Melioidosis aka Whitmore’s Disease: Thailand’s Unknown Deadly Disease

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UBON RATCHATHANI – Melioidosis is Thailand’s third most-deadly infectious disease kills 40 percent of those infected, but very few have ever heard of it.

Melioidosis, also known as Whitmore’s disease, has long been known to be endemic in parts of South and East Asia, the Pacific and northern Australia.

The disease, which often affects the rural poor working in fields, is notoriously difficult to diagnose because it mimics many other bacterial infections but only responds to a handful of antibiotics. As a result, misdiagnosis is common.

Endemic to Thailand’s northeast, melioidosis is caused by a soil and water-dwelling bacteria, B pseudomallei, which is found around the world in tropical regions from East Asia to sub-Saharan Africa, as well as Latin America and the Middle East.

Every year, in the agriculturally intensive regions of Thailand, there are thousands of cases of melioidosis. Of those infected, approximately 40 percent die from the disease, even if they begin treatment. If the patient is not diagnosed and provided with effective antibiotics on time, the mortality rate is at a much higher 90 percent.

Quick diagnosis increases the chances of survival, but it is the difficulty in diagnosing it that causes so many problems, as symptoms vary largely from patient to patient.

The disease was first identified in 1911 in Yangon, but later gained attention, particularly from American doctors during the Vietnam War, when many wounded soldiers were infected through contact with the soil and water. The Americans had  dubbed  the disease the ‘Vietnam Time Bomb’ because exposed soldiers often didn’t develop symptoms until after they had arrived back home.

Identifying and Treating Melioidosis

Dr Vipada Chaowagul is known as the “Mother of Melioidosis” among her colleagues. She has worked in the field for almost 40 years.

Although she is the deputy director of administration at another hospital in the city, she comes to Sappasit Prasong Hospital every Tuesday. The province has such a high number of cases that the hospital started a special weekly melioidosis clinic for patients to receive test results and check-ups.

By lunchtime, she has seen almost 30 patients. Between her visits, she tells of the challenges she has faced in her career of treating the disease. While the lab became proficient at diagnosing the disease, effective treatment techniques took longer to develop.

“For five years, I had been working on melioidosis and was finding that most of the serious cases die because conventional treatment was not working,” Dr Chaowagul tells Al Jazeera, adding that 95 percent of her patients were dying.

“The cases would come in on one day, and we would know the result of the culture after they were already dead. Because they came and died in 24 hours.”

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