1 00:00:00,040 --> 00:00:03,520 Speaker 1: Our health authorities are warning Territorians to take precautions to 2 00:00:03,600 --> 00:00:08,600 Speaker 1: protect themselves from contracting miliardosus ahead of the wet season. 3 00:00:08,920 --> 00:00:11,119 Speaker 1: Yesterday on the show, we spoke to Peter from Bee's 4 00:00:11,160 --> 00:00:15,040 Speaker 1: Creek about the seriousness of the illness after he caught 5 00:00:15,040 --> 00:00:17,880 Speaker 1: it while working in the yard. Now joining us on 6 00:00:17,960 --> 00:00:19,680 Speaker 1: the line to tell us more about some of the 7 00:00:19,680 --> 00:00:22,520 Speaker 1: things that we should be doing to protect ourselves from 8 00:00:22,600 --> 00:00:27,200 Speaker 1: Royal Darwin Hospital and Mensi's professor of Medicine, Bart Curry, 9 00:00:27,240 --> 00:00:30,840 Speaker 1: Good morning to you, Bart, Good morning, thanks so much 10 00:00:30,840 --> 00:00:34,080 Speaker 1: for your time this morning. Now, first remind us what 11 00:00:34,280 --> 00:00:36,040 Speaker 1: exactly milliadosis is. 12 00:00:37,720 --> 00:00:41,600 Speaker 2: Yeah, thanks, So. Melidosis is a bacterial infection, and the 13 00:00:41,640 --> 00:00:45,720 Speaker 2: bacteria that caused meliodosus live in the top end in 14 00:00:45,840 --> 00:00:51,480 Speaker 2: our soil and surface water, and they are pretty much 15 00:00:51,760 --> 00:00:54,240 Speaker 2: it deeper layers during the dry season. But once the 16 00:00:54,360 --> 00:00:58,000 Speaker 2: rains start and the humidity increases, then the bacteria start 17 00:00:58,040 --> 00:01:02,760 Speaker 2: to proliferate and become common on the surface and so 18 00:01:02,840 --> 00:01:06,560 Speaker 2: they can then infect both humans and animals. And this 19 00:01:06,760 --> 00:01:09,240 Speaker 2: pretty much happens, you know, in the wet season. 20 00:01:09,319 --> 00:01:14,160 Speaker 1: Yeah, and how many cases have we seen over sort 21 00:01:14,160 --> 00:01:16,400 Speaker 1: of last wet season, because I understand it was a 22 00:01:16,400 --> 00:01:18,200 Speaker 1: fairly bad one. 23 00:01:18,520 --> 00:01:21,800 Speaker 2: Yeah, So we sort of do our figures every twelve 24 00:01:21,800 --> 00:01:24,679 Speaker 2: months beginning October the first through to September thirtyth the 25 00:01:24,720 --> 00:01:27,160 Speaker 2: next year, so covering the wet season and the subsequent 26 00:01:27,240 --> 00:01:31,319 Speaker 2: dry and we had in the last twelve months we 27 00:01:31,360 --> 00:01:35,240 Speaker 2: had eighty seven cases and unfortunately, six of those were fatal. 28 00:01:35,680 --> 00:01:40,080 Speaker 2: That was our third largest number we've had over the 29 00:01:40,160 --> 00:01:43,640 Speaker 2: last really three decades or in fact forever. Our worst 30 00:01:43,680 --> 00:01:46,120 Speaker 2: ever year was after we had two years in a 31 00:01:46,200 --> 00:01:50,279 Speaker 2: row of fairly heavy rains back in the early twenty 32 00:01:50,320 --> 00:01:52,760 Speaker 2: ten then through to twenty eleven, So between twenty eleven 33 00:01:52,760 --> 00:01:55,000 Speaker 2: and twenty twelve, in that twelve month period, we had 34 00:01:55,280 --> 00:01:57,440 Speaker 2: ninety seven cases and ten deaths, and that was our 35 00:01:57,480 --> 00:02:01,040 Speaker 2: worst season. Last year was this one just finished was 36 00:02:01,040 --> 00:02:05,000 Speaker 2: our third highest, and the year before that we had 37 00:02:05,040 --> 00:02:07,840 Speaker 2: seventy four cases with seven deaths. So I think the 38 00:02:07,880 --> 00:02:10,120 Speaker 2: reason we had so many cases in the last two 39 00:02:10,200 --> 00:02:12,760 Speaker 2: months was that we had two wet seasons in a 40 00:02:12,840 --> 00:02:15,120 Speaker 2: row which were pretty full on with quite a lot 41 00:02:15,120 --> 00:02:17,320 Speaker 