Analysis of the surge in melioidosis cases during Townsville’s record rainfall during the 2024-25 wet season has reinforced recommendations for emergency care staff.
The lead author of the new study is Colin Banks, an emergency physician at Townsville University Hospital and an Associate Professor at James Cook University.
He said melioidosis is a potentially life-threatening infection caused by bacteria in the soil in tropical and subtropical regions
“Melioidosis usually happens in the wet season where there is a well-documented association between rainfall extremes and melioidosis cases. The bacteria can get into the body through broken skin, inhalation or ingestion of contaminated water or soil,” Dr Banks said.
He said the 2024–25 wet season brought about three times Townsville’s usual rainfall, with significant flooding across the city.
“The melioidosis case load of 57 patients to the TUH Emergency Department was more than double the entire region’s typical annual number. Twelve patients required intensive care and eight patients died,” Dr Banks said.
He said 40 patients were men and 17 were women, with a median age of 62. Thirteen patients identified as First Nations people.
“Most had recognised risk factors for melioidosis, with diabetes the most common, affecting 47 per cent of patients. Six patients had no known risk factors,” Dr Banks said.
He said the study found that melioidosis could present with a broad range of symptoms and sites of infection, making early recognition challenging.
“Following significant rainfall and flooding, clinicians should consider the possibility of infection in patients with relevant risk factors, particularly when an unusual infection does not respond to standard treatment.
“We recommend taking samples from multiple sites on the body rather than relying solely on blood samples. For critically ill patients, early treatment with meropenem – an antibiotic commonly used to treat severe melioidosis – should be given,” Dr Banks said.
He said the advice for the public remained the same.
“Stay away from direct contact with wet soil or muddy water, wear waterproof boots or enclosed footwear and rubber gloves when gardening and cover any cuts, scrapes, burns, or open sores with waterproof dressings.”
He said people should wash their skin and hands thoroughly with soap and clean water immediately after any potential contact with soil or muddy water and use a fitted mask or respirator if using high-pressure hoses around soil.
“Climate change is expected to increase the frequency of severe weather events and heavy rain, so it’s probably wise to keep this advice at top of mind,” Dr Banks said.
Link to paper here.
