A One Health Approach to Determining the Scope of Environmental Burkholderia pseudomallei in the Continental United States.

Burkholderia pseudomallei, the causative agent of melioidosis, poses significant risks to human and animal health as an environmental pathogen with potential for misuse as a biological agent. With a recent case in the continental United States and associated positive environmental samples, there is an increasing need for a more thorough environmental surveillance program to determine the potential scope of environmental B pseudomallei in the continental United States. Such a biosurveillance program would be most efficient-in terms of cost, scope, and impact-when approached through the One Health framework, integrating animal and environmental biosurveillance to inform occupational, public, and veterinary health practitioners. Feral swine may serve as a valuable sentinel species due to their extensive rooting behavior in soil and widespread, invasive presence in the southern United States. Increasing their utility for B pseudomallei surveillance is preestablished federal and state management programs that include animal removal from the environment and pathogen testing. Other environmental sampling methods, such as surface water and wastewater surveillance, could provide sampling coverage of large geographic areas with relatively few samples and associated costs. The environmental detection of B pseudomallei in Mississippi underscores the need for broader biosurveillance efforts to inform the relative risk assumptions used by human and animal health practitioners to promptly diagnose patients. A comprehensive One Health strategy is essential for accurately mapping the distribution of B pseudomallei and ensuring effective risk management.