2: of rain, and so there was a lot of windy 42 00:02:17,400 --> 00:02:21,200 Speaker 2: events as well. So what happens is that it's sort 43 00:02:21,200 --> 00:02:23,800 Speaker 2: of built up over the last couple of years, but 44 00:02:24,120 --> 00:02:27,160 Speaker 2: now that it's got a bit drier, potentially the numbers 45 00:02:27,200 --> 00:02:28,960 Speaker 2: may drop off over the next year or two with 46 00:02:29,040 --> 00:02:31,840 Speaker 2: the Anino cycle that's happening now. 47 00:02:32,000 --> 00:02:34,639 Speaker 1: And Professor Curry, we did speak to a listener yesterday, 48 00:02:34,720 --> 00:02:38,760 Speaker 1: Peter out at bees Creek, who actually contracted meliadosis earlier 49 00:02:38,800 --> 00:02:42,720 Speaker 1: this year. He lost his spleen I believe as a 50 00:02:42,760 --> 00:02:44,880 Speaker 1: result of it and gone through a really tough patch. 51 00:02:44,960 --> 00:02:47,640 Speaker 1: You know, he's in intensive care I think for five 52 00:02:47,680 --> 00:02:50,960 Speaker 1: weeks or in a really bad way for quite a while. 53 00:02:51,000 --> 00:02:53,160 Speaker 1: And I think it was actually a bit of an 54 00:02:53,160 --> 00:02:56,680 Speaker 1: eye opener for myself and for all of our listeners 55 00:02:56,800 --> 00:02:58,160 Speaker 1: just how serious this can be. 56 00:03:00,080 --> 00:03:01,760 Speaker 2: Yeah, So I think the thing is we have deaths 57 00:03:01,800 --> 00:03:05,240 Speaker 2: every year from meliodosis. But I guess the good news, 58 00:03:05,760 --> 00:03:08,400 Speaker 2: if there is good news, is that there's a lot 59 00:03:08,440 --> 00:03:11,400 Speaker 2: more awareness of meloidosis in the public but also in 60 00:03:12,040 --> 00:03:15,919 Speaker 2: our health staff. So where in earlier years people who 61 00:03:15,919 --> 00:03:19,239 Speaker 2: went to ICU the vast majority would die from meloidosis, 62 00:03:19,320 --> 00:03:21,600 Speaker 2: now even though people may be critically ill and go 63 00:03:21,639 --> 00:03:24,320 Speaker 2: to ICU, we would hope that the majority of those 64 00:03:24,400 --> 00:03:27,280 Speaker 2: will still be able to make a recovery. But as 65 00:03:27,280 --> 00:03:29,120 Speaker 2: I said, we did have six deaths over the last 66 00:03:29,160 --> 00:03:29,799 Speaker 2: twelve months. 67 00:03:29,919 --> 00:03:32,760 Speaker 1: Yeah, Professor Curry, what are the things that people need 68 00:03:32,800 --> 00:03:35,200 Speaker 1: to look out for and what's the advice to those 69 00:03:35,360 --> 00:03:38,320 Speaker 1: listening this morning, you know, to try to protect ourselves. 70 00:03:39,280 --> 00:03:41,400 Speaker 2: Yes, So the thing is that we do focus on 71 00:03:41,520 --> 00:03:44,600 Speaker 2: people who have the risk factors for becoming more severely 72 00:03:44,640 --> 00:03:48,360 Speaker 2: and ill once they get infected. So those people are 73 00:03:48,840 --> 00:03:51,680 Speaker 2: adults more than children, and particularly older people. But the 74 00:03:52,000 --> 00:03:54,960 Speaker 2: particular groups that we are concerned about are people who 75 00:03:55,040 --> 00:04:00,480 Speaker 2: have diabetes, people who have excess alcohol use, particularly binge drinking, 76 00:04:00,800 --> 00:04:04,760 Speaker 2: and people with chronic lung and chronic kidney disease. Also 77 00:04:04,880 --> 00:04:09,240 Speaker 2: people who are on immune suppressing drugs for various things, 78 00:04:09,240 --> 00:04:13,320 Speaker 2: particularly if they're on high dose steroids for various conditions. 