What is Buruli Ulcer?

A flesh-eating ulcer has placed Australian health experts on high alert, with new transmission areas for the necrotising skin and soft tissue disease reported in Victoria and Queensland. Known as Buruli ulcer, the disease is caused by a slow-growing genus of Actinobacteria called Mycobacterium ulcerans.

While cases are rare and usually confined to the Bellarine and Mornington peninsulas, the tissue-destroying ulcer has spread to new geographic areas of Victoria, including a small town on the Great Ocean Road and a suburb of Geelong, a city one-hour southwest of Melbourne. In Queensland, cases of Buruli ulcer transmission have spread to the Atherton Tablelands.  

Victoria issues state-wide alert

The new cases prompted local Victorian health authorities to issue a state-wide alert to doctors in a bid to prevent the flesh-eating ulcer from spreading. Late last month, Victoria’s Chief Health Officer Dr Brett Sutton issued an alert naming the coastal town of Aireys Inlet and the Geelong suburb of Belmont as new Buruli ulcer transmission areas. He also introduced free Buruli ulcer tests for patients designed to raise awareness and help catch infections early.

The new cases have created concern among infectious disease experts, with Sutton hoping the state-wide alert will help doctors and patients identify the warning signs. Symptoms often take several months to materialise, which can make the disease difficult to detect and treat if patients have left transmission areas.

“There have been a total 240 cases notified so far in 2019,” says Sutton.

Recognising the symptoms

Buruli ulcer initially presents as a painless lump on the skin, often resembling a small insect bite. The slow-moving infection then starts to borrow its way into a fatty layer that divides the skin from muscle lining. As the infection advances it spreads sideways and starts to destroy tissues before breaking through the skin in the form of an ulcer. Extreme pain is a common side effect. While antibiotics are an effective treatment for early detection, advanced cases of Buruli ulcer can require the removal of skin and in some cases, amputation.  

Mosquitos identified as carriers

While little is known about how Buruli ulcer is spread, there's growing evidence that mosquitoes could be carriers. Human-to-human infection isn't thought to be a cause, meaning patients must travel to transmission areas to be infected.

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