Please use this identifier to cite or link to this item:
Full metadata record
DC FieldValueLanguage
dc.contributor.authorCurrie BJen
dc.contributor.authorFisher DAen
dc.contributor.authorHoward DMen
dc.contributor.authorBurrow JNen
dc.contributor.authorSelvanayagam Sen
dc.contributor.authorSnelling PLen
dc.contributor.authorAnstey NMen
dc.contributor.authorMayo MJen
dc.identifier.citationActa tropica 2000-02-05; 74(2-3): 121-7en
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.en
dc.titleThe epidemiology of melioidosis in Australia and Papua New Guinea.en
dc.typeJournal Articleen
dc.identifier.journaltitleActa tropicaen
dc.subject.meshBacterial Typing Techniquesen
dc.subject.meshBurkholderia pseudomalleien
dc.subject.meshPapua New Guineaen
dc.subject.meshProspective Studiesen
dc.subject.meshRisk Factorsen
dc.subject.meshEndemic Diseasesen
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.
Appears in Collections:(a) NT Health Research Collection

Files in This Item:
There are no files associated with this item.

Items in ePublications are protected by copyright, with all rights reserved, unless otherwise indicated.

Google Media

Google ScholarTM

Who's citing