Latest news with #tropicaldisease
Daily Mail
11-07-2025
- Health
- Daily Mail
Footy legend Sam Backo is unrecognisable in intensive care as he battles life-threatening tropical disease that has killed 34 Aussies this year alone
Footy legend Sam Backo is in the fight of his life in hospital after being diagnosed with melioidosis earlier this year. The tropical disease has killed 34 Aussies this year - and the cult-hero prop, who played seven matches for Queensland - watched Wednesday's Origin decider from the intensive care unit at Cairns Hospital. 'I'm very grateful for my wife, who's been beside me through this journey...(and) all my family that have been praying for me,' Backo, 64, told the ABC. 'That's all they can really do.' Backo - who has been in hospital since April - believes he was infected following a swim in Freshwater Creek at Goomboora Park in Cairns. Backo's diagnosis also comes after he suffered a massive heart attack in 2023, which saw the former front-rower placed in an induced coma. At the time, Rugby league Immortal Wally Lewis, a former teammate of the man known as 'Slammin Sam', said the enforcer was 'unstoppable' up front. Backo recently revealed he was over the worst of the melioidosis - but given his other medical dramas, doctors urged him to 'get his affairs in order'. 'I previously said to them (family), "When your time's up, your time's up" — but I've had a rethink,' he said. Australia has been hit with an unprecedented increase in melioidosis cases this year. The disease, which is caused by bacteria lurking in mud and dirty water, is seasonal in nature, with cases often occurring during wet season when there has been heavy rain or flooding, such as that seen across Queensland during autumn. Those with underlying health conditions like diabetes and lung disease, along with people who drink a lot of alcohol, are urged to take precautions. Symptoms include fever, pneumonia, exhaustion, vomiting, abdominal pains and chest pressure. 'I have 16 beautiful grandchildren, I want to see them grow up into strong people.' 'He was such a dominant prop. Sam just destroyed everyone in front of him. Sam was the size of a cement truck and he made the most of it,' he said. 'That dominating period for Sam, in the late 1980s, probably gave Queensland dominance in size for the first was unstoppable. 'He certainly drew plenty of love and support from the indigenous community. He was a very proud representative of that community.' Backo played 134 first grade matches between 1983 and 1990 - 114 for the Canberra Raiders and 20 for the Brisbane Broncos. He was named in the Indigenous Australian team of the century and was the first Aussie forward to score tries in all three Tests during the Ashes series in 1988. Always a passionate Maroons supporter, Backo copped some grief this week for cheering too loudly while watching Billy Slater's men wrestle back the interstate shield at Accor Stadium. 'One of the nurses came around and roused on me,' he said. 'I tried to keep quiet for the rest of the game.'
ABC News
10-07-2025
- Health
- ABC News
Former State of Origin player Sam Backo in intensive care with melioidosis infection
Former Rugby League front rower Sam Backo continues to fight for his life after contracting the potentially deadly tropical disease melioidosis in Cairns. The 64-year-old watched Wednesday's night's State of Origin clash from the intensive care unit (ICU) at Cairns Hospital. Backo, who represented Queensland seven times between 1988 and 1990, has been in hospital since he was diagnosed with the disease in April. The infection comes two years after he survived a massive heart attack and underwent quadruple bypass surgery. "I'm very grateful for my wife, who's been beside me through this journey … all my family that have been praying for me," Backo said. Melioidosis cases have spiked dramatically in Queensland this year, with 236 notifications and 34 deaths, mostly in the Cairns and Townsville regions, recorded between January 1 and July 6. The 123 notifications in Cairns represented a fourfold increase on the average number of cases for the same period over the previous five years. The disease is caused by Burkholderia pseudomallei, a soil-dwelling bacterium endemic to tropical and subtropical regions throughout the world. The bacteria is often brought to the surface during flooding or excavations. Melioidosis is primarily contracted via contact with contaminated soil or water, most commonly through cuts or abrasions, but can also be caught through the inhalation of dust or water droplets. Most people who become acutely ill develop symptoms within one to 21 days of exposure, although the disease can lie dormant in the human body for months, years or decades. Backo believes he was infected during a swim in Freshwater Creek at Goomboora Park in the Cairns suburb of Brinsmead. He had a small open sore on his upper buttock at the time. "If anybody knows Goomboora, they'll know it's changed a little bit since the flooding," Backo said. Backo tried to ignore the symptoms when they first appeared. "My wife kept saying to me, 'Darl, I think you should go to the doctor,'" he said. "Then my daughters said I looked a bit grey in colour. After four days of deteriorating health, Backo finally agreed to seek medical help. His wife, Chrissy Warren-Backo, took him to Cairns Hospital and dropped him at the front entrance while she found a park. "I'm leaning on a bollard and an old gentleman and his wife come walking up past me," Backo said. "He's looked at me and he said, 'Mate, are you alright?' "I knew then that something was