The US Centers for Disease Control and Prevention is sounding the alarm on a rare illness that was previously only seen in tropical climates, particularly South Asia and northern Australia. Now, two people are dead and two have recovered after being infected with melioidosis — a disease that had never before been detected on contiguous US soil. Melioidosis has now been seen in Georgia, Kansas, Texas, and Minnesota, LiveScience reported. The only other known cases of melioidosis in the US were in the Virgin Islands and Puerto Rico in the Caribbean. None of the four patients claimed to have traveled outside the country prior to becoming sick between March and July of this year. The CDC “believes the most likely cause is an imported product (such as a food or drink, personal care or cleaning products or medicine) or an ingredient in one of those types of products,” according to the statement released Monday. About a dozen cases of melioidosis are seen each year in Americans, nearly all of which can be attributed to travel. This is the first time doctors are seeing the illness seemingly originate within the contiguous US. Caused by the bacterium Burkholderia pseudomallei, melioidosis can take several weeks to set in after exposure to the pathogen. Symptoms include cough and shortness of breath, fatigue, nausea, vomiting, intermittent fever and body rashes, the CDC wrote in a message to physicians on how to spot the illness. Risk factors for developing the disease include diabetes, liver or kidney disease, chronic lung disease, cancer or another condition that weakens the immune system, the CDC warned.