New Delhi: A study led by Oxford University predicts that India may have a high infection rate for melioidosis, a bacterial disease that mimics other diseases, making it difficult to diagnose.

The study published on Tuesday in Nature Microbiology looks at the global distribution of the burden of melioidosis which remains poorly understood and, according to the authors, is likely to be present in more countries than previously thought.

The study estimates that melioidosis killed 89,000 of the 165,000 people who contracted it in 2015.

The disease is contracted through the skin, lungs or by drinking contaminated water and is particularly tricky to diagnose because it mimics other diseases. The bacterium is resistant to a wide range of anti-microbial drugs, and inadequate treatment can result in fatality rates exceeding 70%.

“Melioidosis is a great mimicker of other diseases and you need a good microbiology laboratory for bacterial culture and identification to make an accurate diagnosis. It especially affects the rural poor in the tropics who often do not have access to microbiology labs, which means that it has been greatly underestimated as an important public health problem across the world," said Direk Limmathurotsakul, head of microbiology at Mahidol Oxford Tropical Medicine Research Unit in Bangkok and assistant professor at Mahidol University.

“Our study predicts high infection rates in countries such as India and Vietnam, where the disease is gradually being recognized more frequently," said Limmathurotsakul.

The study, funded by Wellcome Trust, was led by researchers at Oxford University, the Mahidol Oxford Tropical Medicine Research Unit in Bangkok, the University of Washington in Seattle and Mahidol University in Thailand, among others.

Patients with diabetes mellitus, chronic kidney disease or excessive alcohol intake are high-risk groups for melioidosis. The authors mapped documented human and animal melioidosis cases and environmental reports of B. pseudomallei, the causal bacterium, published between 1910 and 2014. They found that the disease is severely under-reported in most of the 45 countries where it is known to be endemic.

“We predict that the burden of this disease is likely to increase in the future because the incidence of diabetes mellitus is increasing and the movements of people and animals could lead to the establishment of new endemic areas," said Limmathurotsakul in an Oxford University release.

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