{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:39:26Z","timestamp":1788262766795,"version":"build-2803163510"},"reference-count":35,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p><jats:italic>Burkholderia pseudomallei<\/jats:italic>, the causative agent of melioidosis has long been considered able to exist in a latent form. Seropositivity among U.S. soldiers returning from the Vietnam conflict led to melioidosis being dubbed \u201cthe Vietnamese time bomb.\u201d Cases assigned to \u201c(re)activation from latency\u201d over 30 years of the Darwin Prospective Melioidosis Study (DPMS) were reviewed and reassessed and additional cases from DPMS years 31\u201334 were added. Historical reports of melioidosis attributed to activation from latency were reviewed. Some earlier DPMS cases and most historical cases described as activation from latency more accurately reflect undiagnosed chronic melioidosis, often with relapsing\u2013remitting courses, rather than truly latent, asymptomatic infection. Such protracted disease should now be diagnosable much earlier, provided melioidosis is considered and laboratory facilities are available. The longest plausible duration of asymptomatic latency remains 29 years. In conclusion, activation from latency is a rare event in melioidosis, accounting in our analysis for under 3% of DPMS cases, consistent with why the Vietnamese time bomb never eventuated.<\/jats:p>","DOI":"10.4269\/ajtmh.24-0007","type":"journal-article","created":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T18:06:34Z","timestamp":1716919594000},"page":"156-160","source":"Crossref","is-referenced-by-count":16,"title":["Melioidosis and Activation from Latency: The \u201cTime Bomb\u201d Has Not Occurred"],"prefix":"10.4269","volume":"111","author":[{"given":"Matthew","family":"Howes","sequence":"first","affiliation":[{"name":"Infectious Diseases Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart J.","family":"Currie","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia;"},{"name":"Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Nat Rev Microbiol","first-page":"155","article-title":"Burkholderia pseudomallei and melioidosis","volume":"22","author":"Meumann","year":"2024"},{"key":"b2","series-title":"Am J Trop Med Hyg","first-page":"1074","article-title":"Development of antibodies to Burkholderia pseudomallei during childhood in melioidosis-endemic northeast Thailand","volume":"74","author":"Wuthiekanun","year":"2006"},{"key":"b3","series-title":"Semin Respir Crit Care Med","first-page":"111","article-title":"Melioidosis: Evolving concepts in epidemiology, pathogenesis, and treatment","volume":"36","author":"Currie","year":"2015"},{"key":"b4","series-title":"Lancet Infect Dis","first-page":"1737","article-title":"The Darwin Prospective Melioidosis Study: A 30-year prospective, observational investigation","volume":"21","author":"Currie","year":"2021"},{"key":"b5","series-title":"J Infect Dis","first-page":"598","article-title":"The pseudomallei group: A review","volume":"124","author":"Howe","year":"1971"},{"key":"b6","series-title":"Indiana Med","first-page":"247","article-title":"Recrudescent pulmonary melioidosis. 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