Increase in Melioidosis Expected This Wet Season
As the wet season intensifies across North Queensland, clinicians and community members alike should be aware of a likely rise in melioidosis cases. Last year we saw significant activity:
- Townsville’s Northern Beaches recorded a high number of infections
- Southern Cairns experienced a notable outbreak near the Bruce Highway upgrade zone
With more older adults and medically vulnerable people moving into peri‑urban areas—and frequently disturbing soil through gardening, renovations, and off-road activities—the risk is again increasing.
Below is a concise overview of what to watch for, how to reduce risk, and what clinicians should do during this period of heightened alert.
What Is Melioidosis?
Melioidosis is a serious infectious disease caused by Burkholderia pseudomallei, a hardy bacterium that naturally lives in soil, mud, and surface water.
It is endemic in tropical northern Australia, including North Queensland, and cases sharply increase during the wet season when soil and water become more easily aerosolised or come into contact with skin.
How infection occurs:
- Through skin abrasions exposed to contaminated soil or muddy water
- Through inhalation, particularly during storms, flooding, or cleaning muddy environments
- Through reactivation, sometimes years after the original exposure, from internal abscesses
While infection is uncommon, patients can deteriorate rapidly. Mortality in Australia is around 20% despite high-quality care.
Who Is Most at Risk?
Certain underlying conditions significantly increase susceptibility to melioidosis:
- Older age
- Diabetes
- Chronic alcohol use
- Immune compromise
- Chronic lung, kidney, or other systemic diseases
These groups must take extra precautions during and after heavy rain events.
Common Presentations
Melioidosis is sometimes called “the great imitator” because it can affect almost any organ system.
Frequent clinical presentations include:
- Pneumonia
- Sepsis
- Genitourinary infections, especially prostate abscesses
- Skin and soft tissue infections
- Internal abscesses in liver, spleen, kidneys, lungs, or central nervous system
Because symptoms vary widely, a high index of suspicion is essential during the wet season.
Preventive Measures
Simple protective behaviours can significantly reduce risk, especially after storms or flooding:
- Manage underlying conditions such as diabetes
- Avoid direct contact with soil, mud, or floodwaters when possible
- Clean wounds promptly:
- Wash thoroughly
- Apply antiseptic
- Cover with a waterproof dressing
- Wear:
- Gloves and closed‑in shoes when gardening or working outside
- A mask when hosing down mud or pressure‑cleaning
- Vulnerable individuals should stay indoors during heavy rainfall and avoid unnecessary outdoor work soon after floods
Clinical Guidance
For healthcare providers, early recognition and targeted testing can prevent severe disease.
Clinicians should:
- Encourage protective clothing during post‑flood clean‑ups
- Consider melioidosis in patients with:
- Pneumonia
- Sepsis
- Unexplained abscesses
- Skin/soft‑tissue infections
- Order cultures (sputum, wound swabs, blood, urine, aspirates) when suspicious
- Do not rely on serology—it cannot reliably diagnose acute infection
- Refer any suspected cases to hospital for specialist management and early intravenous therapy
- Advise patients to attend Emergency promptly if their condition worsens
- Notify Public Health of all confirmed melioidosis cases
For further detail, clinicians can review Queensland Health guidance
👉 here
