Reassessing the distribution of Burkholderia pseudomallei outside known endemic areas using animal serological screening combined with environmental surveys: The case of Les Saintes (Guadeloupe) and French Guiana.

Background: Melioidosis, an emerging infectious disease that affects both humans and animals, is caused by the soil-dwelling bacterium Burkholderia pseudomallei. It is endemic in South and Southeast Asia, and northern Australia, causing an estimated 165,000 human cases annually worldwide. Human cases have been reported in the French West Indies (Martinique and Guadeloupe) since the 1990s. Conversely, no human cases have been reported in French Guiana, a French territory in South America. Our study aimed to investigate whether B. pseudomallei is locally established in Guadeloupe and French Guiana using animals as a proxy. Methodology/principal findings: Blood samples were collected from different animals from 56 farms in French Guiana (n = 670) and from two goat farms in Les Saintes (n = 31), part of the archipelago of Guadeloupe and tested by enzyme-linked immunosorbent assay (ELISA). In Les Saintes, a serological follow-up was performed, and soil, water and goat rectal swabs were collected and analyzed by culture and PCR. The highest seroprevalence rates (39%) were observed in goats in Les Saintes, followed by horses (24%) and cattle (16%) in French Guiana. In the two goat farms, supplementary analyses detected B. pseudomallei from one goat rectal swab, and a B. pseudomallei strain was isolated from the soil. Conclusions/significance: Our animal serological data suggest the presence of B. pseudomallei in Les Saintes and French Guiana. In Les Saintes, environmental surveys confirmed the endemicity of the bacteria, which is consistent with documented human cases of melioidosis on the island. We did not conduct an environmental survey in French Guiana. Nevertheless, our serological results call for local environmental surveys and a retrospective reassessment of human infections with melioidosis-like symptoms. Author summary: Melioidosis, a disease caused by the environmental bacterium Burkholderia pseudomallei, has historically been described in Southeast Asia and northern Australia. However, recent studies have demonstrated its presence outside these areas, both in the environment and in patients without a history of travel to known endemic areas. In addition, the predicted increase in extreme climatic events in the near future could increase the prevalence of the disease and lead to its emergence in new areas. For these reasons, it is important to identify areas at risk outside of known endemic areas. Hypothesizing that we would have little chance of finding B. pseudomallei through random environmental surveys, we used serological testing to find evidence of past exposure to the bacteria in apparently healthy domestic animals. We identified seropositive animals in Les Saintes and French Guiana. We then searched for the presence of B. pseudomallei in the immediate vicinity of the seropositive animals in Les Saintes, and isolated it in the soil of a goat farm. Our study suggests that domestic animals could be used as sentinels for the detection of melioidosis outside of countries with frequent human cases. [ABSTRACT FROM AUTHOR]