Published Date: 2004-03-22 23:50:00
Subject: PRO/EDR> Melioidosis - Australia (NT) (02)
Archive Number: 20040322.0797
MELIOIDOSIS - AUSTRALIA (NORTHERN TERRITORY) (02)
A ProMED-mail post
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International Society for Infectious Diseases
Date: Sat, 20 Mar 2004 13:41:45 +1030
From: Allen Cheng <email@example.com> (edited)
So far this 2003/4 wet season, 15 cases of melioidosis have presented to
the Royal Darwin Hospital, the referral center for the endemic Top End
region of the Northern Territory. Previously the epidemiology of
melioidosis was reviewed using notifiable diseases data (1).
In that report, it was noted that a cluster of cases occurred after heavy
rainfall in Queensland. The association between rainfall and cases is also
well-described, with a shift in the presentation of disease to pneumonia
and more severe disease after heavy rain (2). Clustering has also been
noted after other severe weather events such as the Katherine floods in Jan
1998 and heavy rainfall after tropical cyclone Thelma in Dec 1998
(manuscript in preparation).
It is unlikely that melioidosis was introduced by returning Australian
soldiers following WW2 as stated. There is extensive molecular diversity of
isolates throughout northern Australia, including many isolated coastal
islands with little external contact (3).
Introduction of melioidosis is believed to have occurred to areas outside
the endemic area such as a focus in southwest West Australia, where
clinical isolates over 25 years were clonal on ribotyping (4).
1. Cheng AC, Hanna JN, Norton R, et al, Comm Dis Intell 2003; 27: 272-77.
2. Currie BJ, Jacups SP. Intensity of rainfall and severity of
melioidosis, Australia. Emerg Infect Dis 2003; 9:1538-39
3. Currie BJ, Fisher DA, Howard DM, et al. The epidemiology of melioidosis
in Australia and Papua New Guinea. Acta Tropica 2000;74:121-27
4. Currie B, Smith-Vaughan H, Golledge C, et al. _Pseudomonas
pseudomallei_ isolates collected over 25 years from a non-tropical endemic
focus show clonality on the basis of ribotyping. Epidemiol Infect
Allen Cheng, Bart Currie, Dale Fisher, Nick Anstey, Emma Spencer, Vicki Krause
[ProMED thanks the above authors for their input regarding the epidemiology
and origins of _B. pseudomallei_ infection in Australia. - Mod.LL]