wrong." Melioidosis can trigger a range of symptoms, including skin infections, ulcers and pneumonia. The bacteria can also enter the bloodstream and spread to other parts of the body, causing high fever, organ failure and septic shock. Backo's condition has been complicated by his heart attack, which led to him being placed into an induced coma for 12 days. He is now waiting for a bed at Prince Charles Hospital in Brisbane so he can have his implantable cardioverter defibrillator upgraded to a pacemaker. Backo said he was over the worst of the melioidosis but, given his other medical conditions, doctors had spoken with him about "getting [his] affairs in order" in case the worst happened. "I previously said to them, you know, 'When your time's up, your time's up' — but I've had a rethink," he said. "I have 16 beautiful grandchildren. Cairns Hospital and Hinterland Health Service tropical health services director Jacqui Murdoch said melioidosis was uncommon in healthy adults, and rarely seen in children. But she said it occasionally occurred in people with pre-existing medical conditions such diabetes or those with kidney or lung problems, or in people on medication that lowered the immune system. Dr Murdoch urged anyone who may be at higher risk to take precautions to avoid infection. "Try not to work outside if it's raining, control your diabetes and try to reduce your alcohol intake," she said. "When you go outside, wear protective footwear and gloves, wash your skin thoroughly after exposure to soil or muddy water, and wear a mask if you're using a hose or high-pressure cleaner around soil. Backo awoke feeling relatively chipper on Thursday morning after Queensland's textbook State of Origin win. But the former Canberra Raider did cop some strife for cheering too loudly while watching the game. "One of the nurses came around and roused on me," Backo said. "I tried to keep quiet for the rest of the game." He said the medical staff at Cairns Hospital were his "angels". "They're the ones that have been saving me the whole way through," Backo said.
Yahoo
02-07-2025
- Health
- Yahoo
Meet the Oropouche virus. It may be visiting your city soon.
Oropouche virus disease was a relatively rare illness for decades, lurking on the margins of tropical rainforests in the Caribbean and South America. Sporadic reports of an infection causing fevers, coughs, chills, and body aches emerged among people living near or moving into the jungle. A tiny insect called a midge spreads the disease, and the earliest known case dates back to 1955 in a forest worker near a village called Vega de Oropouche in Trinidad. Since most people who were infected with the virus recovered on their own and since cases were so infrequent, it barely registered as a public health concern. But a few years ago, something changed. A major Oropouche fever outbreak beginning in 2023 infected at least 23,000 people across Bolivia, Brazil, Colombia, Cuba, the Dominican Republic, and Peru. It wasn't just confined to remote wilderness areas but was spreading in metropolises like Rio de Janeiro. In some cases, travelers were infected and then brought the virus home: So far, Oropouche fever has sprung up in the US, Canada, and Europe in people returning from the afflicted region. The outbreak has killed at least five people. The sudden rise of Oropouche disease startled scientists and health officials. Since its discovery, there have only been around 500,000 known cases. By contrast, there are upward of 400 million dengue infections each year. It's likely then that many more Oropouche infections have gone undetected, especially since its symptoms overlap with those from other diseases and there's little active screening for the virus. What Oropouche fever is, how you can identify it, and what spreads the disease. What researchers know about the startling outbreak across South American in 2023 and 2024. The threat the disease's spread poses to the United States. Now, researchers are looking back at the outbreak to try to find out what they missed and what lessons they can apply to get ahead of future epidemics. Oropouche virus is a critical case study in the complicated factors that drive vector-borne diseases. Dynamics like deforestation, urban sprawl, international travel, and gaps in surveillance are converging to drive up the dangers from infections spread by animals. And as the climate changes, new regions are becoming more hospitable to the blood suckers that spread these diseases, increasing the chances of these seemingly-remote infections making it to the US and getting established. That means more people will face threats from illnesses that they may never have considered before. 'It's very likely that these public health problems that people before called 'tropical disease' are not so tropical anymore and are basically everywhere,' said William de Souza, who studies arboviruses — viruses spread by arthropods like insects — at the University of Kentucky. 'Vector-borne disease is not a local problem; this is a global problem.' The rising specter of Oropouche fever comes at a time when the United States is cutting funding for research at universities, pulling back from studying vector-borne disease threats, and ending collaborations with other countries to limit their risk. The Oropouche virus belongs to the family of bunyaviruses. They appear as spheres under a microscope, and they encode their genomes in RNA, rather than DNA as human cells do. RNA viruses tend to have high mutation rates, making it harder to target them with vaccines and increasing the odds of reinfection. Oropuche's relatives include the viruses behind Crimean-Congo hemorrhagic fever, spread by ticks, and Rift Valley fever, spread by mosquitoes. 