Melioidosis Alert Issued in North Queensland Following Ex-Tropical Cyclone Koji

North Queensland health authorities have issued an alert regarding melioidosis, a serious bacterial infection, after heavy rainfall and flooding attributed to Ex-Tropical Cyclone Koji. Four individuals have been hospitalized with the disease in the Mackay and Whitsunday regions, prompting authorities and medical experts to highlight the increased risk during clean-up efforts and outdoor activities in affected areas.

Authorities and medical experts are highlighting the increased risk of melioidosis during clean-up efforts and outdoor activities in affected areas after Ex-Tropical Cyclone Koji.

Overview of Current Situation

Four individuals, aged between 67 and 89, have been hospitalized with melioidosis in North Queensland. These individuals were exposed to mud or floodwaters. Two are from Armstrong Beach, one from Seaforth, and one from Bowen; all are currently receiving treatment at Mackay Base Hospital.

As of January 19, 16 cases of melioidosis were confirmed across Queensland. This includes six in Cairns, five in Townsville, one in Mackay, and one in the Torres and Cape regions, with new infections specifically noted in the Mackay area. Separately, 47 diagnoses of melioidosis have been reported in Queensland this year, and a previous outbreak saw over 130 cases in a region last year. Data from a previous year indicates 36 individuals died with the illness between January and November, while nine people died from both melioidosis and glanders in 2022.

Steven Donohue, director of the Mackay Public Health Unit, stated that the diagnoses serve as a warning for those involved in clean-up operations following the ex-Tropical Cyclone Koji event. Queensland Health has initiated a public health campaign, and investigations are underway to identify factors contributing to the current increase in cases.

Understanding Melioidosis

Melioidosis is a rare tropical disease caused by the bacterium Burkholderia pseudomallei, which naturally resides in deep soil and muddy water across northern Australia. Cases are most frequently reported during the wet season, particularly after significant rain or flooding, as these conditions can bring the bacteria to the surface. Microbiologist Jeffrey Warner noted that the bacteria are typically brought to the surface by rainfall, especially after 30 millimeters or more.

The bacteria can enter the body through:

• Cuts or sores on the skin.
• Inhalation of contaminated dust or water droplets.
• Consumption of untreated water.

The disease does not typically spread from person to person or from animals. While exposure can lead to illness days, months, or even years later, most exposed individuals do not fall ill.

Symptoms can emerge between one day and three weeks post-exposure and may include:

• Fever
• Cough
• Difficulty breathing
• Skin ulcers
• Non-healing sores

In severe instances, the infection can spread via the bloodstream, potentially leading to sepsis. If left untreated, the infection can be fatal.

Individuals at higher risk for severe illness include those with pre-existing health conditions such as:

• Diabetes
• Kidney disease
• Lung disease
• Cancer
• Weakened immune systems
• The elderly
• Heavy alcohol consumers

Treatment and Prevention

There is currently no vaccine for melioidosis. Early medical treatment is considered essential. The disease is managed with antibiotics for a minimum of three months, and severe cases often necessitate hospitalisation and intensive care.

Health authorities and experts recommend the following actions, particularly during the wet season and post-flooding clean-up:

• Avoid direct contact with muddy soil or floodwater when possible.
• Wear waterproof footwear and gloves during gardening or outdoor work, especially in areas with wet soil.
• Cover any cuts, sores, or wounds with waterproof dressings before engaging in outdoor activities.
• Wash skin thoroughly with soap and clean water if it comes into contact with soil or muddy water.
• Exercise extra caution with foot and wound hygiene, particularly for individuals with diabetes.
• Consider wearing a mask when using high-pressure hoses near soil or bore water, or when pressure washing, spraying, or mowing lawns, as these activities can aerosolize the bacteria.
• Avoid gardening or working with soil immediately after heavy rainfall.
• Treat groundwater with caution.

Personal Experience and Expert Insights

Leichan Williams, a 50-year-old woman from Cairns, shared her experience after contracting melioidosis during a gardening session last year. She believes the bacteria entered through a cut while she was clearing debris from a drain without adequate protection. Williams developed sepsis, an extreme reaction to the bacteria, which severely affected her knee, necessitating two surgeries. The infection also spread to her back and heart, and she developed a blood clot. While leg amputation was considered, antibiotics controlled the infection. One year later, Williams has returned to work but experiences lasting impacts and faces a high risk of reinfection. She fit the higher-risk criteria due to being over 50 and having chronic conditions such as diabetes and high blood pressure.

Michael Clements, Rural Chair of the Royal Australian College of General Practitioners, indicated that the period following a flooding event is particularly hazardous due to heavy rains bringing the bacteria to the surface. He highlighted that melioidosis can present late and be deadly. Microbiologist Jeffrey Warner suggested that new housing developments, where bacteria are present, may also contribute to increased cases.

"The period following a flooding event is particularly hazardous due to heavy rains bringing the bacteria to the surface. Melioidosis can present late and be deadly."

Seek Medical Advice Promptly

Anyone feeling unwell after potential exposure to muddy water or soil is advised to seek medical advice promptly. Residents can contact their local doctor, health centre, or call 13 HEALTH (13 43 25 84). For emergencies, call 000.