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A new bacteria has made a home in the Gulf Coast region and scientists are not happy. Burkholderia pseudomallei is typically endemic to much warmer climates, but with the rapid rate of climate change, the landscape of bacterial infection is changing in the U.S. Like this particular bacteria on the Gulf Coast, diseases once unseen in the U.S now thrive.
“This is a big deal because clinicians generally speaking only consider melioidosis in patients who have recent travel to an endemic area like Thailand, South Asia, Australia,” Julia Petras, an epidemic intelligence service officer with the Center for Disease Control and Prevention’s (CDC) bacterial special pathogens branch, told STAT News. “They would not consider just somebody living in the Gulf Coast area who has never traveled, that they would have melioidosis.”
However now, “parts of Florida, Alabama, Texas, Louisiana, Mississippi” risk becoming long-term habitats for the bacteria, according to Petras.
The CDC investigated two cases that appeared starting in 2020 within 10 miles of each other. As a result, CDC issued a health alert to physicians saying they “identified the bacterium Burkholderia pseudomallei (B. pseudomallei) for the first time in the environment in the continental United States. This bacterium causes a rare and serious disease called melioidosis. B. pseudomallei was identified through environmental sampling of soil and water in the Gulf Coast region of southern Mississippi during an investigation of two human melioidosis cases.”
However, officials believe that the bacteria on the Gulf Coast may have existed in the region for much longer. In 2004 and 2018, there were two reported cases of Burkholderia pseudomallei infections in people in Texas who had not traveled outside of the U.S.
The arrival of Burkholderia pseudomallei in the U.S. highlights two major areas of concern: climate change and the increased risk of antimicrobial-resistant bacteria. Luckily, biotech can help solve the problem today.
Climate change and bacteria
“I think that climate change could play a role. Rising temperatures could play a role in the grand scheme of things because the bacteria prefers a tropical or subtropical climate,” Petras told STAT News.
This is not the first time the U.S. has seen an increase in the spread of disease as a result of rising temperatures. In addition to Burkholderia pseudomallei, things like Naegleria fowleri, more commonly known as brain-eating amoeba, are also moving north.
This is a global challenge, as a study published by Nature Climate Change this week confirms 58% of infectious diseases have been aggravated by extreme weather and climate change. Researchers found more than 1,000 pathways by which climate can cause infectious disease, including warming, rain, floods, and drought.
There has even been speculation that the emergence of COVID-19 can be tied, in part, to climate change and deforestation, with the Harvard School of Public Health commenting, “We don’t have direct evidence that climate change is influencing the spread of COVID-19, but we do know that climate change alters how we relate to other species on Earth and that matters to our health and our risk for infections.”
“As the planet heats up, animals big and small, on land and in the sea, are headed to the poles to get out of the heat. That means animals are coming into contact with other animals they normally wouldn’t, and that creates an opportunity for pathogens to get into new hosts,” continues Harvard.
Put simply, if we want to ensure the health of future generations, we need to address how we live and interact with our environment now, as well as understand the major threats that are already in play.
The AMR threat comes home
Federal officials are on notice as Burkholderia pseudomallei is considered a Tier 1 select agent, along with anthrax and Ebola, meaning it is dangerous enough to be considered a bioterrorism weapon. And with a mortality rate of 10 to 50 percent, action is imperative.
As we have reported time and time again, AMR is one of the greatest threats to public health. But AMR is not being properly addressed.
According to a study published earlier this year in The Lancet, antibiotic-resistant infections have become a leading global cause of mortality. The study showed 1.27 million people died worldwide in 2019 as a result of antibiotic-resistant infections, roughly double the number of fatalities caused by HIV/AIDS or malaria.
Yet, as Henry B. Skinner, CEO of the AMR Action Fund, wrote for Harvard Public Health, “Another pandemic is upon us, and policymakers are once again proving slow to respond, to the detriment of global health.” The arrival of Burkholderia pseudomallei on the Gulf Coast is just one example.
During an AMR panel at the BIO International Convention in June, experts illuminated the need for AMR development. “We need to bring the passion that our community now has to tackle pandemics and bring it to AMR,” said Colonel (Ret.) Matthew Hepburn of DARPA.
And this development is well within the abilities of the biotech community to address successfully. “I’m cautiously optimistic,” Hepburn continued. “The world has been affected by the COVID-19 tragedy, but there’s a lot of time for a lot of resources, and we can take what we’ve learned from the pandemic to really be armed with passion and knowledge, but also frankly with the development of effective treatments.”
“The problem is that we haven’t had an investment in antimicrobial research and development,” continued Michael Dudley of Qpex Biopharma. “Over the last 10 years, there was $26 billion put into oncology. But in AMR over the last 10 years there’s only been a $1.6 billion investment.”
The role of One Health
With the emergence and expansion of diseases like Zika, Ebola, the West Nile virus, and avian influenza, the biotech sector started thinking of ways to expand their responses to climate change.
As Eddie J. Sullivan, Ph.D., President, CEO and Co-Founder of SAB Biotherapeutics, wrote in 2018, “The goal of biotechnology companies is to understand the interconnectedness of organisms and leverage nature’s toolbox to solve complex health challenges.”
One Health is critically important. A combination of direct action, investment, and political engagement, One Health aims to help governments and businesses understand the interconnectedness of our environment and prioritize actions that support the health of the planet and its people.
“A One Health program can also help mitigate our country’s risk of bioterrorism. Estimates show that about 80 percent of potential pathogens used in bioterrorism or biowarfare are common zoonotic pathogens. Raising awareness of these vulnerabilities will enhance our nation’s preparedness for such risk,” Sullivan explained.
“The best way to respond to an outbreak is to prepare before it happens. Establishment of this One Health Program facilitates a concentrated effort by the United States to coordinate real-life solutions for serious health challenges,” he continued.
We need to invest antimicrobial R&D
When it comes to the health care side, the AMR Action Fund, developed in collaboration with the World Health Organization (WHO), the European Investment Bank, and the Wellcome Trust, is a groundbreaking fund that “expects to invest more than $1 billion to bridge the funding gap and respond to the AMR threat.” The goal is to bring “2-4 new antibiotics to market this decade that will save patient lives.” The fund is essentially looking to fill in the gaps of a lagging AMR R&D market.
And, as we’ve reported, Congress is taking steps as well to open up the opportunities for AMR R&D. The proposed PASTEUR Act aims to incentivize investment in the market by creating a “Netflix-style subscription model for novel antimicrobials, where hospitals or governments pay a fee for as much or as little as needed,” according to Good Day BIO.
Another bill, The DISARM Act, “would modernize Medicare reimbursement for hospitals that appropriately use advanced antibiotics and, in turn, help provide some necessary financial assurance to fuel more research and development”, a Fortune article explains.
According to U.S. Senator Bob Casey, (D-PA) who introduced the legislation along with Sen. Johnny Isakson (R-GA), “The DISARM Act would strengthen the pipeline that brings effective medication to the patient bedside to help save the lives of the 23,000 Americans who die each year from drug-resistant infections.”
