Sot dat disease, also known as Whitmore disease or Melioidosis, has caused 23 deaths and over 700 infections in Thailand since the beginning of the year, prompting health officials to issue a public health alert. This dangerous infection progresses rapidly if not treated promptly.

The bacteria Burkholderia pseudomallei causes sot dat disease and is often associated with the term 'flesh-eating bacteria'. Doctor Nguyen Hoang Anh from the Infectious Diseases Unit, General Internal Medicine Department at Tam Anh General Hospital in Ho Chi Minh City, clarifies that 'flesh-eating bacteria' is not a specific bacterial species but a descriptive term for necrotizing fasciitis, a rapidly progressive soft tissue infection. Common agents include Streptococcus pyogenes, Staphylococcus aureus, Vibrio vulnificus, and various Gram-negative or anaerobic bacteria. These bacteria release toxins that obstruct microvessels and cause tissue necrosis, rapidly destroying subcutaneous tissue and creating the sensation of being 'eaten'. This condition can progress within hours to several days, necessitating urgent surgical intervention.

Burkholderia pseudomallei primarily causes infection by forming pus-filled pockets and spreading through the bloodstream, leading to abscesses in organs such as the liver, spleen, lungs, bones, or prostate. After entering the body through the skin, respiratory tract, or digestive system, the bacteria can manifest as various clinical forms, including pneumonia, sepsis, skin and soft tissue infections, or multi-organ abscesses. Clinical symptoms of sot dat disease are diverse, ranging from high fever, respiratory failure, and hypotension to prolonged fever, arthritis, and skin lesions, making diagnosis challenging. Some cases progress rapidly to fulminant septic shock, resulting in quick death if not detected early.

Doctor Hoang Anh explains a patient's health condition. Illustration: Tam Anh General Hospital.

"Despite the bacteria's presence in contaminated soil and water, sot dat is not easily transmissible within the community", said Doctor Hoang Anh. "The disease primarily spreads to humans through direct contact with contaminated environments, especially via minor skin abrasions, inhalation of dust or water droplets containing the bacteria, or through the digestive tract. High-risk groups include agricultural workers who frequently handle soil and mud, as well as individuals with underlying conditions such as diabetes, chronic kidney disease, or compromised immune systems."

According to Doctor Hoang Anh, diagnosis relies on bacterial culture and isolation from blood or bodily fluids, or tests such as multi-agent PCR and enzyme-linked immunosorbent assay (ELISA). Whitmore disease can be cured with specific antibiotics if detected early.

Currently, no vaccine is available for prevention, making proactive measures crucial. Doctor Hoang Anh advises individuals with open wounds to avoid direct contact with contaminated soil and water. When working, it is important to use gloves and boots, and to thoroughly clean and cover any abrasions. Additionally, avoid consuming untreated water or food, limit exposure to dusty environments and heavy rain, and proactively protect your respiratory system when outdoors. If suspicious symptoms such as prolonged fever, cough, shortness of breath, or unusual skin lesions appear, individuals should seek medical examination at a hospital instead of self-treating.

Nhat Thanh