Australia’s Bellarine Peninsula has seen a large increase in the number of Buruli ulcer (also known as Bairnsdale ulcer or Searl ulcer) cases caused by the flesh-eating Mycobacterium ulcerans. The state of Victoria already recorded 35 cases for this year, a 75 percent increase in cases since this time last year, and the number of infections affecting children under five has more than doubled to 10 percent of all cases. The mode of transmission for the pathogen remains unclear, although experts believe it to be spread mostly by mosquitoes and other insects, with the possibility of also being transmitted via open wound exposure. With the country’s wet winter providing an ideal breeding ground for mosquitoes, health officials are concerned that the number of cases will continue to rise. The disease, true to its name, is most often characterized by tissue necrosis, although the early stage of infection is characterized by a painless nodule. With early detection, the disease can be treated with targeted antibiotics. However, the 3 to 6 month incubation period of the pathogen and its strong ability to confer resistance have limited the effectiveness of drugs. More often, treatment is by surgical excision of the lesion or in more advanced stages of the disease, removal via skin grafting.
Buruli ulcer is considered a neglected but emerging tropical disease and is widely reported as the second most frequent mycobacterial disease in humans after tuberculosis. In the tropical regions of Southeast Asia, South America, and West Africa where flooding and wetlands are common and health infrastructure is poor, these lesions can lead to severe deformities, amputation, and disabilities. The disease is observed to have spread over the years to previously non-endemic regions as a result of ecological change and international travel. Southeast Australia is the only non-tropical area in the world where the Buruli ulcer is detected. In mid-August, 25 cases of buruli ulcer were also reported in Asunafo South District of Ghana.