Intensity of exposure and incidence of melioidosis in Thai children

Allen C. Cheng*, Vanaporn Wuthiekanun, Direk Limmathurotsakul, Wirongrong Chierakul, Sharon J. Peacock

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Citations (Scopus)


Summary: There is a high background seroprevalence of antibodies to Burkholderia pseudomallei in Thailand that limits its use as a diagnostic tool. It is believed that this results from childhood exposure to the bacterium in mud and surface water. The increasing prevalence of antibodies with age is a marker of the intensity of exposure. A susceptible-infected-susceptible (SIS) model was calibrated with data on seroprevalence in children (<15 years) in Udon Thani and Ubon Ratchathani (n=2214). In this mathematical model, children were assumed to gain antibodies at a constant rate related to exposure events, and waning antibody response occurred at a constant rate. The intensity of exposure appeared to be higher in Udon Thani than in Ubon Ratchathani, with 24% vs. 11% of patients becoming seropositive each year. In Udon Thani children, antibodies appeared to be long-lasting, compared with those in Ubon Ratchathani, where the mean duration was 5.2 years. Based on an estimated paediatric disease incidence in Ubon Ratchathani of 4.15 per 100,000 population, it is estimated that approximately 1 in 4600 antibody-producing exposures results in clinical infection. Childhood seroprevalence can be used as a marker of intensity of exposure. Further work to separate the effect of exposure to B. thailandensis and cross-reactivity to B. pseudomallei is proposed.

Original languageEnglish
Pages (from-to)S37-S39
JournalTransactions of the Royal Society of Tropical Medicine and Hygiene
Issue numberSUPPL. 1
Publication statusPublished - Dec 2008
Externally publishedYes

Bibliographical note

Funding Information:
We thank James McCaw, School of Population Health, University of Melbourne for mathematical advice. AC is supported by an NHMRC Health Professional Fellowship.


  • Burkholderia
  • Epidemiology
  • Mathematical
  • Melioidosis
  • modelling
  • Paediatric
  • pseudomallei
  • Thailand


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