TY - JOUR
T1 - Probable airborne transmission of Burkholderia pseudomallei causing an urban outbreak of melioidosis during typhoon season in Hong Kong, China
AU - Wu, Wing Gi
AU - Shum, Marcus Ho Hin
AU - Wong, Ivan Tak Fai
AU - Lu, Kelvin Keru
AU - Lee, Lam Kwong
AU - Leung, Jake Siu Lun
AU - Lao, Hiu Yin
AU - Lee, Annie Wing Tung
AU - Hau, Pak Ting
AU - Chan, Chloe Toi Mei
AU - Wong, Harmen Fung Tin
AU - Fung, Sharon Ka Yee
AU - Wong, Sally Choi Ying
AU - Ng, Iain Chi Fung
AU - Ng, Timothy Ting Leung
AU - Chow, Ning
AU - Ho, Alex Yat Man
AU - Hung, Mei Fan
AU - Chow, Franklin Wang Ngai
AU - Wong, Maureen Mo Lin
AU - To, Wing Kin
AU - Lam, Tommy Tsan Yuk
AU - Luk, Kristine Shik
AU - Siu, Gilman Kit Hang
N1 - Publisher Copyright:
© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group, on behalf of Shanghai Shangyixun Cultural Communication Co., Ltd.
PY - 2023/5/1
Y1 - 2023/5/1
N2 - Between January 2015 and October 2022, 38 patients with culture-confirmed melioidosis were identified in the Kowloon West (KW) Region, Hong Kong. Notably, 30 of them were clustered in the Sham Shui Po (SSP) district, which covers an estimated area of 2.5 km2. Between August and October 2022, 18 patients were identified in this district after heavy rainfall and typhoons. The sudden upsurge in cases prompted an environmental investigation, which involved collecting 20 air samples and 72 soil samples from residential areas near the patients. A viable isolate of Burkholderia pseudomallei was obtained from an air sample collected at a building site five days after a typhoon. B. pseudomallei DNA was also detected in 21 soil samples collected from the building site and adjacent gardening areas using full-length 16S rRNA gene sequencing, suggesting that B. psuedomallei is widely distributed in the soil environment surrounding the district. Core genome-multilocus sequence typing showed that the air sample isolate was phylogenetically clustered with the outbreak isolates in KW Region. Multispectral satellite imagery revealed a continuous reduction in vegetation region in SSP district by 162,255 m2 from 2016 to 2022, supporting the hypothesis of inhalation of aerosols from the contaminated soil as the transmission route of melioidosis during extreme weather events. This is because the bacteria in unvegetated soil are more easily spread by winds. In consistent with inhalational melioidosis, 24 (63.2%) patients had pneumonia. Clinicians should be aware of melioidosis during typhoon season and initiate appropriate investigation and treatment for patients with compatible symptoms.
AB - Between January 2015 and October 2022, 38 patients with culture-confirmed melioidosis were identified in the Kowloon West (KW) Region, Hong Kong. Notably, 30 of them were clustered in the Sham Shui Po (SSP) district, which covers an estimated area of 2.5 km2. Between August and October 2022, 18 patients were identified in this district after heavy rainfall and typhoons. The sudden upsurge in cases prompted an environmental investigation, which involved collecting 20 air samples and 72 soil samples from residential areas near the patients. A viable isolate of Burkholderia pseudomallei was obtained from an air sample collected at a building site five days after a typhoon. B. pseudomallei DNA was also detected in 21 soil samples collected from the building site and adjacent gardening areas using full-length 16S rRNA gene sequencing, suggesting that B. psuedomallei is widely distributed in the soil environment surrounding the district. Core genome-multilocus sequence typing showed that the air sample isolate was phylogenetically clustered with the outbreak isolates in KW Region. Multispectral satellite imagery revealed a continuous reduction in vegetation region in SSP district by 162,255 m2 from 2016 to 2022, supporting the hypothesis of inhalation of aerosols from the contaminated soil as the transmission route of melioidosis during extreme weather events. This is because the bacteria in unvegetated soil are more easily spread by winds. In consistent with inhalational melioidosis, 24 (63.2%) patients had pneumonia. Clinicians should be aware of melioidosis during typhoon season and initiate appropriate investigation and treatment for patients with compatible symptoms.
KW - airborne transmission
KW - Burkholderia pseudomallei
KW - core genome-multilocus sequence typing
KW - Melioidosis
KW - typhoon
KW - urban outbreak
UR - http://www.scopus.com/inward/record.url?scp=85159248631&partnerID=8YFLogxK
U2 - 10.1080/22221751.2023.2204155
DO - 10.1080/22221751.2023.2204155
M3 - Journal article
C2 - 37070526
AN - SCOPUS:85159248631
SN - 2222-1751
VL - 12
JO - Emerging Microbes and Infections
JF - Emerging Microbes and Infections
IS - 1
M1 - 2204155
ER -