Flesh-Eating Infection Buruli Ulcer Spreads Through Australia and Experts Don't Know Why

Medical journal demands 'urgent' response to epidemic of flesh-eating ulcer

Doctors in Australia are warning that a mysterious flesh-eating skin disease has become a "worsening epidemic" in one part of the country, and they are calling for help to learn how to stop it.

Once it infects its host, M. ulcerans - belonging to the same genus as leprosy and tuberculosis - produces a unique toxin which both causes tissue damage and inhibits the immune system's ability to deal with it.

In 2016, there were 182 new cases reported, a spike of 72%.

The team emphasizes that "efforts to control the disease have been severely hampered because the environmental reservoir and mode of transmission to humans remain unknown". "It starts generally with a small nodule, but over time it opens up and creates an ulcer".

The disease can be treated with several weeks of antibiotics, though in severe cases, it can destroy muscle tissue and cause permanent disability or amputation. Until a few years ago, infections were more commonly reported from tropical regions in Queensland with occasional cases in other states.

In 2017, 2206 cases were reported globally, compared to 1920 cases in 2016, with Australia and Nigeria reporting the most cases.

Although the disease has been acknowledged to exist in the state since 1948, very little progress has been made in curtailing the bacterium simply because we actually know very little about it. "Novel antibiotics or targeted antitoxin treatments are required as wound infection is a serious problem for thousands of patients with chronic wounds", he said past year. In some cases it can also affect bone, causing "gross deformities", according to WHO.

"All age groups, including young children, are affected, and the emotional and psychological impact on patients and their carers is substantial".

In a letter published Monday in the Medical Journal of Australia, a trio of doctors says incidents of Buruli ulcer have surged by 400 per cent in the last four years. "The route of infection is not certain but possibilities include fresh water, possum poo and insect bites".

The infection seems to happen more in warmer months and bites or trauma to the skin may play a role.

They are also baffled as to why most of the Australian infections have been in the state of Victoria, while New South Wales, South Australia and Tasmania have been mostly spared.



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