{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T17:02:05Z","timestamp":1757610125976,"version":"3.44.0"},"reference-count":39,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Melioidosis, a fatal infectious disease caused by the saprophytic bacterium <jats:italic>Burkholderia pseudomallei<\/jats:italic>, is endemic to Kaohsiung, Taiwan. To assess potential exposure to the pathogen among residents, seropositivity to the <jats:italic>B. pseudomallei<\/jats:italic> flagella protein was measured, revealing an overall positivity rate of 14.6%, with peak rates observed in individuals ages 10\u201319 and 80\u201399 years old. Geographical analysis identified seropositivity clusters (&gt;16%) spanning northern, central, and southern Kaohsiung, whereas clinical cases were concentrated in the northern (Qieding district) and central regions (Zuoying and Nanzi districts). Spatial autoregression using the Moran <jats:italic>I<\/jats:italic> revealed a prominent central cluster, with SaTScan and Ripley K function analyses confirming cluster radii of 6.2\u20138.8 and 6.4\u20136.7 km, respectively. These clusters encompassed Zihguag, Nanzi, and Zuoying districts, where 454,000\u2013513,000 residents were potentially exposed to <jats:italic>B. pseudomallei<\/jats:italic> over a 20-year period (2003\u20132024). Melioidosis incidence peaked in 2005 (8.5 cases per 100,000 people), 2009\u20132011 (15.6\u201323.4 cases per 100,000 people), and 2024 (28.2 cases per 100,000 people), coinciding with catastrophic typhoons. Annual melioidosis incidence within the hot spot correlated with rainfall intensity during typhoon events. Flooded areas caused by typhoons overlapped with the hot spot, inundating 38\u201343% of the region. Higher <jats:italic>B. pseudomallei<\/jats:italic> polymerase chain reaction positivity rates (11\u201322%) were detected in northern rivers flowing through the hot spot compared with lower rates (0\u20137%) in southern or eastern nonhot-spot areas. These findings suggest that typhoon-related flooding may contribute to the formation of melioidosis hot spots in Kaohsiung.<\/jats:p>","DOI":"10.4269\/ajtmh.24-0854","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T19:30:09Z","timestamp":1752175809000},"page":"666-673","source":"Crossref","is-referenced-by-count":0,"title":["Spatial and Temporal Analyses of Melioidosis in Kaohsiung, Taiwan"],"prefix":"10.4269","volume":"113","author":[{"given":"Kuang-Yueh","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Physics, National Kaohsiung Normal University, Kaohsiung, Taiwan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuang-Ying","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, National Chung Cheng University, Chiayi, Taiwan;"},{"name":"College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsin-Ping","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Biotechnology, National Kaohsiung Normal University, Kaohsiung, Taiwan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bing-Mu","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi, Taiwan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duen-Wei","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Biotechnology, National Kaohsiung Normal University, Kaohsiung, Taiwan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao-Shen","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan;"},{"name":"School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsi-Hsun","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan;"},{"name":"Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung-Yuan","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Physics, National Kaohsiung Normal University, Kaohsiung, Taiwan;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"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":"Nat Microbiol","first-page":"15008","article-title":"Predicted global distribution of Burkholderia pseudomallei and burden of melioidosis","volume":"1","author":"Limmathurotsakul","year":"2016"},{"key":"b3","series-title":"Trends Microbiol","first-page":"105","article-title":"Burkholderia pseudomallei","volume":"32","author":"Phillips","year":"2024"},{"key":"b4","series-title":"Vet World","first-page":"26","article-title":"A systematic review and meta-analysis of the global prevalence and relationships among Burkholderia