by Jocelyn Wright, Australian Doctor
Ten people have been struck down with the potentially deadly soil-borne disease melioidosis, including a woman who has died from it, after disastrous flooding in North Queensland.
Townsville public health unit physician Dr Julie Mudd says that while two cases of melioidosis are being cared for in the community, seven remain in Townsville hospital for intensive treatment.
The soil-borne bacterium Burkholderia pseudomallei, which causes melioidosis, has been stirred up by heavily contaminated floodwaters, with authorities warning they expect more locals will become infected during the flood clean-up.
“It’s a very serious infection … [but] we’re not calling it an outbreak; it is what we would consider a seasonal variation,” Dr Mudd says.
Clinical microbiologist Dr Gemma Robertson, from the University of Queensland, says, given the catastrophic flooding and increased rainfall, the spike in cases seen in the region is not unexpected.
The infection can manifest from mild skin and soft tissue infections to life-threatening bloodstream infections, Dr Robertson says.
Patients with pre-existing conditions — such as diabetes, kidney disease and those on steroids — are at higher risk of complications, she tells Australian Doctor.
She recommends that all suspected cases are referred to hospital for investigation.
“Any presenting symptoms consistent with pneumonia must get referred to the hospital for evaluation because they can’t be treated as an outpatient if they have significant melioidosis,” Dr Robertson says.
Red flags include any sign of sepsis, such as hypotension, shortness of breath or haemodynamic instability.
“They should be referred urgently to emergency. The only thing that stops it becoming fatal is early intervention with antibiotics,” she says.
Dr Robertson says mortality for melioidosis in Australia is comparatively low compared with other regions, in the range of 10-15% of cases.