79 00:04:13,320 --> 00:04:15,480 Speaker 2: They're all the people who once they get infected with 80 00:04:15,520 --> 00:04:19,000 Speaker 2: these bacteria, the immune system can't deal with it, and 81 00:04:19,000 --> 00:04:22,839 Speaker 2: the bacteria can then spread fairly quickly, causing blood poisoning 82 00:04:22,920 --> 00:04:25,520 Speaker 2: and then the more severe sepsis as we call it 83 00:04:25,520 --> 00:04:26,200 Speaker 2: that people have. 84 00:04:27,000 --> 00:04:28,960 Speaker 1: What should people do if they think they have it? 85 00:04:30,279 --> 00:04:34,039 Speaker 2: Yeah, So the first thing is that the presentations of 86 00:04:34,080 --> 00:04:37,080 Speaker 2: meloidosis are quite vary, but around half of people have 87 00:04:37,160 --> 00:04:41,320 Speaker 2: a respiratory infection which can lead to pneumonia, so basically 88 00:04:41,360 --> 00:04:44,200 Speaker 2: cough and fever. Some people will have just fevers alone, 89 00:04:44,680 --> 00:04:47,640 Speaker 2: and then some people can have non healing skin saws 90 00:04:47,680 --> 00:04:50,120 Speaker 2: that may not respond to the standard of antibiotics that 91 00:04:50,160 --> 00:04:54,720 Speaker 2: their GP gives them. All of those situations, if people 92 00:04:54,760 --> 00:04:58,200 Speaker 2: are thinking about meloidosis, then we strongly recommend they go 93 00:04:58,279 --> 00:05:02,400 Speaker 2: to their primary care or if they're particularly and well, 94 00:05:02,440 --> 00:05:05,320 Speaker 2: go to the emergency department. And the doctors and nurses 95 00:05:05,360 --> 00:05:07,240 Speaker 2: in the top end are well aware of the tests 96 00:05:07,279 --> 00:05:10,160 Speaker 2: that need to be done, so we can now diagnose 97 00:05:10,200 --> 00:05:12,840 Speaker 2: it much more quickly than we used to be able 98 00:05:12,880 --> 00:05:15,400 Speaker 2: to do, and that enables us to then give the 99 00:05:15,480 --> 00:05:19,960 Speaker 2: right therapy, which is quite a complicated therapy requiring hospitalization. 100 00:05:20,680 --> 00:05:24,839 Speaker 2: So basically, seeking medical attention is important. And each year 101 00:05:24,880 --> 00:05:28,719 Speaker 2: we hear from down South people who have got meliodosis 102 00:05:28,800 --> 00:05:30,920 Speaker 2: up in the top end. They may have been someone 103 00:05:30,960 --> 00:05:33,080 Speaker 2: who's a local here who's gone down to visit family, 104 00:05:33,200 --> 00:05:35,520 Speaker 2: or someone who's been up here as a tourist, and 105 00:05:35,560 --> 00:05:39,080 Speaker 2: it's not, unfortunately not uncommon for those people to not 106 00:05:39,240 --> 00:05:42,720 Speaker 2: be diagnosed when they're down south because many of our 107 00:05:42,760 --> 00:05:45,440 Speaker 2: colleagues they have never heard of melodosis. It's really very 108 00:05:45,480 --> 00:05:47,440 Speaker 2: much a Northern Australian thing. 109 00:05:47,800 --> 00:05:51,400 Speaker 1: Yeah, goodness mate. I mean, look, living in the tropics 110 00:05:51,440 --> 00:05:53,680 Speaker 1: is a wonderful thing for so many reasons, isn't it 111 00:05:53,720 --> 00:05:56,080 Speaker 1: reveressa curry? But gee, we've got a few things we've 112 00:05:56,080 --> 00:05:58,160 Speaker 1: got to keep a lookout for, and I always seem 113 00:05:58,200 --> 00:06:00,679 Speaker 1: to talk to you about those different things. 114 00:06:02,040 --> 00:06:05,320 Speaker 2: Yeah, look, I think what I should have mentioned, like 115 00:06:05,360 --> 00:06:07,200 Speaker 2: what people should actually be doing to avoid it now 116 00:06:07,920 --> 00:06:10,440 Speaker 2: when the rain start coming. And the main thing is that, 117 00:06:10,480 --> 00:06:13,640 Speaker 2: particularly if you're one of those risk groups, it's very 118 00:06:13,640 --> 00:06:18,400 Speaker 2: important that you avoid exposure to wet season soil and water. 119 00:06:18,920 --> 00:06:22,000 Speaker 2: So if you we'd recommend if you're in a risk group, 120 00:06:22,120 --> 00:06:24,520 Speaker 2: not to be gardening. But if you do feel you 121 00:06:24,560 --> 00:06:28,400 Speaker 2: absolutely need to garden, definitely wear footwear, sturdy footwear and gloves. 