4-year-old Lylah Baker has been fighting a severe infection for the last six weeks. After treating the girl for almost anything they could think of, doctors were flabbergasted when they found an organism growing in her blood. It seems to have been caused by a deadly form of foreign bacteria known as Burkholderia pseudomallei, found mostly in tropical regions of Southeast Asia and northern Australia.
So, how did this young girl from a small Texas town get infected?
A Mysterious Illness
Baker is an unusual case. She lives with her parents and 1-year-old sister in a small town 60 miles outside of Dallas. She hasn’t traveled much, other than the occasional trip to the beach on the Gulf of Mexico near Corpus Christi. “I don’t think she’s ever left Texas,” said Ashley Kennon, who is also a nurse.
Doctors at Children’s Medical Center Dallas say the infection started out as a simple stomach bug, but quickly evolved into something much worse. Her family thought she had a rare autoimmune disorder that can be triggered by an infection. For weeks, her condition deteriorated, despite various treatment methods. Doctors had to insert a tube down her throat to help her breathe. They gave her MRIs and CT scans, and hooked her up to a machine to filter and replace her blood. She also took steroids and antibiotics, but nothing seemed to work.
“They were even treating her for rabies, just to be cautious, even though she had never been bitten,” her aunt said.
A neurosurgeon then took a sample from her brain, which revealed the underlying infection.
“I think the doctors are still stunned. Nobody expected this,” Kennon added. The infection made its way into her blood and all the way up to her brain, leading to extensive brain damage.
“She’s lucky to be alive,” Kennon said, who’s serving as a spokesperson for the Baker family. “The brain damage she has from this is pretty extensive. This is a little girl, 4 years old, who was walking and talking and so excited for preschool in the fall, who now can’t speak and can’t hold her head up, can’t walk. It’s kind of like starting over.”
Watch Out for Deadly Bacteria
The CDC issued a notice to healthcare providers on June 30th alerting them that three people with no connection to each other have been sickened by the bacterium since March of this year. Baker is the only child on the list. The other two are in Minnesota and Kansas.
The agency says that all three cases suggest a similar source of exposure, “such as an imported product or animal.” Burkholderia pseudomallei is often passed from animals to humans in tropical environments.
Investigators at state agencies are currently investigating how this bacterium got into the U.S. While the agency says, “The risk of exposure in the United States is unknown but is believed to be low,” finding the source of infection is key to preventing future outbreaks.
Burkholderia pseudomallei causes the disease known as melioidosis, which is difficult to diagnose due to its wide-ranging symptoms, some of which may appear years after infection. Studies show it kills between 10% to 50% of those who get infected. Melioidosis is typically treated with up to two weeks of intravenous antimicrobial therapy, followed by three to six months of oral antimicrobial therapy.
The first case mentioned in the CDC advisory was first detected in Kansas in March. That person, an adult male who remains anonymous, later died of his complications 10 days after being admitted to a local hospital. Officials confirmed that he had underlying health conditions that made him more susceptible to chronic obstructive pulmonary disease and cirrhosis.
The second adult to get infected is a woman in Minnesota who also had underlying health conditions. She first became ill in May and has been discharged from an unidentified hospital to a transitional care unit. The diagnosis was confirmed after they ran genome sequencing on the bacterium.
Doug Schultz, a spokesperson for the Minnesota Department of Health, said, “We are just beginning our investigation. We are conducting a thorough investigation into medical history, what household products the case used, their hobbies, and foods consumed. This will be compared to other states to see if there are any commonalities.”
All three individuals experienced similar symptoms, including coughing, shortness of breath, fatigue, nausea, and vomiting. Some had fevers and rashes that came and went. They were later diagnosed with infectious encephalitis, an inflammation of the brain.
Investigators say none of them have recently traveled outside the area around their homes, “therefore there are no known common links pertaining to travel inside or outside of the U.S.”
Sniffing Out the Source
Officials recently visited the Baker family to take blood tests and ask them a series of questions related to their health. They told the family that they are “mainly interested in liquid products,” because the bacterium best survives in moist environments. Investigators looked at various items in the home, including liquid vitamins, cleaning products, detergents, dish soap, various hygiene products, and anything else Lylah may have accidentally ingested or had contact with.
They are also investigating a pet Betta fish Lylah got last winter as a possible source of infection. Kennon said that they are hoping to test the aquarium and other related equipment. The freshwater fish is native to Southeast Asia. They’re also looking at garden soil and any plants that may have been imported from another country. Kennon said Lylah helped her grandmother plant flowers shortly before getting sick.
Some have even suggested traces of the bacterium may be hiding in the soil in parts of the U.S. Last year, the CDC and the Texas Department of Health published an article suggesting the possibility that Burkholderia pseudomallei could be endemic to warmer U.S. states like Texas.
It’s too soon to say whether any of these items or events had anything to do with Lylah’s illness. The bacterium isn’t easily spread from person to person. Officials say there’s no evidence to suggest a biological attack.
“Testing suggests a common source of infection, but that source has not yet been identified,” the CDC said in its statement.
Lylah has been moved to a rehabilitation hospital outside Dallas. Depending on insurance, the family hopes she gets at least 30 days of physical therapy so she can relearn how to move and talk on her own. Her mom is on unpaid leave from her job at a veterinary clinic, while her dad is a paramedic firefighter. His colleagues have been raising money for Lylah’s care via GoFundMe on their time off.
“It’s just the fear of the unknown,” her aunt said. “The miracles have been worked. She’s pretty much survived the unimaginable. She’s definitely beaten the odds, that’s for sure. So, everything she does is a huge success for us.”