Melioidosis

Melioidosis is a very serious disease and this information acts as a timely reminder for people with diabetes who are more prone to infection with melioidosis.

During the ‘wet season’ the threat of contracting Melioidosis greatly increases.

What is Melioidosis? Melioidosis is a disease caused by bacteria called Burkholderia pseudomallei. These bacteria live deep in the soil during the ‘dry season’ and come to the top during the’wet season’ to be commonly found in surface water and mud, and may become airborne.

Melioidosis infections are more common in the Northern Territory during the ‘wet season’ and similarly in other tropical climates such as Northern Queensland, the Kimberley Region of Western Australia and South East Asia.

How can you get Melioidosis? The disease is contracted from the bacteria that cause Melioidosis entering the body via cuts, abrasions and sores in the skin. Melioidosis can also be contracted by the inhalation of dust or droplets and ingestion of contaminated water, which is very rare. Though Melioidosis has been found among farm animals, it does not usually spread from animal to humans or person to person.

Who is most at risk of getting Melioidosis? People who have one or more of the following conditions are more susceptible to infection; diabetes, kidney disease, cancer, lung disease, alcoholism, people who are on steroid therapy, also people on immunosuppressive therapy. Healthy people who work in muddy soil without good hand and feet protection are also at risk.

Diabetes patients are still number one for susceptibility to contracting melioidosis.

A study in 2005 of the risk in patients with melioidosis from various factors is given in the table below.

Risk Factor Patients No. (%) No. who died Mortality rate (%)

Diabetes 93 (37) 19 20 Excessive alcohol consumption 98 (39) 20 20 Chronic lung disease 67 (27) 18 27 Chronic renal disease 26 (10) 8 31 Kava consumption 20 (8) 3 15 Other* 51 (20) 13 25 Nil especial risk factors 51 (20) 1 2 * Includes cancer, steroid therapy and rheumatic heart disease.

The reported cases across the Northern Territory during 2007 were thirty four compared to twenty seven in 2006.

Darwin: Shop 1 & 2 Tiwi Place, Tiwi NT 0810  PO Box 40113, Casuarina NT 0811  Phone: 08 8927 8488  Fax: 08 8927 8515  Email: [email protected] Alice Springs: 7/16 Hartley Street (Jock Nelson Centre), Alice Springs NT 0870  Phone: 08 8952 8000  Fax: 08 8952 7000  Email: [email protected] www.healthylivingnt.org.au  ABN 11 374 693 055 D06 Healthy Living NT is the trading name of the Diabetes Association of the Northern Territory Incorporated.

How do you know that you have Melioidosis? Onset of symptoms may be sudden or gradual, with acute illness developing anywhere from 1 to 21 days after being infected. Melioidosis requires urgent medical treatment with specific antibiotics, if untreated the infection can be fatal.

A common problem for people infected with Melioidosis is a productive cough and difficulty breathing; other symptoms include fever with headache, and confusion, and pain and/or difficulty passing urine.

Melioidosis is diagnosed by testing a sample of blood, sputum, pus or urine.

Can Melioidosis be prevented? Yes, Melioidosis can be prevented! The most important preventative measure against melioidosis, especially for people with diabetes, is to avoid contact with muddy water in the wet season wherever possible. This is especially important after periods of heavy rainfall, when the risk of getting infected with the melioidosis bacteria is highest. This includes activities in your own gardens and yards as well as elsewhere.

Always wear waterproof shoes or boots when you are outside in the ‘wet season.’ Protective gloves should also be worn when handling soil.

What is the treatment? Most people need to be admitted to hospital initially. They are treated with antibiotics which, usually have to be continued for at least three months. Most people will recover completely when treatment is started early.

If you are sick with a fever, remember to mention Melioidosis to your doctor, especially if you are travelling to places where Melioidosis is not well known.

Top End Facts The Northern Territory prospective melioidosis study has documented 340 culture-confirmed cases in the 12 years since October 1989, with 59 deaths (17%). From October 2004 until Feb 2005 there have been 24 cases of culture confirmed melioidosis, which is more than double for the figures for the same time last year.