122 00:06:28,880 --> 00:06:30,680 Speaker 2: And if you have any cuts or anything like that, 123 00:06:30,680 --> 00:06:33,160 Speaker 2: then they need to be washed or covered to avoid 124 00:06:33,360 --> 00:06:35,800 Speaker 2: soil exposure. But if you do have exposures of soil, 125 00:06:35,839 --> 00:06:39,880 Speaker 2: then vigorously wash any cuts that happen. And the other 126 00:06:39,920 --> 00:06:43,280 Speaker 2: thing that we're recommending is that when we get the 127 00:06:43,600 --> 00:06:47,680 Speaker 2: pre cyclonic heavy winds and rains. People in those risk groups, 128 00:06:47,760 --> 00:06:51,279 Speaker 2: we strongly recommend they stay inside because we have in 129 00:06:51,360 --> 00:06:54,479 Speaker 2: our work at Menzies shown that during those periods of 130 00:06:54,480 --> 00:06:58,200 Speaker 2: heavy winds and rain, the bacteria get aerosolized, and so 131 00:06:58,240 --> 00:07:01,320 Speaker 2: people can actually breathe in the bacteria and that leads 132 00:07:01,320 --> 00:07:03,920 Speaker 2: to a much more rapid onset of disease and they 133 00:07:03,960 --> 00:07:07,280 Speaker 2: can very quickly get a severe pneumonia and then blood poisoning. 134 00:07:07,640 --> 00:07:11,600 Speaker 2: So that inhalation of the bacteria during those windy, rainy 135 00:07:11,640 --> 00:07:15,120 Speaker 2: events is something that we worry about every year. So 136 00:07:15,480 --> 00:07:20,400 Speaker 2: definitely stay inside in those conditions, or if absolutely people 137 00:07:20,440 --> 00:07:23,440 Speaker 2: have to go out to do something, then wear a mask. 138 00:07:23,520 --> 00:07:26,720 Speaker 2: And I think the other group of people that we've 139 00:07:27,840 --> 00:07:30,840 Speaker 2: found in the last couple of years, and we've had 140 00:07:30,880 --> 00:07:32,720 Speaker 2: a few each year for the last few years, are 141 00:07:32,760 --> 00:07:36,920 Speaker 2: people using high pressure hosing, and that is, for instance, 142 00:07:37,040 --> 00:07:40,720 Speaker 2: high pressure hosing to clean their driveways or the yard 143 00:07:41,480 --> 00:07:43,680 Speaker 2: or clean mud off cars if the cars has been 144 00:07:43,720 --> 00:07:47,160 Speaker 2: out in the mud. And we're getting cases of people 145 00:07:47,240 --> 00:07:51,160 Speaker 2: who have inhalational melodosis from high pressure hosing where the 146 00:07:51,600 --> 00:07:56,680 Speaker 2: pressure from the water jet is basically aerosolizing the muddy 147 00:07:56,720 --> 00:07:59,600 Speaker 2: areas on the path or the mud on the car 148 00:07:59,680 --> 00:08:03,120 Speaker 2: and then people are then breathing it in. So particularly 149 00:08:03,160 --> 00:08:06,400 Speaker 2: if you're in those risk groups, we'd recommend no high 150 00:08:06,400 --> 00:08:08,400 Speaker 2: pressure hosing. But if you are high pressure hosing, then 151 00:08:08,400 --> 00:08:11,840 Speaker 2: wear a mask again and that way you might avoid 152 00:08:12,200 --> 00:08:14,640 Speaker 2: breathing in the bacteria. That's our small number of patients, 153 00:08:14,680 --> 00:08:17,559 Speaker 2: but they can be very unwell because it's going straight 154 00:08:17,600 --> 00:08:18,400 Speaker 2: into the lungs. 155 00:08:18,600 --> 00:08:20,760 Speaker 1: And look, it just goes to show you though, as well, 156 00:08:20,880 --> 00:08:23,640 Speaker 1: how important that research is that you guys do at 157 00:08:23,640 --> 00:08:26,520 Speaker 1: the Men'sie School of Health, because, as you touched on before, 158 00:08:26,520 --> 00:08:29,520 Speaker 1: you know, sometimes when people are then down south, they 159 00:08:29,560 --> 00:08:32,560 Speaker 1: may not get diagnosed properly because they don't actually have 160 00:08:32,640 --> 00:08:34,480 Speaker 1: to deal with things like this like we do in 161 