'Vector-borne disease is not a local problem; this is a global problem.' William de souza Oropouche spreads mainly through the bites of a 1- to 3-millimeter-long insect called, appropriately, a biting midge (Culicoides paraensis). Midges are sometimes called sand flies or no-see-ums in the US, and they breed in damp soil, rotting vegetation, and standing water. Like mosquitoes, they feed on blood to drive their reproduction, but their minuscule bodies can easily slip through mosquito nets. When a midge bites an infected host, it can pass on the pathogen to a human during a subsequent bite. There's also evidence that the virus may be sexually transmissible, but no such cases have been documented yet. The Centers for Disease Control and Prevention recommends that male travelers from regions where Oropouche is spreading should not have sex for six weeks if they show symptoms of the disease. Vector-borne diseases like Oropouche continue to surprise us because there are so many variables that have to align in order to spread them — the pathogens, the vectors, the hosts, and the environment. Unlike diseases like Covid-19 or influenza, vector-borne illnesses don't spread directly from person to person. Instead, they require an animal, often arthropods like ticks, midges, and mosquitoes. The range, reproduction, and behavior of these organisms add another confounding factor in the spread of the diseases they carry. Globally, vector-borne diseases account for 17 percent of infectious diseases, leading to more than 700,000 deaths per year, according to the World Health Organization. But not every part of the world is equally vulnerable. In cooler regions, vector-borne infections are often a minor public health concern, but in countries like Brazil, 'it's at the top,' said Tatiane Moraes de Sousa, a researcher at the Oswaldo Cruz Foundation (Fiocruz) in Rio de Janeiro. 'Oropouche before 2024 was concentrated just in the Amazon. Last year, we saw the spreading of Oropuche in almost all Brazilian states.' That gets to the first obstacle in tracking Oropouche: Which animals are the reservoirs for the virus and where are they? So far, researchers have detected the virus in animals including sloths, capuchin monkeys, marmosets, domestic birds, and rodents. These organisms form what's known as the sylvatic, or forest, cycle of the virus. How the virus jumps between all these animals and which ones are most concerning for people is not known. Additionally, it may be possible that other insects may be able to carry the Oropouche virus, but it's not clear whether they can spread it to humans. The pattern that does emerge is that when people spend more time inside and around the fringes of tropical rainforests, where the animals that harbor the virus and the insects that spread them reside, they're more likely to get infected. With deforestation and development, more people are moving into areas where the disease naturally spreads. 'This is a classical example of how human behavior can lead to the emergence of a pathogen,' said Natasha Tilston, who studies Oropouche virus at the Indiana University School of Medicine. People can travel great distances, and as people move back and forth from the wilderness to cities, they can unwittingly carry viruses like Oropouche. If enough of them gather in cities where vectors are present, they can trigger an urban epidemic cycle as the virus travels from person to midge to person. This was likely the pattern in the 2023–2024 outbreak in major cities in South America. It's also true that more health workers were on guard for Oropouche and thus identified more infections. 'The outbreak is probably a combination of one, there are more cases, and two, we're also looking for a lot more than we did before,' Tilston said, noting that some past outbreaks of dengue may have actually been Oropouche as well. One factor is that the virus likely evolved. Viruses mutate all the time, and most mutations are either inconsequential or detrimental to the virus, slowing or stopping its reproduction. But occasionally, a change can confer an advantage or make the pathogen more destructive. The Oropouche virus has a genome structure that makes it even more prone to a type of mutation called reassortment. 'Reassortment is when you have two similar viruses infect the same cell and they mix genomes,' explained University of Kentucky's de Souza. 'People previously infected by the old virus are now susceptible to new infection. This could help explain why the Amazon region, where this has been circulated for a long time, saw this emerge, because people were probably reinfected.' The strain behind the outbreak appears to reproduce faster and cause more severe illness than prior varieties as well. Part of the reason this outbreak racked up so many infected people is that health officials were starting to deploy the tools to identify on a wider scale. Particularly in the wake of the Covid-19 pandemic, more health departments across the region built up their tools to detect viruses. But researchers still aren't sure exactly what spurred the virus to spread so suddenly across so many countries. Travel restrictions imposed during the Covid-19 pandemic started relaxing in 2023 and made it easier for people to move back and forth from the rural areas where the virus is endemic to the cities where it became established. The 2023–2024 outbreak also coincided with a powerful El Niño event that brought gargantuan amounts of rain and triggered unprecedented flooding across many parts of South America. These were also years that set new temperature records. Higher temperatures can speed up the reproduction of the virus inside midges. But scientists aren't exactly sure how this heat and water affected the vectors, though Brazil has seen outbreaks of other infectious diseases in the aftermath of floods. 