Meliodosos Flashcards
Is meliodosis nationally notifiable disease?
No. Notifiable in QLD, NT, WA.
What causes melioidosis?
Burkholderia pseudomallei
Ubiquitous in soil and water of tropical / sub-tropical regions
How is meliodosis transmitted?
Direct contact with contaminated soil or water (through skin cuts, sores)
Inhalation or drinking contaminated water.
What are the clinical features of melioidosis?
Pneumonia, sepsis, non-healing skin lesion/ulcer.
Other: GU, neuro, OM, septic arthritis, deep tissue abscess, chronic disease (subacute pulmonary or non-healing skin infection)
Who are at higher risk for melioidosis?
Older adults, First Nations, chronic disease (diabetes, renal, lung, RHD), immunosuppressed, heavy alcohol consumption.
Rare in healthy adults and children.
What is the case definition of melioidosis?
Confirmed = lab definitive; isolation of B. pseudomallei from any site.
How is melioidosis diagnosed?
Culture from specimens (blood, resp secretions, urine, CSF, wound).
Serology and PCR not particularly useful.
What is the incubation period for melioidosis?
1 - 21 (mean 9) days.
Rapid onset (hours) in association with inhalation and high infective dose.
What is the infectious period for melioidosis?
Environmental pathogen. Person-person transmission rare.
Neonatal cases following perinatal transmission and breastfeeding in association with mastitis.
Where is meliodosis endemic?
Northern Australia, SEA, South Asia/Indian subcontinent.
When does the incidence of melioidosis increase?
Following tropical storms, floods, extreme weather events.
QLD (Dec-May). Climate change will likely alter global epidemiology.
What is the mortality of melioidosis?
Variable. 10% in Australia, 40% in Thailand. High in low resource countries.
How can melioidosis be prevented?
Health education:
* Avoid contact with soil or muddy water
* Wear footwear/gloves for outdoor work
* Protect open wounds, lesions or burns
* Foot and wound care for diabetics
* Mask when using high-pressure hose
* Participants of activities involving mud exposure cautioned about potential risk of melioidosis.
* Risk assessment may be required for events with large number of participants
What resources are available for public health management of melioidosis?
QLD, NT, WA guidelines.
How are melioidosis cases managed?
- Consult with clinician about possible source of infection (recreation/occupation/travel)
- Specialist advice, recognise sepsis and rapid commencement of IV ABx (TGs)
- Counsel case on nature of infection, mode of transmission
How are melioidosis contacts managed?
No contact tracing (no person-person transmission) but can inform others potentially exposed.
Community clusters (temporal/geographic):
* Genetic analysis to examine relationship of cluster isolates
* Environmental sampling - soil/water
* Clinician notification - GP, community health, hospital
* Communication - inform about cluster and recommendations to minimise infection
