Local medical researchers and scientists are acknowledging that the death rate for melioidosis in the country may be higher than the figure for dengue related deaths.
Head of Genetech Research Institute, Dr. Dharshan de Silva pointed out that while some would argue that based on the rising number of cases being detected that the disease had indeed reached epidemic proportions in Sri Lanka, it was more factually accurate to say that the disease was under-reported and under-diagnosed.
Burkholderia pseudomallei is the natural saprophytic soil bacterium which causes the infectious disease melioidosis.
According to Dr. De Silva, the disease mostly affected farmers, in particular paddy growers. It is suspected that it is through cut wounds and unapparent abrasions that individuals are infected.
The infection is acquired accidentally, during occupational, recreational or lifestyle exposure to soil, mud or water containing the bacterium which enters the body by percutaneous inoculation, inhalation or ingestion.
He said the infection occurs in all age groups, including children and in both sexes though the highest incidence is seen in middle aged males of 40-50 years, living in rural areas.
Persons with occupational exposure to soil, such as farmers and cultivators and house or road construction workers are at special risk, as are personnel in the Police and defence forces according to Dr. De Silva.
There is an increased incidence among three-wheeler drivers and motorcyclists due to exposure to dust and in persons affected by flooding. The custom of walking barefoot and using natural sources of water for drinking and bathing in tanks and rivers may also contribute to the increased risk of infection.
A large number of cases have been found in Batticaloa and elsewhere in the districts of Kurunegala, Puttalam, Gampaha, Badulla and Kandy while cases have been reported from all the provinces. Cases are also found in Australia and Thailand.
Symptoms include fever lasting between four to six days or even longer. Patients test negatively for dengue. Apart from protracted fever, there would be an abscess or abscesses on the body of the patient.
Melioidosis may involve any system and is often multifocal. Clinical presentation ranges from severe to mild and from acute to chronic. Typical presentations include fulminant septicaemia, severe community acquired pneumonia or lung abscess, single or multiple abscesses of the superficial or deep tissues including liver, spleen, kidney and cerebral abscess, musculoskeletal disease such as abscess of the psoas muscle, septic arthritis or osteomyelitis, skin and soft tissue abscesses and skin infection, genitourinary infection and lymph node abscess and suppuration.