'El Niño and other climate phenomena have been associated with the change of the patterns of many different vector-borne diseases,' de Souza said. 'For Oropouche specifically, we don't have the answers yet, but the likelihood of impact is very high.' On top of all this, there aren't any specific ways to keep an outbreak in check once it ignites. There are no vaccines or treatments for Oropouche fever yet. So when all the factors align to spread the disease, there isn't much people can do to target the disease, and when it reaches a new area, there aren't as many people with immunity and few health workers who know what they're dealing with. Fortunately, the Oropouche outbreak has died down, but a variety of infections are gaining a toehold in new places as infected people travel and as vectors move into new habitats, and the US is increasingly vulnerable. According to the CDC, the number of vector-borne disease cases per year has doubled in the US since 2001. Last year, the US saw transmission of mosquito-borne diseases like Eastern equine encephalitis and West Nile virus. Malaria, a disease once eradicated across the country, saw the first local infections in 20 years in 2023 in Florida and Texas. Vectors like the Asian tiger mosquito are spreading further north as the climate changes and expands favorable conditions for its survival. With travelers moving back and forth from regions where diseases are endemic, many will unwittingly bring back dangerous souvenirs, whether a stowaway insect in their luggage or an infection in their blood. And with midges, mosquitoes, and ticks spreading to new regions, dangerous pathogens are extending their reach. There are ways to slow the spread of these diseases, however, and the US has managed to do so before. The US famously launched a successful campaign to eradicate malaria within its borders. The first step is to simply acknowledge the threat. As Oropouche showed, there may be diseases lurking closer than we realized that we simply haven't bothered to look for. It's fairly simple to do things like dump standing water where insects can breed or spray insecticides on midge breeding grounds. But some places are getting creative, working to build up habitats for fish, bats, birds, and dragonflies that are natural predators of mosquitoes and midges to limit their spread. Limiting the destruction and development in wilderness areas can reduce the likelihood of diseases spilling over from animals into humans. Some regions are looking at even more drastic ways to stymie vectors. One measure that's gaining traction is deploying sterile male mosquitoes. When they mate, they produce eggs that won't hatch, thus reducing the population of the insect. Brazil recently inaugurated a factory that breeds mosquitoes to carry a bacterium known as Wolbachia that prevents the mosquitoes from reproducing easily, slowing the viruses that cause dengue, Zika, and chikungunya, a disease that can cause fever and joint pain, now established in the Americas. Hawaii is using these mosquitoes to arrest the spread of avian malaria. Vaccines and treatments are critical tools for addressing the diseases directly. Many pathogens can be controlled with these measures, but because they more commonly spread in poorer countries, there is less investment in containing them. Many vector-borne diseases like Oropouche are considered 'neglected,' and so when they do spread beyond their typical range, there isn't much available to help those who get sick. But the growing burden of these diseases demands a new generation of tools that can target multiple threats. 'We are seeing so many outbreaks that we need broad vaccines,' said Fiocruz's Sousa. Additionally, vector-borne diseases aren't each waiting for their turns. Countries can have multiple outbreaks at the same time on top of all the other health concerns that emerge during severe weather like extreme heat or the health care disruptions in the wake of a disaster like a major storm. 'We are seeing cumulative threats because we are seeing not just one vector-borne disease,' Sousa said. 'In a lot of scenarios, we are also maintaining high levels of communicable diseases.' Right now, some health departments are being proactive, keeping an eye out for sick travelers, collecting mosquitoes in the wild to see what kinds of germs they're carrying, and coordinating with researchers across the country. 'We've been having biweekly meetings with CDC to talk about the potential for Oropouche coming into the US and spreading,' said Bethany Bolling, zoonotic virology group manager at the Texas Department of State Health Services. 'We've seen in the past that Florida and Texas are some of the primary areas where these new viruses start to establish, so in Texas, we're trying to be aware of Oropouche and what the vectors are.' For the US, Brazil's experience with Oropouche is an important lesson that could help health officials prepare and counter the disease when it inevitably arrives. 'There is a real threat to the United States,' Tilston said. 'I think we have all the right settings, and I think it's just a matter of everything being in the right place at the right time. With climate change, it's just really a matter of when it's going to happen.'