pseudomallei sequence types isolated from humans, animals, and the environment","volume":"17","author":"Laklaeng","year":"2024"},{"key":"b5","series-title":"Trop Med Infect Dis","first-page":"26","article-title":"Transmission modes of melioidosis in Taiwan","volume":"3","author":"Hsueh","year":"2018"},{"key":"b6","series-title":"Emerg Microbes Infect","first-page":"2204155","article-title":"Probable airborne transmission of Burkholderia pseudomallei causing an urban outbreak of melioidosis during typhoon season in Hong Kong, China","volume":"12","author":"Wu","year":"2023"},{"key":"b7","series-title":"PLoS Negl Trop Dis","first-page":"e0003834","article-title":"Airborne transmission of melioidosis to humans from environmental aerosols contaminated with B. pseudomallei","volume":"9","author":"Chen","year":"2015"},{"key":"b8","series-title":"Curr Microbiol","first-page":"208","article-title":"Diabetes and infectious diseases with a focus on melioidosis","volume":"81","author":"Uthaya Kumar","year":"2024"},{"key":"b9","series-title":"Trans R Soc Trop Med Hyg","first-page":"636","article-title":"Melioidosis in Hainan, China: A restrospective study","volume":"109","author":"Fang","year":"2015"},{"key":"b10","series-title":"Am J Trop Med Hyg","first-page":"1113","article-title":"Increasing incidence of human melioidosis in northeast Thailand","volume":"82","author":"Limmathurotsakul","year":"2010"},{"key":"b11","series-title":"Front Immunol","first-page":"718719","article-title":"Hijacking of the host\u2019s immune surveillance radars by Burkholderia pseudomallei","volume":"12","author":"Mariappan","year":"2021"},{"key":"b12","series-title":"Lancet Infect Dis","first-page":"e176","article-title":"A call to action: Time to recognise melioidosis as a neglected tropical disease","volume":"22","author":"Savelkoel","year":"2022"},{"key":"b13","series-title":"Trans R Soc Trop Med Hyg","first-page":"165","article-title":"Characterisation of predominant molecular patterns of Burkholderia pseudomallei in Taiwan","volume":"107","author":"Chen","year":"2013"},{"key":"b14","series-title":"Infect Genet Evol","first-page":"105654","article-title":"The genetic diversity and evolution analysis of the Hainan melioidosis outbreak strains","volume":"123","author":"Wang","year":"2024"},{"key":"b15","series-title":"J Clin Microbiol","first-page":"2553","article-title":"Nonrandom distribution of Burkholderia pseudomallei clones in relation to geographical location and virulence","volume":"44","author":"Vesaratchavest","year":"2006"},{"key":"b16","series-title":"PLoS Negl Trop Dis","first-page":"e0012652","article-title":"Multilocus sequence typing of clinical Burkholderia pseudomallei isolates from Cambodia","volume":"18","author":"Gyamfi","year":"2024"},{"key":"b17","series-title":"Trop Med Int Health","first-page":"1005","article-title":"Case cluster shifting and contaminant source as determinants of melioidosis in Taiwan","volume":"17","author":"Dai","year":"2012"},{"key":"b18","series-title":"Epidemiol Infect","first-page":"415","article-title":"The occurrence of melioidosis is related to different climatic conditions in distinct topographical areas of Taiwan","volume":"142","author":"Mu","year":"2014"},{"key":"b19","series-title":"PLOS Glob Public Health","first-page":"e0000431","article-title":"Estimation of seroprevalence of melioidosis among adult high risk groups in southeastern India by indirect hemagglutination assay","volume":"2","author":"Raj","year":"2022"},{"key":"b20","series-title":"Pathogens","first-page":"1363","article-title":"An investigation of Burkholderia pseudomallei seroprevalence in market pigs slaughtered at selected pig abattoirs in Uganda","volume":"11","author":"Ekakoro","year":"2022"},{"key":"b21","series-title":"Am J Trop Med Hyg","first-page":"1222","article-title":"Seroepidemiology of Burkholderia pseudomallei, etiologic agent of melioidosis, in the Ouest and Sud-Est Departments of Haiti","volume":"99","author":"Weppelmann","year":"2018"},{"key":"b22","series-title":"J Clin Microbiol","first-page":"2599","article-title":"Prevalence of melioidosis in the Er-Ren River Basin, Taiwan: Implications for transmission","volume":"45","author":"Su","year":"2007"},{"key":"b23","series-title":"J Microbiol Immunol Infect","first-page":"267","article-title":"Seroprevalence of melioidosis