. At that point, the CDC has already issued a nationwide alert on June 30 over three other melioidosis cases in three other states: Kansas, Minnesota, and Texas. Despite the scattered cases, genetic analyses of the B. pseudomallei isolates indicated that they were all connected and that the strain traced back to those found in India and Sri Lanka.
The first case occurred in March 2021 in an adult in Kansas who died of the infection. The two other cases occurred in May: an adult in Minnesota who survived and a 4-year-old girl in Texas who was left with brain damage. Though state and CDC health investigators knew the cases were connected and that an imported product or animal was likely to blame, they had yet to figure out a common source. According to Pavlick’s presentation Tuesday, the boys’ tragic death in Georgia would reveal the answer.
Pavlick laid out the boy’s case and the aftermath. On July 7, a week after the CDC’s melioidosis alert, the boy started feeling ill with fever, weakness, sore throat, nausea, and vomiting. Pavlick noted that he had no underlying health conditions and was previously considered healthy. By July 12, the boy was taken to a local emergency department and admitted to the hospital, where he tested positive for SARS-CoV-2, which may have obscured his melioidosis. The next day, he was transferred to a children’s…