{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T11:21:10Z","timestamp":1787829670077,"version":"build-2784847793"},"reference-count":14,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Townsville, North Queensland, experienced record rainfall in the 2024\u20132025 wet season with an associated surge in the number of patients with melioidosis. A large proportion presented to the Townsville University Hospital (TUH) emergency department (ED), presenting an opportunity to assess the surge from an ED perspective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective case series of all patients with melioidosis that presented to TUH ED between 1 November 2024 and 30 April 2025. Cases for the entire region were sourced from the Statewide Reference Laboratory, and then individually assessed to ascertain whether they first presented to the TUH\u2010ED.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 57 patients with confirmed melioidosis that presented to the TUH ED in the 2024\u20132025 wet season, 40 males and 17 females. Risk factors for melioidosis were present in 51 (88%), with diabetes being the most common (47%). ED blood cultures were taken in 54 patients and were positive in 36 (67%). All patients were admitted, with a median length of stay of 11\u2009days; 12 (21%) patients had an intensive care admission, and hospital mortality was eight (14%). Pulmonary involvement was evident in 79% and prostatic involvement in 30% of males. Meropenem was administered in ED to 53% overall, and 80% of those with severe illness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The surge of patients with melioidosis demonstrated a wide spectrum of infection foci and severity of illness. In melioidosis endemic regions following significant rainfall, we recommend to culture widely, administer meropenem for severe infections and consider melioidosis as a cause for unusual presentations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1742-6723.70325","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T08:02:12Z","timestamp":1785916932000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["An Extraordinary Wet Season and a Surge of Melioidosis: A Retrospective Case Series From a Tropical Emergency Department"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6477-7033","authenticated-orcid":false,"given":"Colin","family":"Banks","sequence":"first","affiliation":[{"name":"Townsville University Hospital  Townsville Queensland Australia"},{"name":"James Cook University  Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3136-7548","authenticated-orcid":false,"given":"Amanda","family":"McConnell","sequence":"additional","affiliation":[{"name":"Cairns Hospital  Cairns Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3506-4536","authenticated-orcid":false,"given":"Christopher S.","family":"Heather","sequence":"additional","affiliation":[{"name":"Townsville University Hospital  Townsville Queensland Australia"},{"name":"James Cook University  Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maisie","family":"Stephen","sequence":"additional","affiliation":[{"name":"Townsville University Hospital  Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2171-8286","authenticated-orcid":false,"given":"Kristen\u2010J\u00fcrgen","family":"Schroeder","sequence":"additional","affiliation":[{"name":"Townsville University Hospital  Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3429-918X","authenticated-orcid":false,"given":"Isaac","family":"Tredinnick","sequence":"additional","affiliation":[{"name":"Townsville University Hospital  Townsville Queensland Australia"},{"name":"James Cook University  Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3880-961X","authenticated-orcid":false,"given":"Shannon","family":"Wong","sequence":"additional","affiliation":[{"name":"Townsville University Hospital  Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinay","family":"Gangathimmaiah","sequence":"additional","affiliation":[{"name":"Townsville University Hospital  Townsville Queensland Australia"},{"name":"James Cook University  Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/tropicalmed3010027"},{"key":"e_1_2_10_3_1","unstructured":"Mahidol Oxford Tropical Medicine Research Unit \u201cMelioidosis.Info\u201d accessed February 11 2026 https:\/\/www.melioidosis.info\/map.aspx."},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2006.74.1074"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1128\/cmr.18.2.383\u2010416.2005"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.31128\/ajgp\u201004\u201018\u20104558"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1473\u20103099(21)00022\u20100"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/qco.0000000000000827"},{"key":"e_1_2_10_9_1","unstructured":"NT Health \u201cNT Melioidosis Guideline\u201d accessed February 3 2026 https:\/\/digitallibrary.health.nt.gov.au\/nthealthserver\/api\/core\/bitstreams\/78de80ef\u2010afe5\u20104aea\u2010860a\u20106ea801354542\/content."},{"key":"e_1_2_10_10_1","unstructured":"\u201cTownsville Dashboard\u201d Your city accessed February 11 2026 https:\/\/dashboards.townsville.qld.gov.au\/city."},{"key":"e_1_2_10_11_1","unstructured":"Bureau of Meteorology \u201cClimate Statistics for Australian Locations\u201d accessed January 26 2026 https:\/\/www.bom.gov.au\/climate\/averages\/tables\/cw_032040_All.shtml."},{"key":"e_1_2_10_12_1","unstructured":"Bureau of Meteorology \u201cTownsville Queensland Daily Weather Observations\u201d accessed October 11 2025 https:\/\/www.bom.gov.au\/climate\/dwo\/IDCJDW4128.latest.shtml."},{"key":"e_1_2_10_13_1","unstructured":"Queensland Health \u201cNotifiable Conditions Annual Reporting\u201d accessed February 2 2026 https:\/\/www.health.qld.gov.au\/clinical\u2010practice\/guidelines\u2010procedures\/diseases\u2010infection\/surveillance\/reports\/notifiable\/annual."},{"key":"e_1_2_10_14_1","unstructured":"Townsville Hospital and Health Service \u201cAbout Us\u201d accessed February 2 2026 https:\/\/www.townsville.health.qld.gov.au\/about\u2010us\/."},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2009.04.010"}],"container-title":["Emergency Medicine 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