When cases of melioidosis were diagnosed in four patients in four different states, doctors were puzzled. Melioidosis, infection with the bacterium Burkholderia pseudomallei, is typically associated with exposure to soil and water in tropical and subtropical environments, and is rarely diagnosed in the US. When it is, it is usually in patients who had travelled to endemic areas. These patients had not.

Patient 1 was a 53-year-old woman in Kansas with a history of COPD and several other chronic diseases including drug abuse. She presented to the ER with a 4- to 5-day history of shortness of breath, cough, malaise, and weakness. Blood cultures grew B. pseudomallei. Despite aggressive treatment, she died after 9 days in the hospital.

Patient 2 was a previously-healthy 5-year-old girl in Texas who developed a fever. A lower respiratory culture confirmed the diagnosis of meliodosis. She was treated with antibiotics and recovered enough to be discharged, but she remained wheelchair-bound and non-verbal.

Patient 3 was a 53-year-old man in Minnesota who was brought to the ER by family members who found him with altered mental status and weakness. He appeared to have encephalopathy. He also complained of hip pain, and cultures of both blood and joint aspirate grew B.pseudomallei. He was treated with antibiotics, but there was osteonecrosis of the infected hip joint and his confusion did not decrease after discharge.

Patient 4 was a 5-year-old boy in Georgia who was diagnosed with both melioidosis and COVID-19. He died after 4 days in the hospital.

None of these patients had travelled outside the US. An article in The New England Journal of Medicine reported the ingenious detective work that eventually explained what happened. An aromatherapy room spray from the home of Patient 4 was found to be contaminated with melioidosis bacteria and all four patients were determined to have been infected with the same strain. The strain was traced to India.

The product, Better Homes & Gardens Lavender & Chamomile Essential Oil Infused Aromatherapy Room Spray with Gemstones, was sold at Walmart. The advertising said:

Transform your home into a spa with Better Homes & Gardens Essential Oil Infused Aromatherapy Spray in Lavender & Chamomile. The lavender scent is great for soothing anxiety and helps with restlessness while the Chamomile scent adds a sweet mixture to the spray. Use at your home or in the office. Just a couple sprays of your favorite Better Homes & Gardens Essential Oil Infused Aromatherapy Spray enhances the space for a stress free, relaxing, and re-energizing experience. Better Homes & Gardens Essential Oil Infused Aromatherapy Spray comes in various soothing fragrances to meet any of your emotional and body wellness needs.

The FDA issued a press release, and Walmart recalled the product.

Conclusion: Aromatherapy is not risk-free

It might not be fair to call this melioidosis outbreak a consequence of aromatherapy, but it was surely a consequence of consumer gullibility and inadequate regulation.

Users of this room spray were led to believe, without evidence, that it would enhance their space, relieve stress, relax and energize them, and meet their emotional and body wellness needs. The Better Home and Gardens label reassured them that it was safe. Better Homes and Gardens didn’t explain why they added gemstones; I can’t help wondering what their thinking was. This certainly wasn’t science-based medicine.

Author

  • Harriet Hall, MD also known as The SkepDoc, is a retired family physician who writes about pseudoscience and questionable medical practices. She received her BA and MD from the University of Washington, did her internship in the Air Force (the second female ever to do so),  and was the first female graduate of the Air Force family practice residency at Eglin Air Force Base. During a long career as an Air Force physician, she held various positions from flight surgeon to DBMS (Director of Base Medical Services) and did everything from delivering babies to taking the controls of a B-52. She retired with the rank of Colonel.  In 2008 she published her memoirs, Women Aren't Supposed to Fly.

Posted by Harriet Hall

Harriet Hall, MD also known as The SkepDoc, is a retired family physician who writes about pseudoscience and questionable medical practices. She received her BA and MD from the University of Washington, did her internship in the Air Force (the second female ever to do so),  and was the first female graduate of the Air Force family practice residency at Eglin Air Force Base. During a long career as an Air Force physician, she held various positions from flight surgeon to DBMS (Director of Base Medical Services) and did everything from delivering babies to taking the controls of a B-52. She retired with the rank of Colonel.  In 2008 she published her memoirs, Women Aren't Supposed to Fly.