Annual Report 2003/2004 Menzies School of Health Research
Tabled paper 1523
Tabled Papers for 9th Assembly 2001 - 2005; Tabled papers for 9th Assembly 2001 - 2005; Tabled papers; ParliamentNT
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The climate, landscape and lifestyle of the tropics lures residents and visitors to enjoy the great outdoors. While enjoying our land and coast, its important to remember we share this environment with some of the deadliest wildlife in the world. Toxinology research at MSHR is currently undertaking work involving jellyfish and venomous snakes which are common to Australias Top End. With the assistance of Royal Darwin Hospital Emergency Department and Gove Surf Life Saving Club, we continue to monitor the occurrence and type of jellyfish in the waters of the Top End of the Northern Territory. This data is important to ensure distribution of timely public health warnings. We also continue to update our collection of snakes and document all snakebite envenomings in the Top End. Clinical symptoms of each of the Top Ends dangerous snake species have been defined to allow accurate and expedite identification of snakebites. 12 | Infectious Diseases Division | Menzies School of Health Research 2003 Annual Report Tropical Toxinology MSHR 2003 Research & Education Report provides detail on all research projects and is available online at www.menzies.edu.au Key achievements A new treatment for Irukandji jellyfish stings using intravenous magnesium has been successfully used at the Royal Darwin Hospital following its first use in Queensland. Description of stings from a new jellyfish species found on the Gove Peninsula. Elucidation of the brown snake paradox why neurotoxicity is uncommon despite the presence of a potent neurotoxin in brown snakes. Melioidosis is a potentially fatal disease caused by infection from the bacterium Burkholderia pseudomallei. The bacteria can be found in soil and surface water in tropical areas, usually after heavy rainfall. Reported incidence of melioidosis is on the rise within endemic regions of South-East Asia and throughout Australias Top End. In the Northern Territory, up to 40 people are infected each year, usually during the monsoonal wet season, causing death in one-fifth of all cases. Those most likely to contract melioidosis have specific risk factors which affect their immunity. The most important risk factor is diabetes, followed by heavy alcohol intake, chronic lung disease, such as seen in heavy smokers, and chronic kidney disease. The high mortality rate from this disease, combined with the increase in the number of diagnosed cases, makes it vitally important that our understanding of this serious tropical disease is improved. Better recognition and treatment of melioidosis through our research over recent years has resulted in the death rate being halved in northern Australia from 40% to 18%. The work of our team will continue to advance knowledge of the incidence, distribution and control of melioidosis, to further improve preventative measures, early diagnosis and effective treatment methods. Melioidosis & Emerging Infectious Diseases Demonstrated a strong link between heavy monsoonal rain and increased severity of melioidosis. The study, which examined rainfall data and cases of melioidosis that occurred in the Top End over a 12-year period, found that patients admitted with melioidosis one to two weeks after heavy monsoonal rainfall and high winds were more ill and 2.5 times more likely to die. This same study suggests that the more severe cases of melioidosis seen after heavy rains and winds may be from people inhaling the bacteria directly into their lungs, resulting in pneumonia and blood poisoning. This is of particular interest as most cases of melioidosis are thought to be acquired when the bacteria enters the body through soil or surface water contamination of cuts and sores. Research in the Top End into the importance of potable water as a source of melioidosis has confirmed that melioidosis bacteria is not uncommonly present in bore water. Use of new DNA fingerprinting methods developed specifically for the melioidosis bacteria to better understand why melioidosis can be such a severe disease and how it spreads from the environment to humans and animals. This new project will hopefully result in new primary preventative measures. Continued research in the use of GCSF (a naturally occurring substance produced by humans and animals in response to infections) for use as an adjunct to antibiotics in the treatment of severe melioidosis. Publication of a proposed scoring system to help clinicians identify patients at risk of death from melioidosis. Key achievements
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