The Threat

We do not know if an attack using the germs that cause melioidosis will ever happen. CDC and other federal agencies prepare for many types of biological attacks, including one using the germs that cause melioidosis. These plans will help CDC, federal agencies, and health departments protect as many people as possible if an attack ever happens.

Why might germs that cause melioidosis be used as a weapon?

If people or groups wanted to use germs as a weapon, they might use the germs that cause melioidosis because:

• They are found in nature in certain parts of the world.
• They cause a disease that can make people very sick. Without prompt treatment with specific antibiotics, people sick with melioidosis can die.
• In the past, some countries that have used bioweapons during war have used germs closely related to the one that causes melioidosis.

How dangerous is melioidosis?

Melioidosis can be a serious disease. Melioidosis germs are naturally resistant to many commonly used antibiotics, which makes the disease difficult to treat. There are a few antibiotics that are effective, though. Without treatment, up to 9 out of every 10 people who get it die. When people with melioidosis get treatment with the correct antibiotics, fewer than 4 out of 10 people die. Medical treatment in an intensive care facility can decrease deaths even more. Only 2 out of 10 people die when they get this level of medical treatment.

People with certain medical conditions are more likely than others to get melioidosis if they come into contact with the germs that cause it. Some of these conditions  are diabetes, heavy alcohol use, chronic lung disease, chronic kidney disease, and others that affect the immune system.

People sick with melioidosis frequently need to be hospitalized for treatment. Even after they are well enough to go home, people who have had melioidosis need to take antibiotics for several months. This long period of treatment makes sure the antibiotics kill all the melioidosis germs in the person’s body and prevents the disease from coming back.

It can also be hard to diagnose melioidosis quickly. The symptoms of melioidosis are the same as more common diseases like community-acquired pneumonia, the flu, or tuberculosis. There are only a few people diagnosed with melioidosis each year in the United States. Those who get melioidosis usually come into contact with the germs that cause it when they are traveling or living in a country where it is found naturally. Because there are so few people in the United States who get melioidosis, most doctors are unfamiliar with the disease.

What might an attack with germs that cause melioidosis look like?

A biological attack that releases germs that cause melioidosis into the air, water, or food might put many people at risk for getting sick. For example, if the germs were released into the air in a crowded place, many people might inhale them. Or, if the germs were put into food, people who eat the contaminated food would eat the germs, too. Anyone who comes into contact with these germs is in danger of getting sick with melioidosis.

You cannot see, smell, or taste the germs, so people might not know right away if there had been an attack. An attack might not be noticed until doctors begin to see many people sick with fevers and respiratory illnesses. Once doctors diagnose patients with melioidosis, they will work with public health authorities to find out how the patients came into contact with the melioidosis germs.