Melioidosis in the Torres Strait islands of far North Queensland

During the six-year period from 1995 to 2000, 23 cases of melioidosis were diagnosed from the Torres Strait islands that lie between northern Queensland and Papua New Guinea. This represents an average annual incidence of 42.7 per 100,000 population, the highest documented to date in this region. This probably reflects the extremely high prevalence of diabetes, the high seasonal rainfall in the area, and the lifestyle of Torres Strait Islanders. The majority of patients (20 out of 23) acquired their disease in one of the more remote outer island indigenous communities. Most patients presented with a community-acquired pneumonia or with deep seated abscesses. One patient presented with the first case of suppurative parotitis due to melioidosis recorded in Australia. Diabetes was the overwhelming risk factor, being present in over three-quarters of all cases. Five patients (22%) died. Strategies to try to minimise illness and death due to melioidosis in the Torres Strait are discussed.