Luke Bantoft knew he was dying.
It was the middle of March, and the 42-year-old type 1 diabetic had been experiencing a debilitating "domino effect" of symptoms after weeks of rain in Cairns.
"I was violently vomiting, I had really, really high fevers, high temperatures, insomnia, I couldn't eat at all, I could drink, and when I'd drink, I'd bring it back up every single time — dehydration kicks in at the same time. Then I had body paralysis and severe body aches," he told 7.30.
A GP confirmed Luke was going into diabetic ketoacidosis, a life-threatening complication of diabetes where the body burns fat for energy and the blood becomes acidic.
But the real estate agent didn't know what had triggered it — his best guess was that he had food poisoning or dengue fever.
"They rushed me into the Cairns hospital, and I was in emergency probably 12 hours, and while they were doing all the different blood cultures I had fevers, I was shivering and vomiting and defecating and just everything was wrong," he said, describing his first moments in hospital.
"Then they came back and said they want to do a CT scan, because we think something's happening inside — that's when they found melioidosis in my lung.
"I had no idea what it was, I had to ask the doctors.
"The only thing I knew was that I was dying, I didn't think I was going to make it."
What followed was 12 long days that were a horrifying fight for survival as his body battled the disease.
'Petrified' of returning home
Melioidosis is a rare infectious disease caused by bacteria commonly found in soil and water in northern Australia and South-East Asia.
It is contracted through open wounds or by breathing it in. The infection can be life-threatening if not treated quickly and there is no vaccine.
While cases are uncommon, they can occur during the wet season after heavy rain or flooding, and those with chronic health conditions such as diabetes, lung or kidney disease are most at risk of becoming sick.
Those who contract it show symptoms including fevers, coughing and difficulty breathing. If left untreated, it can progress into severe illness such as sepsis and ulcers — and can sometimes be fatal.
Even though he was enduring "astronomical pain" in hospital, Luke said it was overshadowed by the emotional torment of watching others around him die from it.
"Two people died, the second week I was in hospital," he told 7.30.
"I met a lady whose husband had just died from melioidosis. I met another lady: her husband was in intensive care and didn't look very good at all.
"And I think too, if I wasn't a diabetic, I wouldn't have gone to the doctor's in the first place, and I'd probably be dead."
Luke is recovering at his parents' place in Palm Cove, afraid to return to his house, where he is convinced he breathed in the disease during a heavy downpour.
"I don't feel well enough to go home and … I'm petrified by going home, because it's somewhere around there, I just don't know where," he said.
"The only theory that I have is, my house backs onto a creek and when it would rain, because it's a tidal creek, at times it would produce a very pungent, muddy smell.
"That's all I can really explain as to where I may have got it from.
"I don't garden. I don't dig in dirt. I drink filtered water [and] I have not been anywhere near contaminated water, not even close. So it has to be airborne."
The experience has left Luke seriously considering whether he moves away from the tropics altogether.
"I can't get sick again. I know the next time, I'm not going to be so lucky," he said.
Symptoms that can mimic 'cancer or tuberculosis'
Luke is one of 218 cases of melioidosis that have been reported so far this year, while 30 people have died from the disease.
Queensland Health confirmed 90 per cent were residents of Cairns and Hinterland or Townsville Hospital and Health Services, which includes 11 people from the Ingham area.
Three-quarters of cases were aged 50 years or older, most were aged over 50, and 95 per cent of cases had a known risk factor, including old age, diabetes and/or chronic lung disease.
It's a mighty jump compared with previous wet seasons — in the same period last year, 53 cases were recorded statewide, with 19 deaths. Thirty-four cases were reported the year prior to that.
One-third of the 106 cases have ended up in intensive care, putting the region's health system under pressure.
Public health physician Dr Simon Smith described the toll as "heartbreaking" in what's been "an incredibly busy three months for the hospital and the infectious diseases team".
"That's how severe it is, people are extremely unwell and require multiple specialists to look after them," Dr Smith told 7.30.
