Scrub Typhus in the Torres Strait Islands of North Queensland, Australia

Faa, Antony G.; McBride, William John Hannan; Garstone, Gaynor; Thompson, Robert E.; Holt, P. M.

doi:10.3201/eid0904.020509

Cited by 43 publications

(43 citation statements)

References 5 publications

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“…There have been few other population-based rates described previously for Australia, but in a geographically restricted area within the Torres Strait in northern Queensland in the 2000 to 2002 seasons (151), a rate of 40 cases per 100,000 was documented. In contrast to many other countries where the disease is endemic, in Australia most patients are from remote locations but are transported to referral hospitals in the Top End region of the Northern Territory, the Kimberley region of Western Australia, and far north Queensland and the Torres Strait for management.…”

Section: Melioidosis In the Australia-pacific Regionmentioning

confidence: 99%

Melioidosis: Epidemiology, Pathophysiology, and Management

2005

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Melioidosis, caused by the gram-negative saprophyte Burkholderia pseudomallei, is a disease of public health importance in southeast Asia and northern Australia that is associated with high case-fatality rates in animals and humans. 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. The sequencing of the genome of a strain of B. pseudomallei has recently been completed and will help in the further identification of virulence factors. The presence of specific risk factors for infection, such as diabetes, suggests that functional neutrophil defects are important in the pathogenesis of melioidosis; other studies have defined virulence factors (including a type III secretion system) that allow evasion of killing mechanisms by phagocytes. There is a possible role for cell-mediated immunity, but repeated environmental exposure does not elicit protective humoral or cellular immunity. A vaccine is under development, but economic constraints may make vaccination an unrealistic option for many regions of endemicity. Disease manifestations are protean, and no inexpensive, practical, and accurate rapid diagnostic tests are commercially available; diagnosis relies on culture of the organism. Despite the introduction of ceftazidime- and carbapenem-based intravenous treatments, melioidosis is still associated with a significant mortality attributable to severe sepsis and its complications. A long course of oral eradication therapy is required to prevent relapse. 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

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Section: Melioidosis In the Australia-pacific Regionmentioning

confidence: 99%

Melioidosis: Epidemiology, Pathophysiology, and Management

2005

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“…At the Royal Darwin Hospital in the Northern Territory, melioidosis is the most common cause of fatal community-acquired bacteraemic pneumonia [44]. Within Thailand, melioidosis occurs in other northern provinces and to a lesser extent in the south, and it is also well recognised in other regions in tropical northern Australia, such as northern Queensland [45][46][47] and the Kimberley region of northern Western Australia [48].…”

Section: Endemic Melioidosismentioning

confidence: 99%

Melioidosis: an important cause of pneumonia in residents of and travellers returned from endemic regions

Currie¹

2003

Eur Respir J

166

171

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“…There are regional variations in disease presentation; for example, northern Australia has a high rate of genitourinary disease, particularly prostate disease, and a distinct encephalomyelitis syndrome (3,26). Parotid abscesses are a common presentation of melioidosis in Thailand (4), but only one case has been documented in Australia (8). The reasons for these differences, whether host, bacterial, or environmental factors, have not been well characterized.…”

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confidence: 99%

Isolates of Burkholderia pseudomallei from Northern Australia Are Distinct by Multilocus Sequence Typing, but Strain Types Do Not Correlate with Clinical Presentation

et al. 2004

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Melioidosis is the disease caused by the saprophytic organism Burkholderia pseudomallei. Previous studies have suggested some strain tropism and differential virulence. In this study, we defined strains by multilocus sequence typing (MLST) of isolates taken from the Top End of Australia's Northern Territory and compared the results with those of other strains typed worldwide. We specifically sought clinical and geographical correlates of strain types. Among 87 Australian isolates, 48 sequence types were defined. None of the sequence types in this study has been found elsewhere in the world. Strains were distributed widely throughout the region, and the different presentations of disease, including neurological and prostatic infection, were associated with many different strains. There was excellent congruence between pulsed-field gel electrophoresis and MLST, and the two typing methods had a similar level of strain discrimination. The work suggests that host and environmental factors may be more important in determining disease presentation than infecting strain type. It is possible that the distinct but diverse strain types found in this study reflect Australia's geographical isolation over many millions of years.

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Scrub Typhus in the Torres Strait Islands of North Queensland, Australia

Cited by 43 publications

References 5 publications

Melioidosis: Epidemiology, Pathophysiology, and Management

Melioidosis: Epidemiology, Pathophysiology, and Management

Melioidosis: an important cause of pneumonia in residents of and travellers returned from endemic regions

Isolates of Burkholderia pseudomallei from Northern Australia Are Distinct by Multilocus Sequence Typing, but Strain Types Do Not Correlate with Clinical Presentation

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