Published Date: 2010-03-25 12:00:03
Subject: PRO/AH/EDR> Melioidosis - Australia (02): (NT)
Archive Number: 20100325.0952

MELIOIDOSIS - AUSTRALIA (02): (NORTHERN TERRITORY)
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Date: Thu 25 Mar 2010
Source: Northern Territory News [edited]
<http://www.ntnews.com.au/article/2010/03/25/134411_ntnews.html>


More people have died from melioidosis in the Top End. The Northern
Territory (NT) Centre for Disease Control (CDC) yesterday (24 Mar
2010) said the risk from the soil-borne bacteria was still strong
after recent heavy rains.

CDC director Vicki Krause said the latest 2 victims were both "older
adults." She could not say where the people died, or where they
contracted the deadly disease. They both died within the past 10
days. There have now been 6 deaths from melioidosis since December
2009. There have been 43 confirmed cases of melioidosis since October 2009.

The disease is known as Nightcliff Gardener's Disease but it is
prevalent throughout the Top End. "We live in the Top End -- it's in
the dirt all around us," Dr Krause said.

People should wear protective clothing such as waterproof gloves and
shoes or boots if working with soil or walking in muddy areas. Dr
Krause said there had been cases of melioidosis in 2010 as far south
as Katherine and Tennant Creek, and in Arnhem Land to the east. She
said the 43 cases were one of the highest numbers for many years, but
the death rate has come down in the past 2 decades from over 30
percent to about 15 percent.

Dr Krause said 10-20 years ago there were routinely more than 10
deaths a year from the disease.

[Byline: Ben Langford]

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Communicated by:
ProMED-mail Rapporteur Brent Barrett
<promed@promedmail.org>

[Infection due to _Burkholderia pseudomallei_ (melioidosis) is
endemic in focal areas of Southeast Asia and northern Australia. In
Australia, it 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 [Royal Australian Air Force] camps with spotlights and large
guns used to defend Darwin from bombing during World War II.). _B.
pseudomallei_ is deemed to be a category B biowarfare agent. It is
primarily an infection of humans with underlying diseases such as
alcoholism, malnutrition, cirrhosis, and immunosuppression, but can
also affect healthy individuals, as in this report. In animal models,
larger inocula can cause more serious infection in immunocompetent individuals.

The manifestations of illness in these patients are not stated nor
whether the individuals had underlying risk factors. Clinically,
infection due to _B. pseudomallei_ may be subclinical, but rapidly
progressive disseminated disease involving the skin, liver, or spleen
can occur. Pneumonia may be the presenting form, either acute or
chronic. The latter may present years after exposure, when the
individual is no longer in an endemic area and may look very much
like pulmonary tuberculosis. The diagnosis can be confirmed
microbiologically and/or serologically.

A map of Australia showing the location of the Northern Territory can
be found at
<http://www.staffordmall.com/media/australia-map.gif>.
- Mod.LL]

See Also

Melioidosis - Australia: (NT) 20100113.0153
2009
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Melioidosis - Australia (NT) 20090116.0184
2008
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Melioidosis - Australia: (NT) 20080123.0279
2007
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Melioidosis - Australia (NT) (03) 20070320.0981
Melioidosis - Australia (NT) 20070102.0016
2006
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Melioidosis 2005 - USA (FL) ex Honduras 20060820.2334
2005
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Melioidosis, fatal - Malaysia (Malacca): susp. RFI 20050601.1530
Melioidosis, fatal - Australia (QLD) (02) 20050326.0873
Melioidosis, fatal - Australia (QLD) 20050324.0851
Melioidosis - Australia (NT) 20050116.0131
2004
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Melioidosis - Singapore (04) 20040917.2578
Undiagnosed illness - Taiwan (03): meliodosis 20040804.2133
Melioidosis - Singapore 20040409.0968
Melioidosis - Australia (NT) (02) 20040322.0797
Melioidosis - Australia (NT) 20040319.0770
Melioidosis - Australia (North Qld.) 20040308.0654
2003
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Melioidosis - Australia (Northern Territory) 20031217.3084
.................................ll/ejp/dk

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