"Often people require the needs of an ICU physician and team, they also often have abscess in the prostate, or the liver, or the spleen that requires surgical intervention, so the surgeons can become very busy with that, and the treatment also consists of antibiotics through a drip for sometimes up to eight weeks."
In the Cairns and Hinterland health district, patients are followed up at home or in clinics for three to six months after being discharged.
"It's an incredible workload," Dr Smith said.
He's hopeful that cases will ease after April — at the conclusion of the wet season — but he expects a second wave of patients to emerge.
He says 15 to 20 per cent of people presenting to hospital have developed a chronic form of the disease months after contracting it. He described those patients as having healthier immune systems, yet developing symptoms that can "mimic" cancer or tuberculosis.
"That's fatigue, weight loss, night sweats," he said.
"But really the concern is that when the wet season comes around again in December and January, then we start seeing that large spike in cases again."
Is the new Bruce Highway to blame?
There are no firm conclusions for why there has been a sudden increase in melioidosis cases in Far North Queensland.
But one theory — documented by Dr Smith and backed by other medical experts and scientists — centres around the staged Bruce Highway upgrade that runs almost 20 kilometres through the muddy plains south of Cairns.
The multi-billion-dollar project commenced in 2010, with more than a decade of construction works stirring up a clay-like soil believed to harbour the bacteria.
The available data paints a clear and rather bleak picture: since work began on the new road corridor, several clusters have popped up in suburbs on either side.
Dr Smith is sure it isn't a coincidence.
"The environment's obviously changed," he said.
"We're seeing quite a lot of roadworks in that urban rural fringe, and that's where we're seeing most of the cases occurring."
Dr Smith's research noted a sudden spike in 2016 and 2017, around 30 to 50 cases per year, coinciding with roadworks and urban expansion — namely, new housing estates being built over cane fields.
In 2021, Dr Smith released his research, wrongly assuming the disease had peaked.
"This is by far the biggest number of cases we've seen since we've started looking at the infections in 1997," Dr Smith said.
"Back then, we'd get five to 10 cases."
The infrastructure body responsible for the project told 7.30 it remained open to advice from Dr Smith and his fellow researchers, having already met with them upon the paper's release.
"Should health investigations confirm ground-disturbing works are a contributing factor in the spread of soil-borne bacteria causing illnesses, TMR will implement any recommendations from experts to ensure essential road projects meet the highest level of safety," a spokesperson from Transport and Main Roads said.
The Queensland government department argued its "stringent environmental protection protocols" also reduced the risk of soil-borne diseases leaving worksites.
Dr Smith said it was too early to make any calls around the ongoing construction, and was also keen to point out there may be a number of other factors contributing to the explosion in cases, including the disease itself.
"Potentially, the bacteria have changed slightly; the strain we're seeing has become more adapted to the environment we're living in — we're doing genetic testing to see if that's the case," he told 7.30.
A rollercoaster you can't stop
Back at his parents' house, Luke Bantoft is slowly on the mend — but his road to recovery is anything but linear.
"It's a funny virus. Sitting here, I'm fine, but as soon as I walk around, I feel like an 80-year-old man with emphysema," he told 7.30.
"It just takes all of my energy, all of my breath, and I have to sit down and gasp for air to try and get my breathing back to normal.
"I have waves where I feel really good, and then it just absolutely depletes me in a matter of seconds, and I feel like crap for a couple of hours.
"I come back up a little bit for a while, and then I just go back downhill. It's a rollercoaster, continuously."
As part of his recovery, Luke has a long-term IV inserted into his arm where antibiotics are administered daily to kill the bacterial infection. But even after it's removed, he will remain on antibiotics for another three months.
He is warning others living in the area to take precautions to avoid contracting the disease.
"I don't think there's enough research and evidence behind it to know what the side effects are after diagnosis, I just think I'm just riding the wave of whatever comes," he said.
"It's a matter of getting the message out there, maybe letting people know how serious it is and do the right thing if you are gardening or cleaning, to wear gloves, wear a mask — that's all I can do.
"This is serious … take heed and be careful."
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