The Center For Disease Control identified the bacterium Burkholderia pseudomallei (B. pseudomallei) for the first time in the environment of the continental United States. This disease was identified through environmental sampling of soil and water in the gulf coast region of Southern Mississippi during an investigation of two human melioidosis cases.                                                                                                                It is unclear how sidespread the bacterrium is in the continental United States. Melioidosis is now considered to be locally endemic in areas of the gulf coast region of Mississippi. Two patients were hospitalized with Sepsis due to pneumonia and had known risk factors for melioidosis. Blood cultures were positive for B. pseudomallei, and both patients recovered following appropriate antibiotic therapy.                                                                                                                                                                                                                                                                   Burkholderia pseudomalle is a gram-negative bacterium and Tier One Agent-that typically lives in soil and water in regions with tropical and subtropical climates around the world, such as South and Southeast Asia, Northern Australia, parts of Central and South America, the U.S. Virgin Islands, and Puerto Rico. In about 5% of cases, symptoms can develop from latent-activated infections well past this 21-day window, months to years later.                                                                                                                                                                                                           Once well established in the soil, B. pseudomallei cannot feasibly be removed from the soil. Melioidosis is now a Nationally Notifiable Disease following a favorable vote at the 2022 CSTE conference.