in diabetic patients in Taiwan","volume":"38","author":"Chen","year":"2005"},{"key":"b24","series-title":"Jpn J Infect Dis","first-page":"224","article-title":"Seroprevalence of anti-flagellin antibody against Burkholderia pseudomallei in Taiwan","volume":"57","author":"Chen","year":"2004"},{"key":"b25","series-title":"J Clin Microbiol","first-page":"352","article-title":"Pseudomonas pseudomallei infection from drowning: The first reported case in Taiwan","volume":"22","author":"Lee","year":"1985"},{"key":"b26","series-title":"Clin Diagn Lab Immunol","first-page":"423","article-title":"Recombinant truncated flagellin of Burkholderia pseudomallei as a molecular probe for diagnosis of melioidosis","volume":"10","author":"Chen","year":"2003"},{"key":"b27","series-title":"Spat Stat","first-page":"100757","article-title":"A hypothesis test for detecting distance-specific clustering and dispersion in areal data","volume":"55","author":"Self","year":"2023"},{"key":"b28","series-title":"Appl Environ Microbiol","first-page":"6891","article-title":"Sensitive and specific molecular detection of Burkholderia pseudomallei, the causative agent of melioidosis, in the soil of tropical northern Australia","volume":"73","author":"Kaestli","year":"2007"},{"key":"b29","series-title":"Biophys J","first-page":"1095","article-title":"On the use of Ripley\u2019s K-function and its derivatives to analyze domain size","volume":"97","author":"Kiskowski","year":"2009"},{"key":"b30","series-title":"Sci Rep","first-page":"8674","article-title":"Rivers as carriers and potential sentinels for Burkholderia pseudomallei in Laos","volume":"8","author":"Zimmermann","year":"2018"},{"key":"b31","series-title":"Pathogens","first-page":"149","article-title":"The epidemiology of melioidosis and its association with diabetes mellitus: A systematic review and meta-analysis","volume":"11","author":"Chowdhury","year":"2022"},{"key":"b32","series-title":"Am J Trop Med Hyg","first-page":"1378","article-title":"Antibodies in melioidosis: The role of the indirect hemagglutination assay in evaluating patients and exposed populations","volume":"99","author":"Chaichana","year":"2018"},{"key":"b33","series-title":"Clin Vaccine Immunol","first-page":"759","article-title":"Surprisingly low seroprevalence of Burkholderia pseudomallei in exposed healthy adults in the Darwin region of tropical Australia where melioidosis is highly endemic","volume":"20","author":"James","year":"2013"},{"key":"b34","series-title":"Trans R Soc Trop Med Hyg","first-page":"416","article-title":"Pilot study of exposure to Pseudomonas pseudomallei in northern Vietnam","volume":"87","author":"Van Phung","year":"1993"},{"key":"b35","series-title":"Trans R Soc Trop Med Hyg","first-page":"576","article-title":"Seroepidemiological surveillance of Burkholderia pseudomallei in Bangladesh","volume":"106","author":"Maude","year":"2012"},{"key":"b36","series-title":"Nat Rev Dis Primers","first-page":"17107","article-title":"Melioidosis","volume":"4","author":"Wiersinga","year":"2018"},{"key":"b37","series-title":"Emerg Infect Dis","first-page":"896","article-title":"Melioidosis outbreak after typhoon, southern Taiwan","volume":"13","author":"Ko","year":"2007"},{"key":"b38","series-title":"Curr Trop Med Rep","first-page":"185","article-title":"The role of climate in the epidemiology of melioidosis","volume":"4","author":"Merritt","year":"2017"},{"key":"b39","series-title":"Emerg Infect Dis","first-page":"1038","article-title":"Endemic melioidosis in residents of desert region after atypically intense rainfall in central Australia, 2011","volume":"21","author":"Yip","year":"2015"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/3\/article-p666.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/3\/article-p666.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/3\/article-p666.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T13:14:03Z","timestamp":1756905243000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/3\/article-p666.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,3]]},"references-count":39,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.24-0854","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"type":"print","value":"0002-9637"},{"type":"electronic","value":"1476-1645"}],"subject":[],"published":{"date-parts":[[2025,9,3]]}}}