BACKGROUND:    @entity6942 results from @entity281 with @entity6943 and is associated with case-fatality rates up to 40%. Early diagnosis and treatment with appropriate antimicrobials can improve survival rates. Fatal and nonfatal @entity6942 cases were identified in Puerto Rico in 2010 and 2012, respectively, which prompted contact investigations to identify risk factors for @entity281 and evaluate endemicity. METHODS:    Questionnaires were administered and serum specimens were collected from coworkers, @entity5526 within 250 m of both @entity1 ' residences, and injection drug user (IDU) contacts of the 2012 patient. Serum specimens were tested for evidence of prior exposure to @entity6943 by indirect hemagglutination assay. Neighborhood seropositivity results guided soil sampling to isolate B. pseudomallei. RESULTS:    Serum specimens were collected from contacts of the 2010 (n = 51) and 2012 (n = 60) @entity1 , respectively. No coworkers had detectable anti-B. pseudomallei antibody, whereas seropositive results among @entity5526 was 5% (n = 2) for the 2010 @entity1 and 23% (n = 12) for the 2012 @entity1 , as well as 2 of 3 IDU contacts for the 2012 case. Factors significantly associated with seropositivity were having skin wounds, sores, or @entity1066 (odds ratio [OR], 4.6; 95% confidence interval [CI], 1.2-17.8) and IDU (OR, 18.0; 95% CI, 1.6-194.0). @entity6943 was isolated from soil collected in the neighborhood of the 2012 @entity1 . CONCLUSIONS:    Taken together, isolation of @entity6943 from a soil sample and high seropositivity among @entity1 contacts suggest at least regional endemicity of @entity6942 in Puerto Rico. Increased awareness of @entity6942 is needed to enable early case identification and early initiation of appropriate antimicrobial therapy.

Contact Investigation of XXXX Cases Reveals Regional Endemicity in Puerto Rico.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity6943 :: ('28450', 'Species') :: ['Burkholderia pseudomallei', 'B. pseudomallei'] @entity1066 :: ('MESH:D014456', 'Disease') :: ['ulcers'] @entity5526 :: ('MESH:D003877', 'Disease') :: ['neighborhood contacts'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infection'] @entity6942 :: ('MESH:D008554', 'Disease') :: ['Melioidosis', 'melioidosis']
@entity6942 :: (MESH:D008554,Disease) :: ['Melioidosis']
