Topical and tropical - health issues in refugee background children

Robert Norton^1,2
1Townsville University Hospital
²Faculty of Medicine, University of Queensland, Brisbane

Burkholderia pseudomallei ,the causative agent of melioidosis. causes significant morbidity and mortality in tropical and subtropical regions including Northern Australia. Modelling estimates suggest that at least 169,000 cases a year are seen worldwide with up to 85,000 deaths. This talk will summarise the current knowledge as it relates to this disease. Culture remains the mainstay of diagnosis. There have been recent advances in using the MALDI-TOF (Vitek MS or Bruker) as the sole method of identification. This enables high diagnostic accuracy of B. pseudomallei isolates within minutes. Moreover, methodology exists to utilise this instrument for organism identification directly from blood cultures. There is interest in a recently developed lateral flow antigen assay for the direct detection of the organism from clinical samples. Direct molecular detection from blood , without culture amplification,,remains challenging. There has been progress in the development of peptide based vaccines and outer membrane vesicle candidates. The organism is a Tier 1 agent in the United States. In Australia it is a Risk Group 2 agent. requiring handling in a BSL 2 cabinet. The risk of transmissibility within laboratories in Australia has been shown to be negligible.

Megan Staples¹

¹Supervising Scientist Leptospirosis Reference Laboratory, Queensland Health and WHO Collaborating Centre for Reference and Research on Leptospirosis (Western Pacific Region)

Leptospirosis is a widespread bacterial zoonoses of global importance and is a notifiable disease in all states and territories of Australia. The Queensland Health Leptospirosis Reference Laboratory located in Brisbane, Australia is also a World Health Organisation Collaborating Centre for Reference and Research on Leptospirosis and provides leptospirosis diagnostic testing and associated support for Australia and the broader Western Pacific Region. 

Leptospiral diagnostics are complex due to the biphasic nature of leptospirosis disease and require clinical consideration around testing requests. Acute phase diagnostics are largely based around the detection of the organism through culture and molecular methods, whereas convalescent phase diagnostics rely predominately on serological techniques. Typing of leptospiral infections allows for further insights into the likely source of infection, potential outbreak linkages and provides valuable epidemiological information for leptospirosis in our region.

This presentation will focus on leptospirosis diagnostics and associated typing, in addition to epidemiologic trends and characteristics, covering both current capabilities and future direction potential as shaped by ongoing research in the genomics space.