Published Date: 2012-01-21 13:12:56
Subject: PRO/EDR> Melioidosis - Australia: (NT)
Archive Number: 20120121.1017731
MELIOIDOSIS - AUSTRALIA: (NORTHERN TERRITORY)
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Wed 18 Jan 2012
Source: Australian Broadcasting Corp [edited]
The husband of a federal member of parliament is recovering in Royal Darwin Hospital after contracting the dangerous soilborne disease melioidosis. The MP says her husband went to see a doctor because a cut on his leg was not healing. She thinks he caught melioidosis while mowing the lawn, despite being vigilant.
"He wears shoes, he wears hats and sunscreen, and wears gloves to make sure he is protected," she said. "(But) he actually wore shorts while he was mowing the lawn. It is very concerning that a little scratch can result in something as serious as melioidosis."
The Northern Territory Centre for Disease Control says there have been 24 cases of meliodosis this wet season, including 2 deaths.
[byline: Jano Gibson]
[Melioidosis occurs mainly affecting people who have direct contact with soil and water. Many have an underlying predisposing condition such as diabetes (commonest risk factor), renal disease, cirrhosis, thalassemia, alcohol dependence, immunosuppressive therapy, chronic obstructive lung disease, cystic fibrosis, and excess kava consumption. (Kava is an herbal member of the pepper family that can be associated with chronic liver disease.) HIV infection, however, may not a clear risk factor for more severe disease. Melioidosis may present at any age, but peaks in the 4th and 5th decades of life, affecting men more than women. In addition, although severe fulminating infection can and does occur in healthy individuals, severe disease and fatalities are much less common in those without risk factors.
In acute severe melioidosis, there is characteristically the rapid progression of respiratory failure that is due to acute respiratory distress syndrome (ARDS) and/or pneumonia. It has been suggested that the ARDS to melioidosis sepsis is more rapid in progression than with other bacteria and may be related to the intracellular interactions of the bacillus and the leukocyte. Bacteremia without shock/hypotension has a substantially better prognosis.
Derived from: Tolaney P, Lutwick LI. Melioidosis. In: Lutwick LI, Lutwick SM (eds). Bioterror: the weaponization of infectious diseases. Totowa NJ: Humana Press, 2008 pp 145-58. - Mod.LL]
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