ABC News
24-06-2025
- Health
- ABC News
Cairns hospital patient dies from rare, soil-borne disease melioidosis
A hospital patient in Far North Queensland has died from the rare soil-borne disease, melioidosis. The fatality reported by the Cairns Hospital and Health Service, is the 32nd fatal case of melioidosis recorded in Queensland this year. The patient was diagnosed with the tropical disease at the start of June. Melioidosis is caused by a bacterium found in soil and water in northern Australia. Most cases occur during the wet season or after heavy rain or flooding. Queensland experienced a significantly above-average wet season from October to April. Townsville in particular recorded its highest wet-season rainfall on record. The record-breaking rain has prompted a surge in melioidosis cases with 235 patients diagnosed with the disease in Queensland this year. It's almost four times the number of cases recorded this time last year. In 2024 Queensland Health recorded a total of 81 melioidosis cases. Queensland Health stated that the outbreak of melioidosis peaked in April and, over the past seven days, the state had not recorded any new cases. There is no vaccine to prevent melioidosis, but Queensland Health said people in North Queensland should take care around soil and muddy water. Anyone gardening is urged to wear gloves and footwear, and those using pressure hoses should wear a face mask. Queensland Health data shows 74 per cent of the 235 melioidosis cases detected this year were in people aged 50 or older. Ninety-four per cent of cases were people who were particularly vulnerable to the disease, with underlying health conditions like diabetes and cancer. Symptoms of melioidosis include fever, cough, and difficulty breathing, and sepsis can occur in rare cases.
ABC News
10-06-2025
- Health
- ABC News
Diagnosing scabies in the Pacific could get easier and faster, saving lives
ABC: podcast. You're listening to Pacific Pulse on ABC Radio Australia. Matthew Paxman: Part of the issue with scabies is you get these tiny little skin lesions and also through all the extra scratching your skin's inflamed. So you can get bacterial infections through the skin. Melissa Maykin: Have you ever had to scrub and lather to get rid of those relentless little mites called scabies? Australian scientists are now developing a world first rapid test that can spot scabies in just 10 to 20 minutes, no lab needed, and it even detects common bacterial skin infections. Scabies is a huge public health headache across the Pacific, with around 18 to 20% of people in Fiji, Solomon Islands and other places affected, especially children. For those who can't get rid of the mites, scabies can link to serious complications like secondary infections, heart and kidney disease. Thanks to Melbourne, Australia's Zip Diagnostics and trials held in Darwin, this portable battery powered test could revolutionise how remote communities fight this itchy, neglected tropical disease. To dive into the science, I'm speaking to the company's Scientific Director, Associate Professor Jack Richards, and the company's PhD Research Assistant, Matthew Paxman. Associate Professor Jack Richards: Look, it's an interesting disease in many regards. And so it's been of interest to us, firstly because it's actually a really common disease. It's all throughout the world, and estimates are in the range of 200 to even 500 million cases per year of this disease globally. So it's a very common disease. It's highly prevalent through the Pacific. So some of the countries that have the highest rates of this in the world are in the Pacific. So I think Fijian Vanuatu was recently identified as in the top five countries of the world. It has a huge impact on the quality of life for people. It's actually caused by a mite, a little insect that actually burrows into the skin. And actually, these burrows cause an inflammatory and allergic response and intense itching. So people that get these infections with scabies mites have a huge impact on their life because they're constantly itching, this through the day and the night, and it's unrelenting. That's sort of the impact of it. And then they also are highly at risk of getting secondary bacterial infections, which can be either localised in those same areas because of all the scratching, or they can actually spread and cause bloodstream infections and septicemia, and even special infections of the heart called rheumatic heart disease. From seemingly innocuous little insect that lives on the skin and burrows in the skin, you've got this huge impact globally on health and just the way of life of people. So we think that's a really important issue to deal with. It's what we call a neglected tropical disease because most people in the world are not interested in really dealing with it or don't have the resources to look at this disease because it really occurs in areas of remote communities and low to middle income countries. The people that suffer the most are the poorest people in the world and often don't have the resources and access to health services. Despite being really common and having a huge impact on their life, not many people are helping to address this issue. Yeah, that's sort of part of the reason. And the other one is really that the diagnostics themselves are very poor. Generally speaking, the current approach to this is that healthcare professionals have a look at somebody's skin and they usually make their best guess of whether this is scabies or not. And in some cases, if they've got access to a laboratory or a microscope, they might send off some skin scrapings and try and identify this scabies insect under the microscope. So we think we can offer something to that. Melissa Maykin: Yeah, that's really another side of this whole issue. So what you talked about having secondary illnesses as a result of the scabies, are you able just to explain quickly what happens in the body due to that infection and the kind of secondary issues that can arise? Associate Professor Jack Richards: Yeah, sure. Matt, do you want to? Matthew Paxman: Yeah. So part of the issue with scabies is you get these tiny little skin lesions and also through