Burkholderia thailandensis Isolated from the Environment, United States.

Burkholderia thailandensis, an opportunistic pathogen found in the environment, is a bacterium closely related to B. pseudomallei, the cause of melioidosis. Human B. thailandensis infections are uncommon. We isolated B. thailandensis from water in Texas and Puerto Rico and soil in Mississippi in the United States, demonstrating a potential public health risk.

Human Rabies - Texas, 2021.

In late August 2021, a boy aged 7 years was bitten by a bat while he was playing outside his apartment home in Medina County, Texas. He informed his parents; however, no rabies postexposure prophylaxis (PEP) was sought because there were no visible bite marks, and the family was unaware that contact with a bat, including in the absence of visible bite marks, might cause rabies. Approximately 2 months later, the child was hospitalized for altered mental status, seizures, and hypersalivation and ultimately received a diagnosis of rabies. Experimental therapies were attempted; however, the child died 22 days after symptom onset. Fifty-seven persons who met criteria for suspected or known exposure to infectious secretions in this case were advised to consult with a medical provider about the need for rabies PEP in accordance with Advisory Committee on Immunization Practices (ACIP) guidelines (1). Rabies, an acute, progressive neuroencephalitis, is nearly always fatal. Although dogs are the most common source of human rabies deaths worldwide and account for an estimated 59,000 annual cases of human rabies globally (2), bats are the most common source of domestically acquired rabies in the United States and have been implicated in 31 (81.6%) of 38 human infections since 2000 (3). Attempts to prevent death or poor neurologic outcomes once rabies symptoms develop have been largely unsuccessful (4). Administration of rabies PEP, comprising rabies immunoglobulin and a series of doses of rabies vaccine, is critical to preventing rabies after an exposure; enhanced public education about the risk posed by bats, and the availability of PEP to prevent rabies, is needed.

Low risk of acquiring melioidosis from the environment in the continental United States.

Melioidosis is an underreported human disease of tropical and sub-tropical regions caused by the saprophyte Burkholderia pseudomallei. Although most global melioidosis cases are reported from tropical regions in Southeast Asia and northern Australia, there are multiple occurrences from sub-tropical regions, including the United States (U.S.). Most melioidosis cases reported from the continental U.S. are the result of acquiring the disease during travel to endemic regions or from contaminated imported materials. Only two human melioidosis cases from the continental U.S. have likely acquired B. pseudomallei directly from local environments and these cases lived only ~7 km from each other in rural Texas. In this study, we assessed the risk of acquiring melioidosis from the environment within the continental U.S. by surveying for B. pseudomallei in the environment in Texas where these two human melioidosis cases likely acquired their infections. We sampled the environment near the homes of the two cases and at additional sampling locations in surrounding counties in Texas that were selected based on ecological niche modeling. B. pseudomallei was not detected at the residences of these two cases or in the surrounding region. These negative data are important to demonstrate that B. pseudomallei is rare in the environment in the U.S. even at locations where locally acquired human cases likely have occurred, documenting the low risk of acquiring B. pseudomallei infection from the environment in the continental U.S.

Melioidosis in a Resident of Texas with No Recent Travel History, United States.

To our knowledge, environmental isolation of Burkholderia pseudomallei, the causative agent of melioidosis, from the continental United States has not been reported. We report a case of melioidosis in a Texas resident. Genomic analysis indicated that the isolate groups with B. pseudomallei isolates from patients in the same region, suggesting possible endemicity to this region.

Trends and Disparities in the Prevalence of Childhood Obesity in South Texas between 2009 and 2015.

BACKGROUND: Recent reports have highlighted possible decreases over time in obesity, particularly among children aged 2-5 years. Hispanic children experience significantly higher obesity rates, and less is known about trends for Hispanic children. METHODS: A large healthcare system-based dataset from south Texas was used to analyze body mass index (BMI) values obtained clinically from 2009 through 2015. Age and race/ethnicity specific prevalence of overweight and obesity were calculated using CDC standards and trends were examined over time using regression analyses, and mapping software was used to identify geographic variation. RESULTS: Hispanic children in south Texas experience levels of obesity (25.3%, 95% CI: 25.1-25.6) significantly higher than their white (16.6%, 95% CI: 16.0-17.2) or black (18.2%, 95% CI: 17.3-19.1) peers. Obesity in Hispanic children aged 2-5 years decreased from 18.5%, 95% CI: 16.6-20.5, in 2009 to 15.1%, 95% CI: 14.3-15.9, in 2015. Obesity in Hispanic adolescents was stable at 30.4%, 95% CI: 28.5-32.4, in 2009 and 31.3, 95% CI: 30.3-32.2, in 2015. CONCLUSIONS: While obesity decreased in the youngest age group of Hispanic children, south Texas continues to experience high levels of obesity that exceed national averages with significant disparities.