Published Date: 2007-01-02 00:00:00
Subject: PRO/EDR> Melioidosis - Australia (NT)
Archive Number: 20070102.0016
MELIOIDOSIS - AUSTRALIA (NORTHERN TERRITORY)
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Fri, 29 Dec 2006
From: Pablo Nart <email@example.com>
Source: Northern Territory News [edited]
There could be a fresh outbreak of a potentially deadly disease in the Top
End [Northern Territory], the Health Department said yesterday, 28 Dec
2006. One man has died from melioidosis in 2006 and there have been 27
further cases. Centre for Disease Control director Vicki Krause warned
there could be more victims following recent rains.
Melioidosis is also known as Nightcliff gardeners' disease [Nightcliff is a
northern suburb of the city of Darwin in the Northern Territory of
Australia. The Nightcliff area was the site of RAAF camps with spotlights
and large guns used to defend Darwin from bombing during World War II. -
Mod.LL]. It is caused by a bacterium found in [some] tropical soils. In
Australia, it is found only in the Top End.
The bacterium lives deeper in the soil during the [dry season] but is
brought to the surface after heavy rainfalls. "Small cuts and sores on the
hands and feet provide a route of infection, but are largely avoidable if
simple protective measures are followed," Dr Krause said. The Centre for
Disease Control recommends wearing waterproof gloves and shoes or boots
during prolonged contact with soil, such as while gardening.
"The bacteria can become airborne, so people with risk factors are advised
to stay indoors during periods of heavy wind and rain in the Top End," Dr
Melioidosis can be fatal and requires "prompt and aggressive'' antibiotic
treatment. The disease can cause many symptoms, including skin ulcers or
sores that fail to heal, abscesses, unexplained fevers, weight loss,
fatigue, cough, shortness of breath, abdominal pain, urinary symptoms and,
occasionally, neurological problems such as headache and confusion.
People most at risk of developing melioidosis have an underlying condition
that impairs the immune system. These conditions include diabetes, heavy
alcohol intake, cancer, advanced age, and kidney or lung disease. Drugs
used to treat cancer and long-term steroid therapy can also impair the
"Healthy people who work with the soil, such as gardeners and people in the
building trade, can also develop the disease and should remember to wear
protective clothing," Dr Krause said.
[Infection due to _Burkholderia pseudomallei_ (melioidosis) is endemic in
focal areas of southeast Asia and northern Australia. Because _B.
pseudomallei_ is deemed to be a category B biowarfare agent, ProMED-mail
may continue to post cases of the infection even if from these endemic
areas. As indicated in the posting, most serious infections due to _B.
pseudomallei_ occur in individuals who are immunocompromised. In animal
models, higher inocula can cause more serious infection in immunocompetent
individuals. A discussion of the infection can be found in the ProMED-mail
A map of Australia showing the location of the Northern Territory and
Darwin can be found at: <http://www.staffordmall.com/media/australia-map.gif>.
ProMED thanks Pablo Nart for this posting. - Mod.LL]