Probable airborne transmission of Burkholderia pseudomallei causing an urban outbreak of melioidosis during typhoon season in Hong Kong, China

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 pati...

Full description

Saved in:
Bibliographic Details
Main Authors: Wing-Gi Wu, Marcus Ho-Hin Shum, Ivan Tak-Fai Wong, Kelvin Keru Lu, Lam-Kwong Lee, Jake Siu-Lun Leung, Hiu-Yin Lao, Annie Wing-Tung Lee, Pak-Ting Hau, Chloe Toi-Mei Chan, Harmen Fung-Tin Wong, Sharon Ka-Yee Fung, Sally Choi-Ying Wong, Iain Chi-Fung Ng, Timothy Ting-Leung Ng, Ning Chow, Alex Yat-Man Ho, Mei Fan Hung, Franklin Wang-Ngai Chow, Maureen Mo-Lin Wong, Wing-Kin To, Tommy Tsan-Yuk Lam, Kristine Shik Luk, Gilman Kit-Hang Siu
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Emerging Microbes and Infections
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/22221751.2023.2204155
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850030838611181568
author Wing-Gi Wu
Marcus Ho-Hin Shum
Ivan Tak-Fai Wong
Kelvin Keru Lu
Lam-Kwong Lee
Jake Siu-Lun Leung
Hiu-Yin Lao
Annie Wing-Tung Lee
Pak-Ting Hau
Chloe Toi-Mei Chan
Harmen Fung-Tin Wong
Sharon Ka-Yee Fung
Sally Choi-Ying Wong
Iain Chi-Fung Ng
Timothy Ting-Leung Ng
Ning Chow
Alex Yat-Man Ho
Mei Fan Hung
Franklin Wang-Ngai Chow
Maureen Mo-Lin Wong
Wing-Kin To
Tommy Tsan-Yuk Lam
Kristine Shik Luk
Gilman Kit-Hang Siu
author_facet Wing-Gi Wu
Marcus Ho-Hin Shum
Ivan Tak-Fai Wong
Kelvin Keru Lu
Lam-Kwong Lee
Jake Siu-Lun Leung
Hiu-Yin Lao
Annie Wing-Tung Lee
Pak-Ting Hau
Chloe Toi-Mei Chan
Harmen Fung-Tin Wong
Sharon Ka-Yee Fung
Sally Choi-Ying Wong
Iain Chi-Fung Ng
Timothy Ting-Leung Ng
Ning Chow
Alex Yat-Man Ho
Mei Fan Hung
Franklin Wang-Ngai Chow
Maureen Mo-Lin Wong
Wing-Kin To
Tommy Tsan-Yuk Lam
Kristine Shik Luk
Gilman Kit-Hang Siu
author_sort Wing-Gi Wu
collection DOAJ
description 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.
format Article
id doaj-art-c3a8a233eced457a8aaf656ab19f7432
institution DOAJ
issn 2222-1751
language English
publishDate 2023-12-01
publisher Taylor & Francis Group
record_format Article
series Emerging Microbes and Infections
spelling doaj-art-c3a8a233eced457a8aaf656ab19f74322025-08-20T02:59:07ZengTaylor & Francis GroupEmerging Microbes and Infections2222-17512023-12-0112110.1080/22221751.2023.2204155Probable airborne transmission of Burkholderia pseudomallei causing an urban outbreak of melioidosis during typhoon season in Hong Kong, ChinaWing-Gi Wu0Marcus Ho-Hin Shum1Ivan Tak-Fai Wong2Kelvin Keru Lu3Lam-Kwong Lee4Jake Siu-Lun Leung5Hiu-Yin Lao6Annie Wing-Tung Lee7Pak-Ting Hau8Chloe Toi-Mei Chan9Harmen Fung-Tin Wong10Sharon Ka-Yee Fung11Sally Choi-Ying Wong12Iain Chi-Fung Ng13Timothy Ting-Leung Ng14Ning Chow15Alex Yat-Man Ho16Mei Fan Hung17Franklin Wang-Ngai Chow18Maureen Mo-Lin Wong19Wing-Kin To20Tommy Tsan-Yuk Lam21Kristine Shik Luk22Gilman Kit-Hang Siu23Department of Pathology, Princess Margaret Hospital, Hong Kong Special Administrative Region, People’s Republic of ChinaState Key Laboratory of Emerging Infectious Diseases, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of ChinaDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Administrative Region, People's Republic of ChinaDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Administrative Region, People's Republic of ChinaDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Administrative Region, People's Republic of ChinaDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Administrative Region, People's Republic of ChinaDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Administrative Region, People's Republic of ChinaDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Administrative Region, People's Republic of ChinaDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Administrative Region, People's Republic of ChinaDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Administrative Region, People's Republic of ChinaDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Administrative Region, People's Republic of ChinaDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Administrative Region, People's Republic of ChinaDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Administrative Region, People's Republic of ChinaDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Administrative Region, People's Republic of ChinaDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Administrative Region, People's Republic of ChinaDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Administrative Region, People's Republic of ChinaDepartment of Pathology, Princess Margaret Hospital, Hong Kong Special Administrative Region, People’s Republic of ChinaDepartment of Pathology, Princess Margaret Hospital, Hong