00:08:34,480 --> 00:08:37,000 Speaker 1: the tropics. But even you know, with what you're just 162 00:08:37,040 --> 00:08:39,520 Speaker 1: talking about then with the high pressure hosing, you know, 163 00:08:39,720 --> 00:08:41,760 Speaker 1: for a lot of people, if you guys weren't doing 164 00:08:41,760 --> 00:08:44,000 Speaker 1: that research, it may not even be something that they 165 00:08:44,000 --> 00:08:46,360 Speaker 1: were aware of. So I think it's really good advice 166 00:08:46,400 --> 00:08:49,880 Speaker 1: for territorians out there listening this morning, particularly if you 167 00:08:49,920 --> 00:08:53,120 Speaker 1: are in those different groups that are at risk. 168 00:08:55,000 --> 00:08:56,960 Speaker 2: Yeah, look, I think I think the other thing that 169 00:08:57,000 --> 00:08:59,960 Speaker 2: we've learned is that we can reassure parents that if 170 00:09:00,040 --> 00:09:02,760 Speaker 2: your kids healthy, the kids can be kids up here, 171 00:09:02,800 --> 00:09:05,400 Speaker 2: and you know, they're all playing sport on the ovals 172 00:09:05,400 --> 00:09:07,640 Speaker 2: which are muddy and wet, and they're out in their 173 00:09:07,760 --> 00:09:12,760 Speaker 2: yards playing around, and we you know, quite a few 174 00:09:12,800 --> 00:09:15,560 Speaker 2: years ago we were worried, well, what advice should we 175 00:09:15,600 --> 00:09:17,959 Speaker 2: be giving parents about kids? And I think the advice 176 00:09:18,440 --> 00:09:21,199 Speaker 2: we're now saying is kids can be kids up here 177 00:09:21,280 --> 00:09:24,320 Speaker 2: and enjoy themselves. Obviously you don't want them playing their 178 00:09:24,360 --> 00:09:28,240 Speaker 2: stormware to drains and things like that. But I think 179 00:09:28,240 --> 00:09:32,119 Speaker 2: the thing is that it's only children who have underlying 180 00:09:32,360 --> 00:09:34,480 Speaker 2: illnesses which the parents are well aware of, that need 181 00:09:34,520 --> 00:09:37,079 Speaker 2: to take the same precautions as those adults with those 182 00:09:37,160 --> 00:09:41,120 Speaker 2: risk factors. So and that's very much a minority of kids. 183 00:09:41,960 --> 00:09:44,280 Speaker 2: What happens, though, is every year we might have one 184 00:09:44,360 --> 00:09:48,320 Speaker 2: or two children who get meleadosis. Healthy kids, but it 185 00:09:48,400 --> 00:09:50,959 Speaker 2: is just a skin sow that's not healing, rather than 186 00:09:51,360 --> 00:09:53,920 Speaker 2: it's spreading into throughout. You know, they don't get the 187 00:09:53,920 --> 00:09:56,319 Speaker 2: blood poisoning that we see in the in the older 188 00:09:56,320 --> 00:09:59,080 Speaker 2: people with the risk factors. So I guess that's been 189 00:09:59,200 --> 00:10:02,400 Speaker 2: a helpful thing to reassure parents that it's not the 190 00:10:02,480 --> 00:10:04,599 Speaker 2: kids that they need to give you the messages, Sue it. 191 00:10:04,679 --> 00:10:07,080 Speaker 2: It's the older people in the community and those who 192 00:10:07,120 --> 00:10:10,120 Speaker 2: are living with one of those conditions which does affect 193 00:10:10,120 --> 00:10:11,040 Speaker 2: their immune system. 194 00:10:11,400 --> 00:10:14,960 Speaker 1: Really good advice Doctor bart Curry or Professor Bart Curry. 195 00:10:14,960 --> 00:10:18,000 Speaker 1: I should say, I always appreciate our chats. You are 196 00:10:18,000 --> 00:10:20,720 Speaker 1: a wealth of knowledge and I love the passion behind 197 00:10:20,760 --> 00:10:22,760 Speaker 1: what you do as well. Thank you so very much 198 00:10:22,800 --> 00:10:24,080 Speaker 1: for your time this morning. 199 00:10:24,880 --> 00:10:26,839 Speaker 2: Oh You're most welcome. Thanks so much, great to speak 200 00:10:26,840 --> 00:10:27,000 Speaker 2: with you. 201 00:10:27,200 --> 00:10:27,960 Speaker 1: Thank you