all the extra scratching, your skin's inflamed. So you can get bacterial infections through the skin from that. So particularly group A strep and staphylococcus aureus, these two bacteria that can grow and cause infections on the skin. So that potentially could cause more severe types of skin lesions, but sometimes they can go deeper into the tissue, into the bloodstream and cause some severe complications like rheumatic fever, rheumatic heart disease, Jack said before. And you get issues such as sepsis and toxic shock, but these conditions are potentially life threatening. So it's really important to control scabies to make sure these bacterias are getting through. The skin needs to stay intact to keep these bacteria that is sometimes commensally on the skin outside of your internal system. Melissa Maykin: Mm. No, thank you for that. It's really good to keep it at layman's level for not just myself, but for anyone who's really not too aware of the kind of health science behind scabies. But I was always of the belief that scabies was contracted from animals. So what carries scabies? Where does it mostly spread from? Matthew Paxman: So animals are affected by scabies as well, but humans won't generally get scabies from an animal. Scabies transmits through skin to skin contact with another infested person. And sometimes the scabies can actually survive on materials like the bed sheets or fabrics. So you need to have your skin exposed to a fertilized mite to contract scabies from another human. So that's why overcrowding is a major risk factor for this disease. Not necessarily hygiene, it's just that close skin to skin contact that causes these high level of transmission in overcrowded regions. Melissa Maykin: Thank you. So just jumping forward to the diagnostic test, are you able to just explain how this tool works? Matthew Paxman: Yeah, so we're looking at molecular diagnostics. So the difference with molecular diagnostics compared to the current diagnostic methods for scabies is we're trying to detect the genetic material of the mites or the particles that they leave behind on the body. So the previous methods, as we mentioned, involves trying to look at the skin and see evidence of mites or eggs. But with the molecular test, it would be a standardized sampling method. Essentially what we're doing is we're adopting the LAMP technique, which is a nucleic acid amplification system called loop-mediated isothermal amplification. So in concept, it's similar to PCR, but it tends to be faster and more specific. And the big benefit of LAMP is you can run it at one single temperature. So that means the instruments that it can run on can be simpler, more portable, and able to be implemented into these resource limited settings that we're really interested in. So that's what we're doing at the moment is we're designing the LAMP assay. So all the constituents that go into it. And then another important aspect is we're trying to design a simplified sample preparation workflow that so any untrained users, healthcare workers, will be able to easily process and run the tests. Melissa Maykin: Yeah, fantastic. I can't really visualize it at the moment, but what does it look like? Yeah, if you're standing in the lab, you're about to run some tests on the scabies. Matthew Paxman: I can, I have some things right next to me. This might not be that relevant for radio, but this is instruments. So at Zip Diagnostics, we have a point of care diagnostic platform called the P2. So it's this instrument here. It's got a touchscreen that provides all the prompts to do the steps. And essentially, our tests are these little lyophilized cartridges. So that's got the LAMP assay in there. And you're going to be able to process the sample on this deck and set up the test and run it within this little light, small, portable instrument. This is a platform approved by the TGA. So we can use it for clinical purposes here in Australia and can probably talk about elsewhere. Yeah, Associate Professor Jack Richards: and Matt's raised some really important points there. Where this disease occurs is in these remote settings in most cases, and they can be really far away from laboratory services. And so it's really important that we take the test to the people that have it. And what Matt's showing us here is a test, which is small, it's very portable, can run off a battery. And it really makes use of the best technology that we've got in the world to detect the DNA of these organisms. So it's a highly sensitive test. And yeah, and it's got to be highly usable for the people that are going to operate this in these environments. And so it's got to be a simple test to run. And it's also got to have components to the test which don't require cold chain supply. So it's no good being in these environments where there's no refrigeration or freezing access. So we have these freeze dried components to the assay which allow it to be then deployed and stored out in those environments. You're ABC: listening to Pacific Pulse on ABC Radio Australia. Melissa Maykin: On the show today, you're hearing from Dr. Jack Richards from Zip Diagnostics and PhD researcher and research assistant, Matthew Paxman. We're talking about a groundbreaking new SCABES test. In 2022, Solomon Islands became the first country to distribute ivermectin to its entire population to tackle SCABES, a disease that affects one in four people there and is linked to serious infections like blood poisoning and kidney disease. The ABC's Jordan Fennell had this report. Prianka Srinivasan ABC: Solomon Islands has become the first country in the world to have the anti-parasitic drug ivermectin distributed to its entire population to treat SCABES. The drug attracted controversy during the pandemic after it was linked to coronavirus misinformation. But as Jordan Fennell reports, health experts are optimistic about the success of the rollout. Jordan Fennell: In a clinic in Honiara, patients are furiously scratching themselves. Oliver Sokana: SCABES is quite distemping in any way we try to describe it. But they will spend time in itching and scratching the body and try to get themselves to feel comfortable. It's really