Endemic Melioidosis in Residents of Desert Region after Atypically Intense Rainfall in Central Australia, 2011

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Teem-Wing Yip, Saliya Hewagama, Mark Mayo, Erin P. Price, Derek S. Sarovich, Ivan Bastian, Robert W. Baird, Brian G. Spratt, and Bart J. Currie

Author affiliations: Northern Territory Centre For Disease Control, Alice Springs, Northern Territory, Australia (T-W. Yip); Alice Springs Hospital, Alice Springs (S. Hewagama); Menzies School of Health Research, Casuarina, Northern Territory, Australia (M. Mayo, E.P. Price, D.S. Sarovich, B.J. Currie); Royal Adelaide Hospital, Adelaide, South Australia, Australia (I. Bastian); South Australia Pathology, Adelaide (I. Bastian); Royal Darwin Hospital, Casuarina (R.W. Baird, B.J. Currie); Imperial College, London, UK (B.G. Spratt)

Abstract

After heavy rains and flooding during early 2011 in the normally arid interior of Australia, melioidosis was diagnosed in 6 persons over a 4-month period. Although the precise global distribution of the causal bacterium Burkholderia pseudomallei remains to be determined, this organism can clearly survive in harsh and even desert environments outside the wet tropics.

Melioidosis, a tropical disease caused by the bacterium Burkholderia pseudomallei, is endemic to Southeast Asia and northern Australia and is being increasingly recognized in other locations globally (1,2). During 1989–2009, a total of 540 cases of melioidosis were documented in a prospective melioidosis study based at Royal Darwin Hospital (latitude 12.4°S) in the tropical north of the Northern Territory of Australia (3). During that 20-year period, 4 of the study participants were considered to have been infected in the central Australia region of the Northern Territory; the other 536 were infected in the tropical north. During the same period, 2 persons who were not included in that study tested positive for B. pseudomallei in the central Australian region and were treated at Alice Springs Hospital (23.8°S), making a total of 6 cases of melioidosis during 20 years attributed to B. pseudomallei infection acquired in Central Australia. The ongoing Darwin prospective melioidosis study is approved by the Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research (approval 02/38).

The Study

Thumbnail of Rainfall in the Northern Territory of Australia during August 1, 2010–July 31, 2011. Rainfall is expressed as percentages of historical mean; the lowest rainfall total was 100% of mean. Cities and towns are indicated by black dots; locations of 6 persons with melioidosis in central Australia are indicated by red dots. Adapted from the National Climate Centre, Australian Bureau of Meteorology (http://www.bom.gov.au). Inset shows location of Northern Territory in Australia.

Figure. Rainfall in the Northern Territory of Australia during August 1, 2010–July 31, 2011. Rainfall is expressed as percentages of historical mean; the lowest rainfall total was 100% of mean. Cities and...

Central Australia (also known as the “Red Centre”) is the most inland part of the arid interior of Australia and features low average annual rainfall, a desert environment, and rivers that are often dry. During March–July 2011, a total 6 cases of melioidosis were diagnosed in patients from Central Australia who resided south of latitude 20°S (Figure) and had not traveled to the tropical north of the country or to overseas regions to which melioidosis is endemic. These cases occurred after exceptionally heavy rainfall in February and March 2011, which resulted in widespread flooding in this normally parched region. The heavy rainfall in Central Australia was linked to a La Niña–associated, record-breaking wet season during 2010–2011 in the tropical north of the Northern Territory (Figure). Tropical Cyclone Carlos formed over the Beagle Gulf north of Darwin on February 15. At Darwin airport, the total rainfall during February 2011 of 1,110.2 mm and during the October–April wet season of 2,926.8 mm were the highest on record for that weather station. At Alice Springs airport, rainfall was 107.6 mm during February 2011, compared with a February mean of 40.3 mm during 1981–2010. The February 2011 rainfall at Tennant Creek airport (19.6°S) was 309.6 mm, compared with a February mean of 122.3 mm during 1981–2010. During the month of March 2011, when the first 3 patients became ill, rainfall amounts at Alice Springs and Tennant Creek airports were 120.6 mm and 222.6 mm, respectively; the annual mean March rainfalls in these locations during 1981–2010 were 35.4 mm and 53.8 mm, respectively.

Dr. Yip is the coordinator for the Northern Territory Centre for Disease Control in the Alice Springs and Barkly Regions of Central Australia, based in Alice Springs. Her work and research interests are in the health of the Aboriginal population in the Northern Territory of Australia.

Acknowledgments

We thank the laboratory scientists at Alice Springs and Tennant Creek hospitals and at SA Pathology for assistance with identification and provision of bacterial strains. We also thank Martin Cutter for epidemiological support.

This work was supported by the National Health and Medical Research Council of Australia (grant numbers 605820, 1046812) and by the Wellcome Trust (grant number WT089472).

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Figure

Figure. Rainfall in the Northern Territory of Australia during August 1, 2010–July 31, 2011. Rainfall is expressed as percentages of historical mean; the lowest rainfall total was 100% of mean. Cities...

Table

Table. Details of 6 residents of desert region in whom melioidosis was diagnosed after heavy rainfall in Central Australia, 2011

Suggested citation for this article: Yip TW, Hewagama S, Mayo M, Price EP, Sarovich DS, Bastian I, et al. Endemic melioidosis in residents of desert region after atypically intense rainfall in Central Australia, 2011. Emerg Infect Dis. 2015 Jun [date cited]. http://dx.doi.org/10.3201/eid2106.141908

DOI: 10.3201/eid2106.141908