What is Whitmore’s flesh-eating bacteria?

The Whitmore bacteria from the external environment primarily enter the host’s body through scratched skin or wounds.

What is Whitmore Disease?

Whitmore (also known as Melioidosis) is a severe acute infectious disease caused by the bacterium Burkholderia pseudomallei. The disease has a very high mortality rate if not detected and treated promptly.

What Type of Bacteria Causes Whitmore?

According to Associate Professor Dr. Do Duy Cuong, Whitmore is caused by the gram-negative bacterium B. pseudomallei (also known as the flesh-eating bacteria). Once inside the body, this bacterium attacks multiple organs, leading to multiple organ failure, shock, and death. Patients with a history of cardiovascular disease, diabetes, chronic kidney disease, etc., are at a higher risk of organ damage and have a higher mortality rate.

Whitmore bacteria typically live in soil and water.

Whitmore is not a new or rare disease; it has been “forgotten” in the community. The disease was first identified in the world in 1911 and appeared in Vietnam in 1936. This bacterium typically lives in soil and water, and the main transmission route is through damaged skin that comes into contact with the bacteria or inhaling dust particles containing the bacteria. Additionally, there is currently no vaccine available for the disease, and once it manifests, it can progress rapidly, potentially taking a patient’s life within 48 hours of hospitalization.

Vietnam is in the Global Whitmore Disease Zone

Whitmore is a regional disease primarily found in Southeast Asia and northern Australia. Notably, the northeastern region of Thailand (close to central Vietnam) is considered the epicenter of the disease. Globally, most reported cases of Whitmore disease have been in Thailand, Malaysia, Singapore, Vietnam, and northern Australia. The incidence rate in Singapore has been reported as 13 cases per 1 million people.

Who is at Risk of Whitmore Disease?

Although Whitmore can attack completely healthy individuals, experts have identified the following at-risk groups:

• Individuals with weakened immune systems
• People with chronic diseases such as cancer, lung disease, liver disease, diabetes, kidney disease, and even HIV.

What are the Transmission Pathways of Whitmore Bacteria?

• Transmission through contaminated food and drink.
• Direct contact with scratched skin, soil, or water that has been contaminated (especially during the rainy season).
• Inhaling dust particles containing the bacteria.
• Transmission from mother to child through breast milk when the mother has a breast abscess.
• Contact with scratched skin and dead animals infected with Whitmore bacteria, such as dogs, cats, cows, goats, etc.

Typical Symptoms Indicating Whitmore Bacteria are Invading the Body:

• If Whitmore causes bloodstream infections, symptoms may include high fever, headache, difficulty breathing, joint pain, and abdominal pain.
• If Whitmore causes widespread infections, characteristic signs will include fever, chest pain, abdominal pain, headache, seizures, and muscle and joint pain.
• If Whitmore causes lung infections, symptoms include cough and chest pain, and you may also experience fever, loss of appetite, and headache.
• If Whitmore causes localized infections in a part of the body, common signs include swelling, pain, and fever. Subsequently, the wound may worsen into ulcers or abscesses.
• Urinary tract infections.

Generally, these symptoms often appear in patients with a history of diabetes or other kidney, lung-related ailments, or in individuals who abuse alcohol, as well as farmers who work frequently with soil. Additionally, older adults are also at higher risk due to weakened immune systems.

As soon as the body exhibits any of the aforementioned symptoms, you need to promptly visit a reputable hospital with a microbiology lab for proper examination and treatment to avoid potential dangerous complications. In particular, patients who have previously been infected with Whitmore bacteria should regularly return for follow-up check-ups, as the disease has a high chance of recurrence and requires persistence in treatment.

How Long is the Incubation Period for Whitmore?

The incubation period from the moment of exposure to the bacteria until symptoms appear usually ranges from 1 to 21 days. However, there are cases where the infected individual shows no symptoms until the disease becomes apparent.

Is Whitmore Disease Contagious?

As of now, there have been no recorded cases of Whitmore being transmitted from person to person. According to experts, this is not considered a contagious disease. Additionally, insects are not vectors for transmission. Therefore, the only risk factor for contracting the disease is direct contact with the bacteria present in contaminated soil or water.

What Can Be Done to Prevent Whitmore Bacteria from Attacking?

Maintain personal hygiene, especially keeping hands and feet clean.

Whitmore bacteria are present in the soil. Additionally, when the wind stirs up dust, individuals may easily inhale Whitmore bacteria, which can reside in the lungs until the immune system weakens, at which point they can proliferate.

Associate Professor Dr. Do Duy Cuong advises that in recent years, the number of reported Whitmore cases has continuously increased, with peaks typically occurring during the rainy season from July to November. Therefore, individuals working in environments with exposure to soil and water should use protective equipment, and if they have any skin abrasions, they need to treat them promptly and thoroughly.

Currently, there is no vaccine to prevent Whitmore, so to protect yourself, you should keep the following in mind:

• When working in environments that involve contact with soil or water, remember to wear boots and protective gloves.
• Avoid contact with contaminated soil and water if you have open wounds or chronic conditions like diabetes or kidney disease.
• Wear a mask when in areas with polluted air or a lot of dust.
• Thoroughly clean food preparation utensils, especially remember to disinfect knives after cutting raw meat or fish.
• If you consume fresh milk products, ensure that they have been pasteurized.

If you have open wounds, make sure to bandage and cover them carefully to minimize the risk of exposure to bacteria.

Treatment for Whitmore Disease

Treating Whitmore is very challenging due to the bacteria’s resistance to most common antibiotics. The treatment process consists of two stages. The attack phase (intravenous antibiotic treatment) aims to prevent severe infections to save the patient’s life. The maintenance phase (oral antibiotics) aims to eliminate any remaining bacteria and reduce the risk of recurrence.

Currently, there is no vaccine available for prevention. In areas where Whitmore is endemic, individuals with weakened immune systems, such as those with AIDS, cancer, and chemotherapy patients, should avoid contact with contaminated soil and water, especially in farm areas.

Dr. Hoang Lan Huong, Deputy Director of Hue Central Hospital, recommends that residents in flood-prone areas should limit contact with muddy soil or water, especially in heavily contaminated areas. People who frequently work outdoors and are exposed to dirty soil and floodwater should use shoes, sandals, and protective gloves.

When there are open wounds or ulcers, avoid contact with contaminated soil or floodwater. If unavoidable, use waterproof bandages and ensure cleanliness. Individuals with chronic diseases such as diabetes or weakened immunity must carefully tend to and protect their wounds to prevent infections from floodwaters.

If you suspect you have the disease, visit the hospital early for examination and testing to confirm the presence of the Whitmore-causing bacteria and receive timely treatment.

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