distemping. Jordan Fennell: Oliver Sakana from the Solomon Islands Ministry of Health is overseeing the rollout of ivermectin to treat SCABES. He estimates they're helping more than 200 people a day. Oliver Sokana: That means we already treated more than 5,000 people in provinces that they already started. Jordan Fennell: In a country with a population of more than 680,000 people, one in four suffer from the skin disease. But relief from the pain will come quickly. Just two doses of ivermectin over the space of a week will get rid of SCABES. Sarah Anderson: Ivermectin is an antiparasitic drug and SCABES is a parasite. And so the ivermectin works to actually kill the little SCABE mite that has dug under the skin and made its home in somebody's skin. Sarah Jordan Fennell: Anderson is the Murdoch Children's Research Institute's World SCABES Program Manager. She says it's not just a disease that makes you itchy. If left untreated, it can lead to serious consequences. Sarah Anderson: So it can lead to very serious skin infections. As kids start scratching the SCABES, the skin breaks and then infection can get into the skin. And then that has been shown to be able to lead to very serious bacterial skin infections, but also to blood infections. And there's also a connection to kidney disease and heart disease. Jordan Fennell: During the start of the COVID-19 pandemic, ivermectin became a controversial drug when former US President Donald Trump urged people to use it to treat coronavirus, but doctors were advising against it. Ms Anderson says while it might not be effective to deal with COVID, for years it has worked to treat antiparasitic diseases like SCABES. Sarah Anderson: Ivermectin for the use of SCABES and other parasites has long been researched and shown to be effective in very, very good trials. Jordan Fennell: She says this distribution project in Solomon Islands is the result of more than 10 years of research and aims to give everyone in the country a treatment of ivermectin to stop the transmission over the next few months. Oliver Sukarna says his team of thousands are working hard to deliver the medicine. We Oliver Sokana: have the evidence. We have the evidence that SCABES is really a public health problem in Solomon Islands. So this MDA rollout is very significant in the control of SCABES in this country. Jordan Fennell: A similar rollout will go ahead in Fiji in September, and if they're able to get more funding, Ms Anderson hopes to take the life-changing treatment to more Pacific countries. Sarah Anderson: SCABES tends to be kind of like the disease that doesn't get a lot of attention. It definitely is an area where we would love to see more people joining this sort of mission to get rid of SCABES. Melissa Maykin: And that's what we're talking about today. That was Sarah Anderson, Murdoch Children's Research Institute World SCABES Program Manager, ending that report by Jordan Fennell for Pacific Beat. But a new diagnostic tool to detect SCABES early is in the works and could be a game changer for Pacific nations and their communities. Here's Zip Diagnostics Associate Professor Jack Richards. Associate Professor Jack Richards: So it's not as simple as just making a widget that just gets thrown at people. What we really want to do is work with communities and work with local experts and stakeholders just to really understand the setting and the need that they've got and the capability that they've got. We want to design this to be a test that's really suitable for them in those environments. So we're just beginning that process now. We're working with a great team up at Menzies who do a lot of work with First Nations communities up in the top end of Australia and beginning to liaise with people across the Pacific. We've done lots of work with PNG in the past and Fiji and Vanuatu. And so we're going to really continue that work to make sure that this test is actually designed and is appropriate for use in those settings. And I think a diagnosis does several things. One is, at the moment, you've got this situation between a patient and a healthcare professional where both of them are trying to make their best guess. Is this scabies or is it something else? Is it a mosquito bite or is it an allergic reaction eczema or something like that? And it creates a really difficult dynamic in the clinical decision making process because there's uncertainty. So one of the aspects of bringing a test like this in is we want data driven clinical decision making and that's a process that occurs between the patient and the healthcare professional. So the patient gets better data and is a participant in a point of care setting of their own clinical management and having access to data that confirms the diagnosis really provides them an incentive to get on with treatment and to complete treatment. And that's actually really important and it's particularly important for scabies. The treatment usually takes the form of a cream, as you mentioned, and that cream is an anti insecticide sort of cream that's applied usually from the neck down to the feet. So it's actually quite a tricky one to apply. Melissa Maykin: It is, yeah. Associate Professor Jack Richards: It's not that fun. You've got to douse yourself literally from head to toe in this cream and usually sit it out for overnight generally and then get up in the morning and wash it all off again. That's the most common form of treatment and usually you've got to back that up with a second round of that treatment one to two weeks later. There is a form of treatment that you can use, which is a tablet, but that's not always available in some of these settings. That's a little bit easier to administer, but it again also requires a sort of follow up dose. So you can see for both of these, having knowledge that this is the disease that you've got and therefore the need to do this sort of treatment because it is laborious can actually really help with doing that treatment course properly. Melissa Maykin: Yeah. Save a lot of people's time and resources going straight to what they know is needed to be done. And yeah, my friend did have to douse herself in the cream. The most tedious part