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dc.contributor.authorCurrie, B J
dc.contributor.authorFisher, D A
dc.contributor.authorHoward, D M
dc.contributor.authorBurrow, J N
dc.contributor.authorSelvanayagam, S
dc.contributor.authorSnelling, P L
dc.contributor.authorAnstey, N M
dc.contributor.authorMayo, M J
dc.date.accessioned2018-05-24T23:55:34Z-
dc.date.available2018-05-24T23:55:34Z-
dc.date.issued2000-02-05
dc.identifier.citationActa tropica 2000-02-05; 74(2-3): 121-7
dc.identifier.issn0001-706X
dc.identifier.urihttps://hdl.handle.net/10137/6849-
dc.description.abstractMelioidosis was first described in Australia in an outbreak in sheep in 1949 in north Queensland (22 degrees S). Human melioidosis was first described from Townsville (19 degrees S) in 1950. Melioidosis is hyperendemic in the Top End of the Northern Territory (NT) and as in parts of northeastern Thailand it is the commonest cause of fatal community-acquired septicemic pneumonia. In the 9 years since 1989 the prospective NT melioidosis study at Royal Darwin Hospital (12 degrees S) has documented 206 culture confirmed cases of melioidosis, with an average annual incidence of 16.5/100,000. Melioidosis is also seen in the north of Western Australia and north Queensland, including the Torres Strait Islands, but is uncommon in adjacent Papua New Guinea. Serological studies suggest that infection is rare in the Port Moresby region, but there is emerging evidence of melioidosis from Western Province. The NT study has documented inoculating events in 52 (25%) of cases, with an incubation period of 1-21 days (mean 9 days); 84% of cases had acute disease from presumed recent acquisition and 13% had chronic disease (sick, > 2 months). In 4% there was evidence of possible reactivation from a latent focus; 28 of 153 (18%) males had prostatic abscesses. The overall mortality was 21% (43 cases), with a mortality rate in septicemic cases (95) of 39% and in non-septicemic cases (103) of 4%. Pneumonia was the commonest presentation in both groups and, in addition, eight patients (two deaths) presented with melioidosis encephalomyelitis. Melioidosis clusters in temperate Australia are attributed to animals imported from the north. Molecular typing of Burkholderia pseudomallei isolates from temperate southwest Western Australia showed clonality over 25 years. In this outbreak and in studies from the NT, some soil isolates are molecularly identical to epidemiologically related animal and human isolates. Molecular typing has implicated the water supply in two clonal outbreaks in remote aboriginal communities in northern Australia. Further prospective collaborative studies are required to evaluate whether there are truly regional differences in clinical features of melioidosis and to better understand how B. pseudomallei is acquired from the environment.
dc.description.provenanceMade available in DSpace on 2018-05-24T23:55:34Z (GMT). No. of bitstreams: 0 Previous issue date: 2000-02-05en
dc.language.isoeng
dc.titleThe epidemiology of melioidosis in Australia and Papua New Guinea.
dc.typeJournal Article
dc.identifier.journaltitleActa tropica
dc.identifier.pubmedidhttps://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/10674639
dc.subject.meshAnimals
dc.subject.meshAustralia
dc.subject.meshBacteremia
dc.subject.meshBacterial Typing Techniques
dc.subject.meshBurkholderia pseudomallei
dc.subject.meshCattle
dc.subject.meshHumans
dc.subject.meshMelioidosis
dc.subject.meshPapua New Guinea
dc.subject.meshProspective Studies
dc.subject.meshRisk Factors
dc.subject.meshSheep
dc.subject.meshEndemic Diseases
dc.identifier.affiliationDivision of Medicine, Royal Darwin Hospital Clinical School and Tropical Medicine and International Health Unit, Menzies School of Health Research, Casuarina, NT, Australia. bart@menzies.edu.au.
dc.identifier.pubmedurihttps://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/10674639
Appears in Collections:(a) NT Health Research Collection

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