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 Mahamad Rodzi Abdul Ghani
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 Silent killer lurks in undiagnosed soil disease

KUALA LUMPUR, Nov 21 -Many Malaysians may be dying every year ofmelioidosis, a soil disease caused by bacteria that killed 24 people inSingapore this year.But it remains a guess how many people succumb to the disease. The reason:Melioidosis is not a notifiable disease here. Therefore, medical officersand doctors do not have to inform the Health Ministry when their patientsdie of the disease.

Statistics, when available, do not tell the whole story.

Professor S.D. Puthucheary, a senior consultant in Medical Microbiology atthe University of Malaya Medical Centre, said of melioidosis: "It remainsgreatly under-diagnosed due to the lack of awareness and diagnosticfacilities for isolation and confirmation." The disease was endemic inMalaysia, with many cases reported in Sabah, Sarawak, Terengganu, Kelantanand Pahang.

Statistics obtained by the New Straits Times showed that over the past fewyears, an average of 35 cases have been reported annually in Sabah, halfof them resulting in death.

Melioidosis is mainly found in Southeast Asia and northern Australia andis caused by the soil bacteria rising to the surface during heavy rainfalland mixing with water. The bacteria enter the body when bruised skin comesinto direct contact with contaminated soil or water.

Symptoms include fever, pneumonia, anorexia, chest pains and musclesoreness.

There is no vaccine but it can be treated with antibiotics if detectedearly. Diagnosis is done by a microscopic evaluation of a saliva sample.

An average 67 melioidosis cases and 12 deaths, or a mortality rate of 18per cent, have been reported annually in Singapore over the past 10 years.

In Malaysia, Puthucheary said, the presence of antibodies to the bacteriawas found in 1.9 per cent to 15.8 per cent of rubber and oil palmplantation workers, army engineers and healthy army recruits.

Detectable antibodies to the bacteria were also found in 17 per cent to 22per cent of farmers and 26 per cent of healthy blood donors in thecountry, suggesting prior exposure to the organism.

Infection was usually higher among young people due to greater exposure tosoil during play or outdoor activities.

Associate Professor Dr Sheila Nathan of Universiti Kebangsaan Malaysia'sSchool of BioSciences and Biotechnology said the bacteria survived bothdry and wet seasons in the clay layer of the soil and were brought to thesurface and distributed by the seepage of water during the wet season.

Besides humans, she added, many animals were susceptible to infection,including sheep, goats, horses, pigs, dogs and cats.

A UKM study revealed that 30 to 40 per cent of the population wassero-positive, meaning that at some point in their lives they had beenexposed to the bacterium.

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