Flesh-eating disease haunts Melbourne with unconfirmed source

'Buruli ulcer' may start with a mosquito bite or possum feces

The Buruli ulcer, recently infecting more and more victims, can rapidly destroy skin and soft tissue if not treated with a combination of specific antibiotics and steroids for weeks and, in many cases, months.

Scientists believe possums may play a key role in the transmission of the flesh-eating disease to humans — or it may come from mosquitoes. In either case, they aren’t yet sure how it gets into humans. But once there, it appears the only thing that has stopped its relentless march through skin and muscle are antibiotics normally used for tuberculosis, leprosy and even the plague. Some patients might need high doses of steroids and varying numbers of surgeries.


The bacterial infection causes significant impacts, bbc.co.uk reports: the aggressive ulcer can cause disfigurement or lead to long-term disability. “It can really eat away at a whole limb,” Daniel O’Brien, an infectious disease physician and Buruli ulcer expert near Melbourne, Australia, told the BBC.
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His patient list includes young children who have needed up to 20 operations to deal with their ulcer, known to destroy nervesblood vessels, muscles and occasionally bone.
The Buruli ulcer isn’t new but hasn’t been a priority, either — it was found in 1897 in Uganda, emerged near Melbourne in 1948 and is still classified as a “neglected” disease by the World Health Organization. Often arising in areas of redevelopment, the bacteria is thought to push its way into possums, who crowd into remaining treed areas, leaving feces in parks, gardens and rooftops, where the bacteria, Mycobacterium ulcerans, gets concentrated.

And therein lies one complication. In Australia, possums are a protected species. They can’t be culled, hunted or otherwise killed or hurt. But in low-lying, swampy areas there’s another culprit: the mosquito.

By taking into account the abundance of possums, the quantities of bacteria in their feces and in the environment, and the abundance of mosquitoes, BBC says, Saras Windecker, a research fellow at the University of Melbourne, is looking at an early warning system that other areas can use. The Buruli ulcer has been found in 33 tropical, subtropical, and temperate countries, but is most prominent in West and Central Africa, Australia and Japan.
The overall number of cases reported globally was around 5,000 up until 2010, when it started to decrease. In 2016, it reached its lowest point with 1,961 cases reported, the World Health Organization says. Since then, the number of cases has started to rise again every year, up to 2,713 cases in 2018.

“COVID-19 is showing us that we can’t see diseases in isolation,” Dr. O’Brien said. “(Coronavirus) may be respiratory and Buruli bacterial, but they both come from nature, they both paste a warning of our interactions with nature, they’re both hugely damaging to human health.

“Learning the lessons of one is so important for the other.”

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