was when she missed a spot and then the scabies didn't go away. So she had to just keep doing it on repeat until she hits. It took months. I was really shocked by how difficult it was for her to get rid of it. And I guess there's also that social stigma too, of feeling quite dirty and quite infested with a disease. There's layers to the feeling of contracting something like that. This I'm sure is going to make a big difference for people to get on top of it really quickly. But maybe Matt, if you can answer this, what other types of common skin infections has this also helped detect? Matthew Paxman: So for our test, we're also going to be designing targets that will detect the two main bacterial infections that often go along with scabies. So that's group A strep and Staph aureus. These are bacteria that commonly are pathogenic to humans, but sometimes they just live on the skin and not cause issues. But then with the scabies, you get the lesions and they can enter your system and cause some severe diseases. So it will be the same sample. So you will only have to take samples or inspect the patient once. A lot of the other diagnostic methods sometimes overlook bacterial infections because if your patient comes in and they're complaining about severe itching, they might not be looking for bacterial infections. So it's really important to be able to diagnose those because they require a different treatment than scabies. So in scabies, you'll need antimicrobial sort of medicines or creams in that case. Melissa Maykin: And a little side to this, I was talking to Dr. Mark Jacobs, World Health Organization, maybe last year about the rise of antimicrobial resistance. It's especially an issue, I guess, in the region, in the Pacific, where antibiotics is scarce. The right antibiotics isn't often administered. Are you working around antibiotics in this way? And is this something that you have to be aware of? Associate Professor Jack Richards: Yeah, it's a really important issue and it's becoming increasingly problematic globally. And it's driven by lots of different factors. But one of the factors is, as you're saying, the lack of diagnostics to really guide, do we need antibiotics in this instance or not? Are we making the right decision to give this patient antibiotics? And more particularly, are we giving the right antibiotics when we do that? And obviously, the best information we can have is, yes, there's this infection here and it is susceptible to this particular antibiotic. So we've even chosen the right antibiotic for this particular bug. So they're the sort of aspirations that we have. And part of that will be part of this test as we develop it. Melissa Maykin: Yeah, great. What happens next now that you've developed this test? Where are things at for you guys? Associate Professor Jack Richards: It's still under development. So it's in the early phases of the development. So Matt is doing the design of that at the moment and making good progress. So we're about to start doing some initial clinical studies with the collaborators that we've got at the Menzies in Darwin so that we can really start to understand if this test is working properly. And then we, as an Australian company, the first Australian company to ever get a point of care molecular test approved by the TGA. So we're going to use all of those learnings and that effort that we put into making this test in Australia. So we're really proud of being able to do that and have Australian made products like this that hopefully are globally important products. And so, yeah, keep people up to date over the next year or two as this goes through the formal clinical studies and the regulatory approval processes. It's a fair journey, obviously, to get these things into use for humans. Melissa Maykin: Yeah, absolutely. Yeah, Matt, was there anything, did you have any comment about how you guys are tracking? Matthew Paxman: Not too much extra than what Jack said. Melissa Maykin: Yeah, that's okay. I just might ask you, Matthew, because this is a PhD area of yours, if I can ask, I guess what fascinates you most about this area? I think you contribute hugely to communities that are very much in need. But yeah, you're able to share just finally a little bit about what drives your motivation in this area of research. Matthew Paxman: So my original study, I was trained as like a biochemist and working at Zip Diagnostics, I've got involved with looking at infectious diseases and different pathogens. And that's really fascinated me. And one area that I was excited about was having a look at different bacterial infections. And then I was pretty naive to scabies before this project started, which makes sense. It's a neglected disease. People in these remote communities know about it, but in other areas, it's not very widely discussed. So it was really interesting, a really interesting disease and really important with this like hidden, massive global prevalence. So I thought it was really important. And I also very much appreciate how important these issues are to regions such as like Indigenous Australian populations and other sort of low middle income areas like the Pacific Islands and certain areas in Africa. So that really fascinates me. Melissa Maykin: A really big thank you to Associate Professor Jack Richards, the Scientific Director of Zip Diagnostics and Research Assistant and PhD candidate Matthew Paxman for their time on the show today. This has been Pacific Pulse with me, Melissa Makin. If you missed any part of this episode and you'd like to listen back, you can search for us on the ABC Pacific website at Pacific Pulse or find us on your favorite streaming platform. If you'd like to hear more conversations about health care in the Pacific, consider listening to the latest episode of PoliTalk with Scott Widear. Basic medications like paracetamol and antibiotics are very hard to come by in many Pacific countries at the moment, and this is leaving doctors and patients struggling under the strain of sickness. You can find them by searching for PoliTalk, P-O-L-I-T-O-K on the ABC Pacific website. This episode was produced on the lands of the Jagera and the Turrbal people.
