Melioidosis, a highly lethal bacterial disease, has become an important health threat in Queensland with particular relevance to the Townsville region. Seventeen-year-old Camille Leahy and her mother Danika have seen the destructive effects of this disease up close and personally. The disease is caused by the bacterium Burkholderia pseudomallei. People typically acquire it through hand contact with infected soil, particularly if those hands contain abrasions on bare skin.
Even though melioidosis can have devastating consequences, it often remains underdiagnosed because its symptoms are non-specific. Dr. Robert Norton, who has studied the disease extensively, underscored how bacteria is reintroduced much more easily following freshwater influxes like rainfall. This occurs because the water table rises in these warm conditions. This year has been especially startling, with 2023 shaping up to be the worst Queensland outbreak in almost three decades.
Camille’s nightmare started when, after years of unexplained symptoms, doctors found the wrong diagnosis. After weekly visits to her primary care doctor, emergency rooms, and infectious disease specialists over a period of three months, she was only then diagnosed with melioidosis.
A Harrowing Journey to Diagnosis
Camille’s 12th birthday was meant to be a joyous occasion, but Camille instead was in the hospital fighting for her life against melioidosis. Her symptoms ranged from absolutely debilitating pain in her legs that is “unbearable.”
“My legs would just ache. Sometimes the pain was just unbearable,” – Camille Leahy
Though she was in terrible pain, Camille did not show the usual symptoms that physicians would look for with melioidosis. That absence of typical presentation added to the challenges of her diagnosis and ultimately, her treatment.
Her mom, Danika Leahy, told us that she worries about the limited messaging focused on the disease and its symptoms.
“I feel like the messaging that goes out there is very narrow with regards to what symptoms to look out for and what precursor conditions make you susceptible,” – Danika Leahy
Danika emphasized the need to raise public awareness about the disease. She noted that Camille had not shown any of the characteristic symptoms usually seen with melioidosis.
“Camille had none of the main symptoms that we would normally look for so maybe there needs to be more messaging around that.” – Danika Leahy
The dearth of public knowledge about melioidosis is one key takeaway from this case. It highlights an immediate need to better educate the public on its warning signs and dangers.
Rising Cases and Environmental Factors
The Queensland health department announced more than 200 melioidosis cases just this year, leading to at least 31 deaths. Environmental factors have been cited by specialists as primary drivers of the recent uptick in cases. As Dr. Robert Norton explained during the 2017 CTC, heavy downpours make the situation even worse by increasing the likelihood of spread.
“Research has shown that if there’s more than 300 millimetres of rain in a fortnight, we start to see disease occurring in our vulnerable people,” – Dr. Norton
Dr. Meumann was again on the mark, attributing higher levels of construction and climate change to a spike in melioidosis cases. He cautioned that urban sprawl near Darwin might have increased exposure risk.
“With construction of new suburbs around Darwin, there has been an increase in cases potentially related to that sort of activity,” – Dr. Meumann
Both experts cautioned that continued, heavy periods of rain might prolong the geographic movement of the virus into new areas.
“How far south it expands is hard to say because it has to be present in the soil,” – Dr. Norton
Given the rising rate of melioidosis cases, this trend is alarming enough. Experts warn that climate change will only make things worse.
“I would say that it’s predicted that with climate change there will be more severe weather events and with that it’s likely there will be an increase in melioidosis cases.” – Dr. Meumann
The Challenge of Diagnosis
Diagnosing melioidosis is infamously challenging because melioidosis can easily imitate other illnesses. Dr. Norton continued that without having detailed information about the bacterium, doctors may not know to test for it or address during diagnostics.
“The biggest problem with diagnosis is that it can mimic a lot of different diseases and in medicine you need to have an idea of what the bug is,” – Dr. Norton
The implications of misdiagnosis are severe. When melioidosis advanced, it led to serious outcomes such as brain injury and death. This disease in Australia has a mortality rate of 10 to 15 percent.
Dr. Norton strongly underscored the need for raising awareness of this condition, particularly among at-risk populations such as pregnant people.
“When it sadly kills people, it does so very quickly and very efficiently and it’s unfortunate we don’t know more about it.” – Dr. Norton
The interaction of environmental factors and low awareness makes melioidosis a rising danger to public health in Queensland.
