This article is more than 2 years old.

January 18, 2016 This article is more than 2 years old.

India is the hotbed of a deadly bacteria.

Melioidosis, a highly contagious disease, is widely prevalent in India, according to a new report by researchers from the University of Oxford. If not treated in time, it can lead to death within just two days of contracting it.

However, diagnosing melioidosis is particularly difficult, causing the illness to largely go under-reported. The report, published in the Nature Microbiology journal, classified India as “endemic but under-reported” as a measure of its melioidosis pervasiveness.

“Some 44% of the total cases (165,000 annually) worldwide are from South Asian countries,” David Dance of the University of Oxford said at Manipal University in November 2015. India tops the list of countries that reported melioidosis deaths, with more than 50% share.

“We estimate there to be 165,000 melioidosis cases per year worldwide, from which 89,000 people die. Our estimates suggest that melioidosis is severely under-reported in the 45 countries where it is known to be endemic, and that melioidosis is probably endemic in a further 34 countries that have never reported the disease,” the report in Nature Microbiology said.

Burkholderia pseudomallei, the bacteria that causes melioidosis and breeds in water and soil, is commonly found in Southeast Asia and Northern Australia. The symptoms of the disease include fever, convulsions, and respiratory discomfort.

In India, rampant, large-scale construction has led to the disease spreading more easily. Besides water, the bacteria can be transported through dust or loose soil, common in construction sites.

“A patient will come with high fever, cough, chills, abscess in internal organs—especially the liver and prostrate—bone and joint ache and rigors, which is a sudden feeling of cold with shivering accompanied by a rise in temperature, often with copious sweating,” Chiranjay Mukhopadhyay, professor at the department of microbiology at Manipal University’s Kasturba Medical College, Karnataka, and head of the Indian Melioidosis Research Forum, told the Mid-day newspaper.

The disease still lacks a licensed vaccine. “Once you’ve got it badly, it is difficult to treat,” Dance said. Diabetic patients and those with chronic kidney diseases are more likely to contract melioidosis.