What is Melioidosis ?
Melioidosis is a disease caused by bacteria known as Burkholderia pseudomallei .The bacteria live below the soil's surface during the dry season but after heavy rainfall are found in surface water and mud and may become airbone.
How is it spread ?
The bacteria that causes melioidosis usually enters the body via cuts and sores in the skin or via inhalation of dust or droplets and very rarely by ingestion of contaminated water. the disease has been found among some domestic and farm animals. melioidosis does usually spread from one person to another or from animals to humans.
Where does Melioidosis usually occur ?
Melioidosis is found in tropical areas throughout the world, particularly in South East Asia and Northern Australia. In sarawak cases typically occur in the Bintulu, Kapit and Belaga.
What are the symptoms?
The symptoms of Melioidosis depend on the site of the infection and this can vary.Often it starts as a chest infection with a productive cough and difficulty breathing. Other possible presentations include fever with headache and confusion, or pain and/or difficulty passing urine. People can become ill from 1 to 21 days after being infected and the onset of symptoms may be sudden or gradual. The infection can be fatal and Melioidosis requires urgent medical attention and treatment with specific antibiotics.
In some cases the illness may come on much more slowly with weight loss, intermittent fever, chest pain and a cough. Some people may present with skin ulcers, boils or joint or bone infections.
There have also been cases where the diseases has caused illness many years after the initial infection. In these cases, the bacteria have been carried by the person and have become active due to a weakening of the immune system.
The diagnosis of Melioidosis is made by growing the bacteria with laboratory testing of blood,sputum,urine or a swab from an abcess or non-healing ulcer.
Who is at risk ?
People most at risk are those with conditions such as diabetes, heavy alcohol consumption, kidney disease, lung disease and cancer and those on immunosuppressive therapy.
Healthy people can also get the disease if they work in muddy soil without good hand and foot protection. Children are at a lower risk for acquiring
Melioidosis compared with adults. However it is still possible for children, particularly those with chronic diseases or weakened immune systems to acquire Melioidosis during the wet season.
What is the treatment ?
All patients should be admitted to hospital initially. They are treated with antibiotics, which usually have to be continued for at least 3 months. If treatment is started early, recovery is usually complete. It is important to complete all antibiotics to prevent relapse.
How can Melioidosis be prevented ?
There is currently no vaccine against Melioidosis.Therefore preventive measures are the key to avoiding infection.
Waterproof shoes or boot will protect your feet when you walk in wet soil where there is pooled water or you work in muddy conditions. For example, when gardening or working in excavations. Open footwear such as sandals are not very good protection.Protective gloves should be worn when handling soil, particularlu during the wet season.
Wounds should be promptly and throughly washed clean and covered. if necessary, use pumping equipment to control water ingress when working in excavatins.
Due to the potential for aerosolisation (airbone droplets) of Bulkholderia pseudomallei people with risks factors such as diabetes,heavy alcohol consumption, kidney disease, lung disease and cancer and those on immunosuppressive therapy should stay indoors during periods of heavy wind.
Children should avoid playing in muddy areas, wet sandpits or places where water has pooled in grassy areas or where grassed areas are boggy. Playing on wet grass is considered to be low risks for acquiring Melioidosis. Sandpits which are dry or dry enough to comfortably play in are also low risk.
There preventative measures are most important if you have any of the following conditions :
Heavy alcohol consumption (>20 standard drinks a week)
- Kidney disease
- Lung disease
- Receiving immunosuppressive therapy
- cuts or sores in your skin, particularly on the hands and feet.