Kong Special Administrative Region, People’s Republic of ChinaDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Administrative Region, People's Republic of ChinaDepartment of Medicine and Geriatrics/Intensive Care Unit, Caritas Medical Centre, Hong Kong Special Administrative Region, People’s Republic of ChinaDepartment of Pathology, Princess Margaret Hospital, Hong Kong Special Administrative Region, People’s Republic of ChinaState Key Laboratory of Emerging Infectious Diseases, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of ChinaDepartment of Pathology, Princess Margaret Hospital, Hong Kong Special Administrative Region, People’s Republic of ChinaDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Administrative Region, People's Republic of ChinaBetween 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.https://www.tandfonline.com/doi/10.1080/22221751.2023.2204155MelioidosisBurkholderia pseudomalleicore genome-multilocus sequence typingairborne transmissionurban outbreaktyphoon
spellingShingle Wing-Gi Wu
Marcus Ho-Hin Shum
Ivan Tak-Fai Wong
Kelvin Keru Lu
Lam-Kwong Lee
Jake Siu-Lun Leung
Hiu-Yin Lao
Annie Wing-Tung Lee
Pak-Ting Hau
Chloe Toi-Mei Chan
Harmen Fung-Tin Wong
Sharon Ka-Yee Fung
Sally Choi-Ying Wong
Iain Chi-Fung Ng
Timothy Ting-Leung Ng
Ning Chow
Alex Yat-Man Ho
Mei Fan Hung
Franklin Wang-Ngai Chow
Maureen Mo-Lin Wong
Wing-Kin To
Tommy Tsan-Yuk Lam
Kristine Shik Luk
Gilman Kit-Hang Siu
Probable airborne transmission of Burkholderia pseudomallei causing an urban outbreak of melioidosis during typhoon season in Hong Kong, China
Emerging Microbes and Infections
Melioidosis
Burkholderia pseudomallei
core genome-multilocus sequence typing
airborne transmission
urban outbreak
typhoon
title Probable airborne transmission of Burkholderia pseudomallei causing an urban outbreak of melioidosis during typhoon season in Hong Kong, China
title_full Probable airborne transmission of Burkholderia pseudomallei causing an urban outbreak of melioidosis during typhoon season in Hong Kong, China
title_fullStr Probable airborne transmission of Burkholderia pseudomallei causing an urban outbreak of melioidosis during typhoon season in Hong Kong, China
title_full_unstemmed Probable airborne transmission of Burkholderia pseudomallei causing an urban outbreak of melioidosis during typhoon season in Hong Kong, China
title_short Probable airborne transmission of Burkholderia pseudomallei causing an urban outbreak of melioidosis during typhoon season in Hong Kong, China
title_sort probable airborne transmission of burkholderia pseudomallei causing an urban outbreak of melioidosis during typhoon season in hong kong china
topic Melioidosis
Burkholderia pseudomallei
core genome-multilocus sequence typing
airborne transmission
urban outbreak
typhoon
url https://www.tandfonline.com/doi/10.1080/22221751.2023.2204155
work_keys_str_mv AT winggiwu probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT marcushohinshum probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT ivantakfaiwong probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT kelvinkerulu probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT lamkwonglee probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT jakesiulunleung probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT hiuyinlao probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT anniewingtunglee probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT paktinghau probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT chloetoimeichan probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT harmenfungtinwong probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT sharonkayeefung probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT sallychoiyingwong probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT iainchifungng probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT timothytingleungng probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT ningchow probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT alexyatmanho probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT meifanhung probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT franklinwangngaichow probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT maureenmolinwong probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT wingkinto probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT tommytsanyuklam probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT kristineshikluk probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina
AT gilmankithangsiu probableairbornetransmissionofburkholderiapseudomalleicausinganurbanoutbreakofmelioidosisduringtyphoonseasoninhongkongchina