melioidosis is a serious infectious disease caused by the environmental saprophyte Burkholderia pseudomallei. The infection is potentially preventable but developing prevention guidelines is hampered by a lack of evidence on which to base them The purpose of this study was to provide evidence for inoculation inhalation and ingestion as routes of infection To achieve this we undertook a matched case-control study and performed home visits to obtain drinking water and culture this for B.pseudomallei. We found that activities associated with increased risk of developing melioidosis included working ian ricefield other activities associated with exposure to soil or water