Hidden danger lurked in an aromatherapy spray!

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Melioidosis came in a lavender aromatherapy spray manufactured in India and sold at Walmart.

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Melioidosis, also called Whitmore’s disease, is an infectious disease that can infect humans or animals. The disease is caused by the bacterium Burkholderia pseudomallei. It is predominately a disease of tropical climates, especially in Southeast Asia and northern Australia where it is widespread.

Melioidosis | CDC

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Melioidosis is not a notifiable disease in Malaysia; therefore, the true incidence of melioidosis in Malaysia is unknown, although more than a thousand cases have been reported throughout Malaysia [34].27 Feb 2018

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6136604/

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MEDPAGE TODAY

How a COVID Misdiagnosis Revealed Deadly Aromatherapy Outbreak

— Case “highlights the importance of autopsy,” medical examiner says

by Kristina Fiore, Director of Enterprise & Investigative Reporting, MedPage Today May 11, 2022

Last Updated May 12, 2022

The boy’s parents weren’t convinced that their 5-year-old had died of COVID-19, so they insisted on an autopsy.

The hospital where he died declined to do one, as did the local medical examiner. His case ended up in the hands of Rachel Geller, MD, an associate medical examiner in Georgia’s DeKalb County.

Geller’s findings ultimately led to the smoking gun in a deadly melioidosis outbreak that CDC investigators detailed in the New England Journal of Medicine in March 2022.

“I think his case highlights the importance of autopsy, even when we think we already have all the answers,” Geller told MedPage Today. “Sometimes we might not be asking the right questions.”

It’s not clear that the culprit product — an aromatherapy spray sold at Walmart — would have been caught as quickly without this autopsy, as it was discovered after an exhaustive search of the boy’s home. But Geller lamented the continued decline in autopsies, which can overturn diagnoses and reveal “clinically significant findings,” she said.

Wrong Diagnosis

Since the child had reportedly died after an adult-like presentation of SARS-CoV-2 infection, Geller suspected she might find heavy red lungs — a sign of the alveolar damage often seen in adult COVID deaths — or perhaps consolidation of lung tissue, a sign of pneumonia.

Instead, she found “numerous green-white, pearly abscesses diffusely involving the lower lobes of the lungs,” surrounded by areas of severe pneumonia, she told MedPage Today. The child’s brain had areas of softening and hemorrhage. He also had microabscesses in his brain and liver, which were revealed on microscopy, she said, and he had hemorrhagic adrenal glands, which is sometimes seen in severe bacterial infection.

Geller said she realized a bacterial infection, and not solely COVID-19, was likely to blame for the child’s death. She sent samples to Wayne Wang, MD, PhD, director of microbiology at Grady Memorial Hospital in Atlanta.

It was a Saturday, outside of normal working hours, when a lab tech discovered the boy had been infected with Burkholderia pseudomallei, a rare and deadly bacteria not typically found in the U.S. It’s more commonly found in contaminated soil and water in tropical or subtropical climates.

“If you see an organism in the category of potential bioterrorism, you stop what you’re doing,” Wang told MedPage Today. “You don’t work it up further. You contact [the CDC] Lab Response Network and the state [health department] lab; that’s protocol. Our tech followed protocol.”

By the end of July, the state lab had confirmed Burkholderia pseudomallei infection, and sent the samples on to the CDC, which also confirmed the bacteria within a few days, Wang said.
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CDC investigators had been looking for a source in a product, likely imported from Southeast Asia, that was in liquid form or “at least had some moisture content in it,” Bower said. “We asked family members about products with moisture, like salves or sprays.”

Scores of products were sampled, with no luck. Only on a second visit to the Georgia boy’s home did investigators find the source — a lavender aromatherapy spray manufactured in India and sold at Walmart, that hadn’t been sampled previously.

“It was a proverbial needle in a haystack, and we found it in that aromatherapy spray bottle,” Bower said. “When we found it, we went back to state health departments and asked them to contact the patients. The family in Texas recalled using that type of spray bottle.”

Geller noted that CDC, the Georgia Department of Public Health, and the child’s parents “worked together to sample dozens of consumer products and natural materials around the house.”

“The contribution of his parents — welcoming investigators into their home and answering questions, even in the setting of grieving the loss of their child — cannot be overstated,” Geller said.

Bower said Walmart was cooperative and immediately pulled the spray — Better Homes & Gardens Lavender & Chamomile Essential Oil Infused Aromatherapy Room Spray with Gemstones — from store shelves and stopped shipment of the product from its warehouses. The official recall launched on Oct. 21, 2021.

The facility in India where it was manufactured has been conducting tests to determine the exact source, but hasn’t yet found it, Bower said.

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CDC confirms link between melioidosis patients and aromatherapy spray sold at Walmart

By Jordan Smith

PublishedOctober 27, 2021

Updated 12:15PM

News

FOX TV Digital Team

ATLANTA – The U.S. Centers for Disease Control and Prevention (CDC) has confirmed the link between several melioidosis patients and an aromatherapy spray sold by Walmart.

According to the CDC, lab tests show bacterial strains of Burkholderia pseudomallei that match strains found in melioidosis patients from Georgia, Kansas, Minnesota and Texas. Officials said this confirms the spray or one of its ingredients caused the infections.

“When you think about the thousands of things people come in contact with around their homes, it’s remarkable we were able to identify the source and confirm it in the lab,” said Dr. Inger Damon, director of CDC’s Division of High-Consequence Pathogens and Pathology. “CDC scientists and our partners found the proverbial needle in the haystack.”

Walmart recalled roughly 3,900 bottles of Better Homes & Gardens Lavender & Chamomile Essential Oil Infused Aromatherapy Room Spray with Gemstones Oct. 22 — offering customers a full refund and a $20 gift card for returning the product.
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The CDC wants anyone with the product to stop using it immediately and follow its instructions for a safe return. Do not pour the spray down a drain or throw it away, the CDC stressed.

The bacteria found in the spray is not native to the United States. Should it end up in a landfill or water supply, it could lead to future outbreaks of melioidosis.
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Melioidosis can present as many types of infections — each with its own string of symptoms. Localized infections will cause pain or swelling at a particular spot, fever, ulceration and abscess.

Pulmonary infection can lead to coughing, chest pains, high fevers, headaches and anorexia. An infection in the bloodstream adds respiratory distress, joint pain, abdominal discomfort and disorientation to the list.

And a disseminated infection may cause fever, weight loss, stomach or chest pains, muscle or joint pain, headache, brain infection or seizures.

People suffering from underlying conditions like diabetes, liver disease, renal disease, thalassemia, cancer or chronic lung disease are particularly susceptible to melioidosis.

https://www.fox29.com/news/cdc-confirms-link-between-melioidosis-patients-and-aromatherapy-spray-sold-at-walmart

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