Melioidosis research in China
Introduction
Melioidosis caused by Burkholderia pseudomallei is a tropical and subtropical disease that has been recognized for more than 80 years since it was first described in Rangoon (Whitmore and Krishnaswami, 1912). When melioidosis was identified as a threat to US army personnel in Vietnam and to returning service men in the US (Howe et al., 1971), a Chinese military scholar discussed, for the first time, the possibility of its existence in southern China in 1972 (Yutu, 1972). A few years later, military veterinary officers realized that horses stationed in southern China might be misdiagnosed as having glanders and be killed according to law. To differentiate glanders from melioidosis in military horses, a collaborating research group was organized to research on melioidosis in China. Over the past two decades, a number of investigations and laboratory studies have been undertaken on B. pseudomallei and melioidosis. However, due to the language barrier, little is known by the outside world. This review, covering almost all the research work in China, is an attempt to share our achievements in this field with our counterparts in other regions of the world.
Section snippets
Geographical distribution of B. pseudomallei
Since 1975, B. pseudomallei has routinely been isolated from environment (Li et al., 1981, Li et al., 1990, Li et al., 1994, Yang et al., 1995a), and a number of isolates identified (Table 1). Earlier studies demonstrated that the pathogen was distributed in the southern provinces of Hainan, Guangxi and Guangdong (Fig. 1). The natural foci were found to be localized to regions south of the Tropic of Cancer (Li et al., 1981). A recent survey isolated the pathogen from Putian in the Fujian
Serotype
It is well established that B. pseudomallei can be classified into two serological types based on the presence or absence of thermolabile and thermostable antigens. Serotype 1 possesses both antigens and is found predominantly in Asia while serotype 2 has only thermostable antigens and is found in Australia and Africa (Dodin, 1970). About 68 strains isolated in China were examined by bi-directional agar diffusion test with antibodies to thermolabile antigens purified by Sephadex 200 from a
Immunological cross reactions between B. pseudomallei and B. mallei
Military veterinary officers showed great concern for the cross reaction to the antigen of B. mallei in horses that had actually been exposed to B. pseudomallei. It was first confirmed that the two species share the same antigens by a bidirectional agar diffusion test (Li et al., 1981). Then, in experimentally infected horses, cross reactions to the antigens of B. mallei were observed through complement fixation test, electroimmunodiffusion and allergic reaction in eyes by eye-dropping of the
Discussion
During the last two decades, melioidosis has received attention as an important tropical disease worldwide (Yang and Zhenzi, 1994), yet it is still unfamiliar to almost all physicians in China. It was due to increased awareness among physicians in endemic areas that human cases were identified and reported in recent years. However, the reported cases have made it clear that human melioidosis, as a newly emerging tropical disease, does exist, but its exact prevalence and threat to farmers, who
Acknowledgements
I am grateful to Dr Donald E. Woods of Canadian Bacterial Diseases Network for his critical review of this manuscript. I also thank Yuhai M. for his careful preparation of the drawings.
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