Melioidosis – a disease of socioeconomic disadvantage

CPD Hours: 1
Current as at 27 October 2021
The clinical manifestations of melioidosis range from localized infection to overwhelming sepsis and death. This article highlights the connection between melioidosis and the socio-economic factors, which further highlights the need for a holistic approach to healthcare in northern Australia, in regards to this population.

Tags:

“Recognize the disproportion in the burden of disease in Australia”

Course Content

The clinical manifestations of melioidosis range from localized infection to overwhelming sepsis and death.

Pneumonia is the most common presentation of melioidosis, and at the Royal Darwin Hospital, B. pseudomallei has been the most common cause of community-acquired bacteremic pneumonia.

The mortality rate associated with melioidosis is high and varies between countries; in northern Australia, it is ∼19%; and severe septicemic melioidosis has reported mortality rates of 86% in northern Australia.

It has the potential for epidemic spread to areas where it is not endemic, and sporadic case reports elsewhere in the world suggest that as-yet-unrecognized foci of infection may exist. Environmental determinants of this infection, apart from a close association with rainfall, are yet to be elucidated.

Studies exploring the role of preventative measures, earlier clinical identification, and better management of severe sepsis are required to reduce the burden of this disease. In northern Australia, basic public health advice is given every year to the general population, and especially to high-risk groups, such as avoiding direct contact with soil and water at the start of each rainy season.

Only Australia, Brunei and Singapore have national surveillance data for melioidosis that are comparable to the estimates. At present, the boundaries of the major endemic region of Australia extending north from Rockhampton along the coast to Darwin and inland, west from Rockhampton to Tennant Creek in central Australia. Townsville was found to have the highest prevalence (5.2%) of positive reactors of all urban populations of Northern Queensland. The extent of the disease is such that it can no longer be considered a rare infection in Northern Queensland. 

This article highlights the connection between melioidosis and the socio-economic factors, which further highlights the need for a holistic approach to healthcare in northern Australia, in regards to this population.

Learning Outcomes

In this session, you will:

  • Recognize the disproportion in the burden of disease in Australia
  • Correlate the connection between melioidosis and the socio-economic factors
  • Discuss the holistic approach to the delivery of healthcare versus the biomedical model of healthcare in terms of treatment for melioidosis
  • Investigate further improvements in Australian healthcare
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